Tennis Elbow (Lateral Epicondylitis)

What it is

Tennis elbow is degeneration of the tendon attachment of the extensor carpi radialis brevis, a forearm muscle that steadies the wrist, at the bony bump on the outside of the elbow (the lateral epicondyle). The weakened attachment becomes painful with lifting and gripping.

What causes it

Most often overuse from repetitive gripping at work or play, such as meat cutting, plumbing, painting, mechanical work, or racquet sports. Less often, a direct blow starts the process. It is most common between 30 and 50.

Symptoms

Pain and tenderness over the outside of the elbow, brought on by gripping or lifting, sometimes traveling down the forearm.

Treatment

Many cases resolve on their own within a year, and treatment without surgery almost always comes first:

• Limiting the aggravating activity and changing grip or technique
• Anti-inflammatory medication
• A counterforce strap worn just below the elbow
• Physical therapy with stretching and strengthening
• Steroid injections, or injections of your own blood or platelet-rich plasma (PRP)

Surgery to remove the degenerated tendon tissue is considered only when pain is disabling and has not improved after six to twelve months of treatment. It is an outpatient procedure.

Recovery

After surgery, therapy restores motion and then strength. Expect recovery to take several months.