What is Lateral Epicondylitis (Tennis Elbow)?
The elbow joint is made up of the humerus (upper arm bone) and the radius and ulna (forearm bones). The bony bumps at the bottom of the humerus are the epicondyles. The bump on the outer side of the elbow is called the lateral epicondyle.
Lateral epicondylitis is a condition that occurs as a result of overusing the forearm muscles that extend and raise the hand and wrist. These muscles attach by tendons to the lateral epicondyle. When these muscles are overused, the tendons become inflamed. Small tears in the tendon tissue can occur, and the muscles may strain and irritate their attachment at the bone. The condition causes pain and tenderness in the lateral epicondyle.
- Most commonly occurs in the racquet sport athlete but can also occur from repetitive daily life activities
- Overuse of the wrist extensor muscles or from frequent twisting at the wrist
- Inadequate rest
- Direct blow to the outside of the elbow in very rare cases
Signs & Symptoms
- Pain with racquet sports
- Pain or tenderness on the outer side of the elbow
- Pain when the wrist or hand is extended against resistance
- Pain worsened by lifting a heavy object
- Pain with making a fist, gripping an object, shaking hands or turning door handles
The treatment type and the duration of treatment will depend on many factors, including the severity of the condition.
Non-operatively, one of the first steps in treating lateral epicondylitis is to eliminate the activities that cause the symptoms, or make the symptoms worse. Activity modification should be attempted for at least six weeks to see if symptoms improve. A tennis elbow strap, or counterforce brace, may be worn just below the elbow to provide support to this area. Treating the area with an ice pack and performing an ice massage are also recommended. A course of physical therapy or occupational therapy may be beneficial.
Very rarely, surgery may be necessary. An incision is made on the outside of the elbow, and the tendons are explored. Tissue that has degenerated will be removed. The tendon may need to be cut at its attachment to the bone, and a small portion of the bone may need to be removed.