Lateral epicondylitis is pain over the outside of the elbow. It is also called tennis elbow, but tennis is not the only cause.
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Tendons connect muscles to bone. Repetitive or stressful movements of the muscles causes strain and pain at the tendon. The forearm muscles are active when a person grips something, such as a tennis racquet. Repeated strain on these muscles can cause damage to the tendon and pain.
Any repetitive motion can cause lateral epicondylitis. Tennis and golf are common causes. Other common causes include raking, using a hammer or screwdriver, painting, and rowing.
This problem is more common in older adults. Other things that may raise the risk are:
- Doing activities that have repetitive movement of forearm (poor technique or equipment can make it worse)
- Jobs that use repeated wrist movement and gripping with a closed fist
- Muscle imbalance
- Lack of flexibility
Symptoms happen slowly over time and may be:
- Pain and tenderness on the outside of the elbow
- Pain that may go down the forearm
- Tight forearm muscles
- Stiffness or trouble moving the elbow or wrist
- Not being able to fully extend the elbow
Pain may be worse when:
- Shaking hands
- Turning doorknobs
- Picking up objects with the palm down
- Hitting a backhand in tennis
- Swinging a golf club
- Pressing on the outside of the elbow
The doctor will ask about symptoms and past health. Questions may also be asked about recent physical activity. A physical exam will be done. This is often enough to make the diagnosis.
The goal of treatment is to ease pain and help with healing. The joint will need rest from movement that causes strain and pain. Complete rest may not be needed. Steps that may help to ease pain include:
- Cold compresses
- A forearm brace or splint to help the area rest
- Over the counter pain pills or creams
- Physical therapy to help with strength, flexibility, and range of motion
- Injections of corticosteroid medicine or platelet-rich plasma
Lateral epicondylitis can return. It can help to have movements evaluated. This may mean seeing a coach about tennis or golf swing or better set up at work station.
To lower the risk of lateral epicondylitis:
- Slowly increase the intensity and duration of activity
- Use the right methods and equipment for sports and activities
- Exercise regularly to keep arm muscles strong
- Lai WC, Erickson BJ, et al. Chronic lateral epicondylitis: challenges and solutions. Open Access J Sports Med. 2018;9;243-251.
- Lateral elbow tendinopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/lateral-elbow-tendinopathy.
- Tennis elbow (lateral epicondylitis). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/tennis-elbow-lateral-epicondylitis.
- Teresa Briedwell, PT, DPT, OCS
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