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Tennis elbow, or lateral epicondylitis, is a painful inflammation of the elbow joint caused by repetitive stress (overuse). The pain is located on the outside (lateral side) of the elbow, but may radiate down the back of your forearm. You’ll likely feel the pain when you straighten or fully extend your arm.
The tendon is the part of a muscle that attaches to the bone. Forearm tendons attach the forearm muscles to the outer bone of the elbow. Tennis elbow often occurs when a specific muscle in the forearm — the extensor carpi radialis brevis (ECRB) muscle — is damaged. The ECRB helps raise (extend) the wrist.
Repetitive stress weakens the ECRB muscle, causing extremely tiny tears in the muscle’s tendon at the point where it attaches to the outside of the elbow. These tears lead to inflammation and pain.
Tennis elbow can be triggered by any activity that involves repetitive twisting of the wrist. These activities may include:
You may experience some of the following symptoms if you have tennis elbow:
Tennis elbow is usually diagnosed during a physical exam. Your doctor will ask you about your job, whether you play any sports, and how your symptoms developed. They will then perform some simple tests to help make a diagnosis. Your doctor may apply some pressure to the spot where the tendon attaches to the bone to check for pain. When the elbow is straight and the wrist is flexed (bent toward the palm side), you’ll feel pain along the outer side of the elbow as you extend (straighten) the wrist.
Your doctor may also 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. These tests are not usually necessary to make a diagnosis.
About 80 to 95 percent of tennis elbow cases can be successfully treated without surgery. Your doctor will first prescribe one or more of the following treatments:
Surgery may be needed if symptoms don’t improve after a year of treatment. You and your doctor can determine whether surgery is necessary to improve your condition.
Surgery is either performed through a small scope that’s inserted into the elbow (arthroscopically) or through a larger incision made directly over the elbow (open surgery). Both methods are used to remove any dead tissue and to reattach healthy muscle onto the bone.
After surgery, your arm may be immobilized with a splint. This is done to help restore muscle strength and flexibility.
Surgery successfully treats tennis elbow in 80 to 90 percent of cases. However, it’s common to experience some loss in muscle strength.
There are a number of ways to help prevent tennis elbow, including:
If you take these steps and avoid putting strain on the tendons of your elbow, you can lower your chances of getting tennis elbow or prevent it from coming back.
Written by: Maureen Donohue
Medically reviewed on: May 25, 2017: William Morrison, MD
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