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by EBSCO Medical Review Board

Lateral Epicondylitis

(Tennis Elbow)

Definition

Lateral epicondylitis is pain over the outside of the elbow. It is also called tennis elbow, but tennis isn't the only cause.
Lateral Epicondylitis
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Causes

Tendons connect muscles to bone. Repetitive or stressful movements of the muscles causes strain and pain at the tendon. The forearm muscles are active when a person grips something, such as a tennis racquet. Repeated strain on these muscles can cause damage to the tendon and pain.
Any repetitive motion can cause lateral epicondylitis. Tennis and golf are common causes. Other common causes include raking, using hammer or screwdriver, painting, and rowing.

Risk Factors

This problem is more common in older adults. Other things that may raise the risk are:
  • Activity that has repetitive movement of forearm (improper technique or tools can make it worse)
  • Jobs that use repeated wrist movement and gripping with a closed fist
  • Muscle imbalance
  • Lack of flexibility

Symptoms

Symptoms happen slowly over time and may be:
  • Pain and tenderness on the outside of the elbow
  • Pain that may go down the forearm
  • Tight forearm muscles
  • Stiffness or trouble moving the elbow or wrist
  • Not being able to fully extend the elbow
Pain may be worse when:
  • Shaking hands
  • Turning doorknobs
  • Picking up objects with the palm down
  • Hitting a backhand in tennis
  • Swinging a golf club
  • Pressing on the outside of the elbow

Diagnosis

The doctor will ask about symptoms and past health. They may also ask about recent physical activity. A physical exam will be done. The doctor can often make the diagnosis based on this.

Treatment

The goal of treatment is to ease pain and help with healing. The joint will need rest from movement that causes strain and pain. Absolute rest may not be needed. Steps that may help to ease pain include:
  • Cold compresses
  • A forearm brace or splint to help the area rest
  • Over the counter pain pills or creams to apply over the area
  • Physical therapy to help with strength, flexibility, and range of motion
Lateral epicondylitis can return. It can help to have movements evaluated. This may mean seeing a coach about tennis or golf swing or better set up at work station. Some pain may not respond to basic care. Injections may help to manage pain. Injection may have corticosteroid medicine or platelet-rich plasma.

Prevention

To lower the risk of lateral epicondylitis:
  • Slowly increase the intensity and duration of activity
  • Use the right techniques and equipment for sports and activities
  • Exercise regularly to keep arm muscles strong

RESOURCES

Ortho Info— American Academy of Orthopaedic Surgeons
http://orthoinfo.org
Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Association of General Surgeons
http://www.cags-accg.ca
Canadian Orthopaedic Foundation
http://www.canorth.org

References

Lai WC, Erickson BJ, et al. Chronic lateral epicondylitis: challenges and solutions. Open Access J Sports Med. 2018;9;243-251.
Lateral elbow tendinopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lateral-elbow-tendinopathy. Accessed January 28, 2021.
Tennis elbow (lateral epicondylitis). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/tennis-elbow-lateral-epicondylitis. Accessed January 28, 2021.

Revision Information