Definition

Lateral epicondylitis is pain over the lateral epicondyle bone on the outside of the elbow. Another name for it is tennis elbow.

Lateral Epicondylitis
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Causes

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. Doing this repeatedly can cause pain at the tendon. Other things that may cause this problem are:

  • Hitting a tennis ball incorrectly
  • Using the wrong size tennis racquet or the wrong tension of racquet strings
  • Gripping or swinging a golf club the wrong way
  • Doing certain arm motions too much, such as:
    • Tennis strokes
    • Golf swings
    • Painting
    • Raking
    • Pitching
    • Rowing
    • Using a hammer or screwdriver

Risk Factors

This problem is more common in older adults. Other things that may raise the risk are:

  • Playing tennis or golf
  • Jobs that use repetitive wrist extension and gripping with a closed fist
  • Muscle imbalance
  • Lack of flexibility

Symptoms

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

Diagnosis

The doctor will ask about your symptoms and health history. You may also be asked about your recent physical activity. A physical exam will be done. It will focus on the elbow.

Images are not usually needed, but they may be done with:

Treatment

The goal of treatment is to ease pain and help with healing. Choices are:

  • Supportive care, such as cold compresses and avoiding activities that cause pain
  • Physical therapy to help with strength, flexibility, and range of motion
  • Wearing a forearm brace to limit movement during healing
  • Medicines, such as:
    • Over the counter pain relievers
    • Corticosteroid injections to ease pain and swelling

Prevention

To lower the risk of this problem:

  • Slowly increase the intensity and duration of activity
  • Use the right techniques and equipment for sports and activities
  • Exercise regularly to keep arm muscles strong
RESOURCES:

Ortho Info— American Academy of Orthopaedic Surgeons
http://orthoinfo.org

Sports Med—American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES:

Canadian Association of General Surgeons
http://www.cags-accg.ca

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

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. Accessed January 28, 2021.

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. Accessed January 28, 2021.

Last reviewed December 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS  Last Updated: 2/1/2021