Lateral epicondylitis, more commonly known as "tennis elbow" is an overuse condition in which the extensor tendons develop tendinosis inflammation in response to repetitive overload.
The extensor carpi radialis brevis (ECRB) muscle and tendon attach to the outside side of the elbow, called the lateral epicondyle of the humerus. This muscle helps stabilize the wrist and aides in wrist and finger extension. Activities that require repetitive wrist extension can aggravate this muscle and lead to lateral epicondylitis.
While lateral epicondylitis is common in athletes who participate in sports such as tennis or pickleball, this condition is also common in chefs, carpenters, painters, plumbers, mechanics and many more sporting activities that require repetitive wrist extension movements.
Signs and symptoms
Patients' with lateral epicondylitis typically have pain most prominent on the outside portion of the elbow where the ECRB attaches to the lateral epicondyle. Pain is usually exacerbated with resisted wrist extension, carrying objects, using a wrench or opening a tight jar. Additionally, pain may be described as a burning sensation and may be more severe at night.
The diagnosis of lateral epicondylitis can be made by physical examination by a skilled provider. Occasionally, imaging such as x-rays or and MRI may be warranted to rule out other conditions such as stress fractures or ligamentous injuries.
Lateral epicondylitis can be treated nonoperatively with activity modification, anti-inflammatories and physical therapy. Some patients find bracing to be helpful as well. Occasionally, for those who fail conservative management with activity modification, physical therapy oral or topical anti-inflammatories, a steroid injection may be beneficial. Other treatment options for this condition can include OSKA pulse magnetic therapy, cold laser therapy, PRP injections and rarely operative management.
Operative management for lateral epicondylitis is only recommended if patients fail all of the above conservative measures. Operative management can be performed either arthroscopically (with a scope) or open to excise the diseases portion of tendon.