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:
Improper technique for hitting a tennis ball
Improper size of tennis racquet or tension of racquet strings
Improper golf swing technique or grip of golf clubs
Doing certain arm motions too much, such as:
Using a hammer or screwdriver
Factors that increase your risk of lateral epicondylitis include:
Playing tennis or golf
Work that requires repetitive wrist extension and gripping with a closed fist
Lateral epicondylitis may develop slowly over time. It may not be associated with a sudden injury.
Pain and tenderness on the outside of the elbow
Possibly pain extending down the forearm
Tightness of forearm muscles
Stiffness or trouble moving the elbow or wrist
Lack of full elbow extension
Pain may be most noticeable when doing activities like:
Picking up objects with your palm down
Hitting a backhand in tennis
Swinging a golf club
Pressing on the outside of the elbow
You will be asked about your symptoms and medical history. You may also be asked about your recent physical activity.
The doctor will examine your elbow for:
Pain on the outside of the elbow when:
Doing certain arm motions
Pressure is applied on the outside of the elbow
Stiffness of elbow and wrist movement
are not usually necessary. However, an x-ray may be needed if the doctor suspects other problems.
Activities that cause pain will need to be avoided. Sports and repetitive motions will need to be stopped until the pain is gone. Activities will need to be altered:
When lifting objects, lift with your palms up
Consult a sports professional to check your form when playing tennis or golf
Regular ice application may help decrease some discomfort and swelling.
You may be referred to a physical therapist. You will learn exercises that may help reduce your symptoms and maintain strength.
Medications may be advised to reduce swelling and pain:
Nonsteroid anti-inflammatory drugs (NSAIDs)
Topical pain relievers that are applied to the skin
Certain injuries may require a brace. It is placed on your forearm. This brace limits the force of your forearm muscles on the tendon.
The doctor may inject
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.
Returning to Physical Activity
Heat may be helpful when returning to physical activity. It can decrease the stiffness in the muscle or tendon.
Start gentle stretching of the wrist and elbow as advised. Do not push the stretch to the point of pain.
Maintain strengthening exercises for the forearm muscles.
Gradually return to the sport. Talk to a sports professional to adjust technique, if needed.
To help reduce your chance of lateral epicondylitis:
Keep your arm muscles
strong. This will decrease the stress on the tendons.
After a short warm-up period,
out your arm muscles.
Learn the proper technique for activities that require forearm motion.
If you play tennis, ask a tennis specialist to check your:
Technique for hitting the ball, especially your backhand
Racket size, tension of racket strings, and composition of the racquet frame
Nirschl RP, Kraushaur BS. Assessment and treatment guidelines for elbow injuries. Phys Sportsmed. 1996;24.
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. Updated July 2015. Accessed November 15, 2017.
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