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Tennis elbow, or lateral epicondylitis, is painful inflammation of the elbow joint caused by repetitive stress (overuse). The pain is typically felt on the outside (lateral) part of the upper arm just above the elbow when you straighten or fully extend your arm.
Any activity that involves repetitive twisting of the wrist can trigger tennis elbow. This includes tennis and other racquet sports, swimming, golfing, turning a key, or using a screwdriver, hammer, or computer.
The tendon is the part of a muscle that attaches to the bone. Forearm muscles attach to the outer bone of the elbow. Researchers are finding that tennis elbow often occurs when a specific muscle in the forearm—the extensor carpi radialis brevis (ECRB) muscle—is damaged. The ECRB helps stabilize the wrist when the elbow is straight.
Repetitive stress weakens the ECRB muscle, causing microscopic tears in the muscle’s tendon at the point where it attaches to the outside of the elbow. These tears produce inflammation and pain (AAOS).
If you have tennis elbow, you may experience one or more of the following symptoms:
Tennis elbow is usually diagnosed during a physical exam. Your doctor will ask about your occupation, whether you take part in any sports, and how your symptoms developed.
Then, he or she will perform some simple tests to help make a diagnosis. Tests may include the application of gentle pressure to the spot where the tendon attaches to the bone to check for pain. Your doctor may also have you flex your arm and wrist in a certain way to see if it causes pain.
Your doctor may order imaging tests, such as an X-ray or MRI scan, to rule out other disorders that can cause arm pain. These include arthritis of the elbow and a herniated disk. These tests are not usually necessary to make a diagnosis.
According to the American Academy of Orthopaedic Surgeons (AAOS), 80 to 95 percent of tennis elbow cases can be successfully treated without surgery (AAOS). Your doctor will first prescribe one or more of the following treatments:
If your symptoms have not improved after a year of treatment, you may need surgery. You and your doctor will determine then whether surgery is necessary to improve your condition.
Surgery is either performed arthroscopically, via a small scope inserted into the elbow, or through a larger incision directly over the elbow (open surgery). With either method, the goal is to remove any diseased tissue and to reattach healthy muscle onto the bone.
After surgery, you will need rehabilitation to help restore muscle strength and flexibility.
The AAOS reports that surgery successfully treats tennis elbow in 80 to 90 percent of cases. However, some loss of muscle strength is common (AAOS).
You can take a number of steps to help prevent tennis elbow, including:
Written by: Maureen Donohue
Medically reviewed by George Krucik, MD
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