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Posted on: 10 January, 2023

What is Lateral Epicondylitis?

Lateral Epicondylitis is a common tendonitis (inflammation of a tendon) that occurs from repetitive movements with gripping and wrist extension.1 It is given the name of Tennis Elbow due to the motion tennis players use. The common backhand movement that they use to hit a tennis ball with a racket includes repetitive forearm pronation and wrist extension. However, tennis players rarely experience lateral epicondylitis.2

Anatomy

There are multiple tendons that originate at the lateral epicondyle of the upper arm bone called the humerus in the elbow. These tendons include Extensor Carpi Radialis Brevis, Extensor Carpi Ulnaris, Extensor Digitorum, Extensor Digiti Minimi, and the Anconeus.3

Symptoms and Physical Exam Findings

  • Pain at the outer aspect of the elbow (Lateral side)
  • Pain and weakness when gripping objects
  • Tenderness over the lateral epicondyle
  • Pain with resisted wrist extension
  • Pain with wrist flexion and pronation4

Etiology/Causes/Risk Factors

  • Overuse of the extensor tendons, primarily the Extensor Carpi Radialis Brevis4
  • Risk factors include: age 40+, smoking, obesity, manual labor work, excessive repetitive typing1,2

Diagnostic Studies

  • X-rays
  • MRI
  • Ultrasound

    • Conservative Treatment Options

  • Rest
  • Ice
  • Compression counterforce elbow strap
  • Elbow strengthening and ROM exercises- Super 7 Exercises
  • Physical Therapy
  • Anti-Inflammatory Medications
  • Steroid Injection
  • Platelet Rich Plasma Injection2

Surgical Treatment Options

  • Lateral Epicondylar Debridement with or without Common Extensor Repair
    • Surgical treatment is only recommended if failed all conservative treatment options or MRI shows chronic changes of the common extensor tendon or tearing1,4

References

  1. Buchanan BK, Varacallo M. Tennis Elbow. In: StatPearls. StatPearls Publishing; 2022. Accessed January 8, 2023. http://www.ncbi.nlm.nih.gov/books/NBK431092/
  2. Hastie G, Soufi M, Wilson J, Roy B. Platelet rich plasma injections for lateral epicondylitis of the elbow reduce the need for surgical intervention. J Orthop. 2018;15(1):239-241. doi:10.1016/j.jor.2018.01.046
  3. Complete Anatomy by 3D4 Medical. Version 8.7.0. Ireland: Elsevier; 2023.
  4. Lateral Epicondylitis (Tennis Elbow) - Shoulder & Elbow - Orthobullets. Accessed January 7, 2023. https://www.orthobullets.com/shoulder-and-elbow/3082/lateral-epicondylitis-tennis-elbow