What is it?

Lateral epicondylitis, also referred to as tennis elbow, causes pain and inflammation on the outside of the elbow where the muscles that extend the wrist attach to the bone. This occurs not only in tennis players, but also in those who perform repeated motions of the wrist.

What are the symptoms?

People with lateral epicondylitis experience pain and tenderness on the outside or lateral side of the elbow, pain or weakness when gripping or twisting the wrist, and pain when lifting objects.

What are the causes?

Lateral epicondylitis is caused by repetitive stress and strain to the muscles and tendons that attach the forearm muscles to the elbow. This can include any sudden change in activity level or intensity, or an incorrect grip or grip size in racquet sports. (See Figure 1.)



Figure 1: From Economou SG, Economou TS:
Instructions for Surgery Patients.
Philadelphia, WB Saunders, 1998, p.589


What is the treatment?

Step 1: Initially, treatment consists of anti-inflammatory medications and a stretching and strengthening program. Stretching is a key component in treating epicondylitis. Hold each stretch for at least 10 seconds, then relax the arm and repeat several times a day and in between activities. (See Figure 2)

Strengthening exercises may also help but are not as useful as stretching. You should not experience pain when performing strengthening exercises. Use a light weight and perform at least three sets of 15 to 20 repetitions. (See Figures 3-8)




Figure 2: Stretching

Step 2: If symptoms continue after you try stretching and strengthening exercises, you may benefit from a cortisone injection. Cortisone decreases swelling and inflammation, and increases blood flow to the area aiding the healing. Most patients feel relief after one injection, but up to three cortisone injections over a period of time may be given.

Step 3: If stretching and strengthening, anti-inflammatory medications and cortisone injections do not relieve your symptoms, then surgery may help. Through a small incision over the bony prominence on the outside of the elbow, the base of the diseased tendon is removed and normal tendon tissue is reattached to the bone.

Figure 3: Wrist Extensors	Figure 4: Wrist Flexors
Figure 5: Radial Deviation	Figure 6: Ulnar Deviation
Figure 7: Supination	Figure 8: Pronation

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