⚠️ Bilateral disease suggests a systemic condition such as a spondyloarthropathy. 🕑 Early diagnosis and management are essential to prevent chronic pain and functional impairment.

🎾 About Tennis Elbow

Tennis Elbow (Lateral Epicondylitis) is pain & tenderness over the outer elbow 🦴.
Caused by repetitive strain of forearm extensor tendons (esp. ECRB).
Despite the name, 💼 anyone with repetitive wrist/arm use (e.g., plumbers, painters, office workers) can develop it.

🧬 Aetiology

🔄 Overuse injury: Repetitive wrist extension & gripping → microtears & degeneration.
🎯 Extensor Carpi Radialis Brevis (ECRB): Most commonly affected tendon.
🏗️ Occupational risks: Carpentry, plumbing, decorating, typing.
🎾 Sports: Racquet sports, weightlifting, throwing activities.

🩺 Clinical Presentation

💥 Lateral epicondyle tenderness: Localized “trigger spot” pain.
🖐️ Pain on wrist extension / gripping: Shaking hands, turning doorknobs, lifting mugs.
⬇️ Weak grip: Functional impairment at work & sport.
🌅 Morning stiffness: Worse on waking, improves with movement.
🔄 Chronic cases: Radiating pain down forearm.

🧾 Differential Diagnosis

🏌️ Golfer’s elbow: Medial epicondylitis (inner elbow pain).
⚡ Radial tunnel syndrome: Radial nerve compression.
💪 Triceps tendinitis: Pain posteriorly at elbow.
🧠 Ulnar nerve entrapment: Tingling in ring/little fingers.
🦠 Septic arthritis: Red, hot, swollen elbow (emergency 🚨).

🔎 Investigations

Diagnosis = mainly clinical 🩺, but tests help rule out mimics:

👉 Provocative tests: Pain on resisted wrist or middle finger extension.
🖐️ Palpation: Focal tenderness at lateral epicondyle.
📡 Ultrasound: Thickened tendon, tears.
🧲 MRI: Severe/atypical cases.
⚡ EMG: If nerve entrapment suspected.

💊 Management

Conservative (first-line):
- 🛑 Rest or modify activities.
- ❄️ Ice packs after activity.
- 💊 NSAIDs (short-term).
- 👐 Physiotherapy: Stretching, eccentric strengthening, manual therapy.
- 🦾 Elbow brace/strap to offload tendon.
Injections:
- 💉 Corticosteroid injections → short-term relief but risk tendon rupture if repeated.
- 💉 PRP (platelet-rich plasma) sometimes used, evidence mixed.
Other therapies:
- 🌿 Acupuncture (adjunctive pain relief).
- 🔊 Shockwave therapy (ESWT) in resistant cases.
Surgery (rare, refractory cases):
- 🔪 Arthroscopic debridement.
- Open tendon release if failed >12 months of conservative care.

📈 Prognosis

✅ Most resolve within 6–12 months with conservative care.
⏳ Some cases persist chronically, especially with ongoing occupational strain.
🔄 Prevention: Ergonomic adjustments & forearm strengthening.

📚 References

AAOS – Lateral Epicondylitis [orthoinfo.aaos.org]
Mayo Clinic – Tennis Elbow
Fitzpatrick JF, Ryan J. Sports Health. Rehabilitation of Tennis Elbow.
Sevier TL, Portas WA. Curr Rev Musculoskelet Med. 2016.
NICE Guidance – MSK pain management.

The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms.

Tennis Elbow (Lateral Epicondylitis)