by Laurie LaRusso, MS, ELS
Lateral epicondylitis is pain at the elbow. The pain occurs over the bone on the outside of the elbow. There are several muscles and tendons that attach on this area of the bone.
This condition is often called tennis elbow, but it is not restricted to people who play tennis. It can also occur in people with jobs that require repetitive motions such as roofers and carpenters.
Lateral epicondylitis is caused by damage to a tendon.
Tendons connects muscles to bone. Repetitive or stressful movements of the muscles causes strain and pain at the tendon. The tendons associated with lateral epicondylitis are connected to forearm muscles. These muscles are active when you grip something, such as a tennis racquet. Actions that can cause irritation to the tendons of the elbow include:
Risk Factors TOP
Factors that increase your risk of lateral epicondylitis include:
Lateral epicondylitis may develop slowly over time. It may not be associated with a sudden injury. Symptoms include:
Pain may be most noticeable when doing activities like:
The doctor will ask about your symptoms and medical history. You may also be asked about your recent physical activity.
The doctor will examine your elbow for:
X-rays are not usually necessary. However, an x-ray may be needed if the doctor suspects a problem with the bones such as calcium deposits.
Avoid activities that cause pain. Do not play sports or do repetitive motions until the pain is gone. You may need to alter how you do certain activities:
Ice may help decrease some discomfort and swelling. Apply ice pack to the outside of the elbow for 15-20 minutes. Repeat for about four times a day for several days. Do not apply ice directly to your skin. Wrap the ice or cold pack in a towel.
You may be referred to a physical therapist. You will learn exercises that may help reduce your symptoms.
The following medication may help reduce swelling in the tendon and pain:
If medication does not decrease your pain, do not return to physical activity. Check with your doctor.
Certain injuries may require a brace. It is placed on your forearm. This brace limits the force of your forearm muscles on the tendon.
Cortisone Injection TOP
The doctor may inject cortisone into the tendon. This may help to reduce pain and inflammation in the short term. Unfortunately the injection may not help in the long run.
When You Are Ready to Return to Exercise TOP
To reduce your risk of getting tennis elbow:
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00068 . Updated September 2009. Accessed November 7, 2012.
Józsa LG, Kannus P. Human Tendons. Human Kinetics; 1997.
Lateral Epicondylitis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated March 4, 2013. Accessed March 6, 2013.
Nirschl RP, Kraushaar BS. Keeping tennis elbow at arm's length. Phys Sportsmed. 1996.
Nicholas Institute of Sports Medicine and Athletic Trauma website. Available at: http://www.nismat.org/ . Accessed November 7, 2012.
Nirschl RP, Kraushaur BS. Assessment and treatment guidelines for elbow injuries. Phys Sportsmed. 1996;24.
11/8/2006 DynaMed's Systematic Literature Surveillance http://www.dynamicmedical.com/what.php : Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333:939.
10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
Last reviewed December 2013 by Teresa Briedwell PT, DPT, PCS
Last Updated: 1/13/2014