Lateral Epicondylitis (“Tennis Elbow”)
Description:
Lateral epicondylitis (also commonly known as “tennis elbow”) is a condition that affects the lateral aspect (or outside) of the elbow. The condition is caused by degeneration of one of the tendons of the forearm that starts at the elbow (on a bony prominence called the lateral epicondyle) and allows you to extend your wrist.
This condition is thought to result from overuse when excessive stress is placed on the common extensor tendon. As a result, lateral epicondylitis is commonly seen in athletes who participate in racquet sports, such as tennis and racquetball, in addition to people who engage in repetitive activities that involve the wrist and/or elbow.
Painters, plumbers, and carpenters are particularly prone to developing lateral epicondylitis. Studies have shown that auto workers, cooks, and even butchers get lateral epicondylitis more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.
Signs & Symptoms:
Patients with lateral epicondylitis typically complain of pain on the lateral aspect (ie the outside) of the elbow. The pain may radiate down the forearm towards the wrist. The pain is often worse with wrist activities, especially gripping and twisting. Often patients complain that opening a jar, shaking hands, or turning a doorknob is painful. Some patients may notice weakness during gripping activities.
Diagnosis:
The diagnosis of lateral epicondylitis is typically made by obtaining a thorough history of the patient’s symptoms and by performing a comprehensive physical examination. X-rays are obtained to rule out other causes of pain, but are usually normal in the setting of lateral epicondylitis.
Treatment:
Lateral epicondylitis is usually treated successfully by non-surgical methods. Initial treatment consists of activity modifications to avoid provocative actions, anti-inflammatory medications, exercises to stretch and strengthen the affected tendon, and frequently a brace, known as a counterforce strap.
In addition, a steroid injection can also be performed to decrease inflammation in the tendon and speed the recovery process. Recently, several studies have shown that an injection of platelet-rich plasma (or PRP) can be extremely helpful in treating lateral epicondylitis.
Approximately 80% to 95% of patients have success with non-surgical treatment. In the rare situation in which the symptoms persist despite adequate conservative treatment, surgery can be performed. During surgery, the degenerative portions of the tendon are excised.
