Tennis Elbow or Lateral Epicondylitis

Tennis elbow is a condition whereby the outer part of the elbow is painful and sore. This is due to repetitive tissue damage in the extensor carpi radialis brevis (ECRB) tendon. This condition is usually due to forearm rotation, overuse of the finger and wrist extensors, lifting with the forearm pronated and activities like throwing, etc. The name “tennis elbow” is a misnomer as 95% of the time, the lesion appears in non-tennis players.

Signs & Symptoms of Tennis Elbow

Patients usually present with pain on the outer side of the elbow, especially over the prominent part of the bone on the outside of the elbow (see Figure A). This pain is exacerbated with gripping and extension movements of the wrist.

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Patients often complain of radiating pain from the outside of the elbow to the forearm and wrist, associated with weakness of the forearm and inability to open doorknobs or handle heavy objects.

A similar condition on the inside of the elbow is known as the Golfer’s elbow.

Diagnosis and Differentials of Tennis Elbow

Typically, the patient has pain in the outside prominent bone of the elbow. This is exacerbated when the elbow is fully extended with the forearm pronated, and the wrist passively flexed.

Differentials like radial tunnel syndrome and olecranon bursitis have to be excluded, as the treatment modalities are different.

Management of Tennis Elbow

As with all conditions, there is a role for conservative management, with appropriate stretching exercises, as well as wearing an elbow brace (see Figure B). Topical non-steroidal anti-inflammatory drugs may reduce the pain. Corticosteroid injection may also be effective in the short term and early stages.

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In recalcitrant cases, surgery may be an option. This is better discussed with your specialist doctor.