Lateral Epicondylitis

Lateral epicondylitis is commonly referred to as tennis elbow. It is a painful condition that develops when the tendons that attach the forearm muscles to the outer bony prominence of the elbow, the lateral epicondyle, become irritated and damaged. This condition is typically the result of overuse of the muscles that extend the wrist.

Individuals who are involved in recreational activities or occupations that require repetitive and forceful use of their forearm muscles have a greater risk of developing lateral epicondylitis. Racket sports may predispose one to this condition, as well as many jobs that entail repeated hand twisting or gripping against resistance.

The muscles of the forearm that are attached by tendons to the lateral epicondyle are responsible for extending the wrist and fingers. When these wrist extensor muscles are subject to chronic overuse and strain it places excessive stress on the tendons that attach them to the lateral epicondyle of the elbow. This leads to tiny tears in the tendons and the development of pain and inflammation. The most common tendon affected is the one attached to the extensor carpi radialis brevis muscle.

Symptoms of lateral epicondylitis develop gradually and may include:

• Pain and tenderness on the outside of the elbow
• Pain the radiates on the outside of the arm
• Pain with activities that involve extension of the wrist, gripping or holding

In diagnosing lateral epicondylitis the doctor will do a complete medical history and physical. This will include questions about occupational and recreational activities, as well as gathering information on the development, type, and location of the symptoms. In the course of the physical exam the doctor will check for tenderness, pain, muscle weakness, and range of motion. The doctor may order additional tests to pinpoint the diagnosis and to rule out other causes.

The majority of cases of lateral epicondylitis respond to conservative treatment. The most important step to recovering is giving the arm a rest for a period of time. Identifying and rectifying flaws in activity equipment or technique can also be very helpful. Elbow straps, physical therapy to strengthen muscles of the forearm, medications, as well as other non-surgical therapies may be employed. Severe cases that do not respond to conservative treatment may require a surgical procedure.

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