What is lateral epicondylitis (tennis elbow)?

Lateral epicondylitis (tennis elbow) is the name for a condition in which the bony bump at the outer side of the elbow is painful and tender.

The elbow joint is made up of the bone in the upper arm (humerus) and one of the bones in the lower arm (ulna). The bony bumps at the bottom of the humerus are called epicondyles. The bump on the outer side of the elbow, to which certain forearm muscles are attached by tendons, is called the lateral epicondyle.

Lateral epicondylitis is also referred to as wrist extensor tendonitis.

How does it occur?

Tennis elbow results from overusing the muscles in your forearm that straighten and raise your hand and wrist. When these muscles are overused, the tendons are repeatedly tugged at the point of attachment (the lateral epicondyle). As a result, the tendons become inflamed. Repeated, tiny tears in the tendon tissue cause pain. Among the activities that can cause tennis elbow are tennis and other racquet sports, carpentry, machine work, typing, and knitting.

What are the symptoms?

The symptoms of tennis elbow are:

• pain or tenderness on the outer side of the elbow

• pain when you straighten or raise your wrist and hand

• pain made worse by lifting a heavy object

• pain when you make a fist, grip an object, shake hands, or turn door handles

• pain that shoots from the elbow down into the forearm or up into the upper arm.

How is it diagnosed?

Your doctor will ask you about your daily and recreational activities. He or she will examine your elbow and arm and will have you do movements that may cause pain in the outer part of your elbow. Your doctor may order x-rays of the elbow.

How is it treated?

Treatment includes the following:

• Put an ice pack on your elbow for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away.

• You can also do ice massage. Massage your elbow with ice by freezing water in a Styrofoam cup. Peel the top of the cup away to expose the ice and hold onto the bottom of the cup while you rub the ice over your elbow for 5 to 10 minutes.

• Do the exercises recommended by your doctor.

Your doctor may recommend that you:

• Take anti-inflammatory medication, such as ibuprofen, for 4 to 6 weeks.

• Wear a tennis elbow strap. This strap wraps around the forearm below the elbow and helps keep the forearm muscles from pulling on the painful epicondyle.

You will need to avoid or reduce racquet sports or other activities that involve repetitive motion of the elbow until your symptoms disappear.

If ice, rest, anti-inflammatory medication, and an elbow strap do not relieve your symptoms, you may need physical therapy. Also, your doctor may recommend an injection of a corticosteroid medication around the lateral epicondyle to reduce the inflammation. In severe cases, surgery may be recommended.

How long will the effects last?

The pain of tennis elbow will last until there is no stress to the area. Avoid physical activities that make the condition worse until the symptoms disappear. Usually the symptoms go away a week or two after you begin treatment.

How can I take care of myself?

To help take care of yourself, follow the full treatment your doctor prescribes. In addition, you can:

• Get enough sleep and avoid becoming overtired.

• Avoid painful activities, including racquet sports, shaking hands, hammering, unscrewing jars, or using a screwdriver.

How can I prevent tennis elbow?

To prevent tennis elbow:

• Use proper form during your activities, whether they are sports or job-related. For instance, be sure your tennis stroke is correct and that your tennis racquet has the proper grip size.

• Warm up before playing tennis or doing other activities that involve your elbow or arm muscles. Gently stretch your elbow and arm muscles before and after exercise.

• Ice your elbow after exercise or work.

• In job-related activities, be sure your posture is correct and that the position of your arms during your work doesn't cause overuse of your elbow or arm muscles.