Lateral epicondylitis--tennis elbow

Causes and Risks:
The injury may be caused by the repetitive motion of twisting the wrist against resistance or frequent rotation of the forearm. There may be a partial tear of the tendon fibers at or near their point of insertion on the humerus. Risk factors are forceful repetitive wrist or forearm movement. The injury is associated with tennis playing. The incidence is 9 out of 10,000 people.

Prevention:
Avoid a repetitious motion or power grip. Rest the elbow when flexion and extension is painful.

Symptoms:
  • elbow pain that gradually worsens
  • pain radiating to the forearm and back of the hand when grasping or twisting
  • weak grasp
  • often there will be pain when the tendon is gently pressed ( palpation ) near where it attaches to the upper arm bone (humerus)



Signs and Tests:
The diagnosis is made by clinical signs and symptoms, since X-rays are usually normal. Tenderness over the elbow can be present.

Treatment:
Treatment is aimed at pain relief and reducing inflammation.

Nonsteroidal anti-inflammatory medications, local injection of cortisone and a local anesthetic into the affected area, immobilization of the forearm and elbow with a splint for 2 to 3 weeks, heat therapy, and physical therapy are all treatments which may improve the symptoms. To prevent the recurrence of the injury, a splint may be worn during aggravating activities, or the activities may need to be modified. Surgical release of the tendon at the elbow is rarely indicated to relieve the pain.

Prognosis:
The probable outcome is good with treatment.

Complications:

  • recurrence of the injury with overuse



Call Your Healthcare Provider:
Apply home treatment (over-the-counter anti-inflammatory analgesics and immobilization) if symptoms are mild or if you have had this disorder before and you know this is what you have.

Call for an appointment with your health care provider if this is the first time you have had these symptoms, or if home treatment does not relieve the symptoms.


This photograph shows the arm bones at the point of articulation (the joint area) between the bone of the upper arm (humerus) and the two bones of the lower arm (radius and ulna).