Lateral epicondylitis, commonly called tennis elbow, results from degenerative wear and tear, or tendinosis, of the tendon where the wrist extensor muscles of the forearm attach to the lateral epicondyle, the bony bump on the outside of the elbow.
It causes pain and tenderness on the outer side of the elbow and may become a chronic, activity-limiting problem without proper treatment.
What Is Lateral Epicondylitis?
Lateral epicondylitis is a degenerative tendon injury involving the attachment of the wrist extensor muscles at the outer elbow.
It commonly develops in tennis players and others who perform repeated resisted wrist motions. The tendon becomes painful from repetitive wear and strain.
Causes and Risk Factors
Causes may include:
- Chronic repetitive stress and strain to the forearm muscles and tendons
- A sudden change in activity level or intensity
- Weakness in the shoulder or wrist muscles
- Improper technique
- Equipment that is improperly sized or too heavy
Risk factors include:
- Sports or occupations requiring repetitive and strenuous forearm and wrist movements, including tennis and other racquet sports
- Poor physical conditioning, including strength and flexibility
- Inadequate warm-up before activity
- Returning to activity before healing, rehabilitation, and conditioning are complete
Symptoms
Common signs and symptoms include:
- Pain and tenderness on the outer side of the elbow
- Hand or wrist weakness
- Difficulty squeezing a ball
- Difficulty picking up objects
- Difficulty opening a door
- Pain or weakness with a handshake
- Elbow stiffness or difficulty moving the elbow
Treatment
Treatment generally includes:
- Rest from aggravating activities
- Stretching exercises
- Eccentric strengthening exercises to encourage the tendon to remodel
- Physical therapy when needed to establish an appropriate therapeutic exercise program
- Counterforce braces or splints to reduce stress on the damaged tendon during required activities
For severe symptoms, corticosteroid injections may reduce pain while rest and therapeutic exercise continue. Cortisone is used only in extreme cases because repeated injections may weaken muscle and tendon tissue and may also cause skin and subcutaneous fat thinning or skin depigmentation.
Nonsteroidal anti-inflammatory medications such as aspirin or ibuprofen, or other pain relievers such as acetaminophen, may be recommended as directed by a physician.
If conservative treatment fails, surgery may be necessary to remove painful damaged tendon tissue, stimulate a healing response, and repair the remaining tendon.
Cold may be used to relieve pain and reduce inflammation. Heat may be used before prescribed stretching and strengthening exercises.
Recovery and Outcomes
Cases of short duration, with symptoms present for less than four weeks, may improve within approximately two to six weeks with proper treatment.
Chronic cases, with symptoms lasting more than eight weeks, may require approximately three to six months to resolve and often require treatment from a physical therapist or athletic trainer.
Potential complications include:
- Recurrence of symptoms leading to a chronic problem
- Chronic pain
- Tendon degeneration
- Partial tendon tear requiring surgery
- Delayed healing or resolution of symptoms
When to See Dr. Chudik
If outer elbow pain, tenderness, weakness, or stiffness persists or worsens, particularly if symptoms interfere with daily activities, sports, or work, schedule an evaluation with Dr. Chudik.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.