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Tennis elbow

Contents of this page:

Illustrations

Elbow - side view
Elbow - side view

Alternative Names    Return to top

Epitrochlear bursitis; Lateral epicondylitis; Epicondylitis - lateral

Definition    Return to top

Tennis elbow is an inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibers, which connect muscle to bone, at or near their point of origin on the outside of the elbow.

Causes    Return to top

This injury is due to repeated motions of the wrist or forearm. The injury is typically associated with tennis playing, hence the name "tennis elbow." However, any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to this condition.

Symptoms    Return to top

Exams and Tests    Return to top

The diagnosis is made based on signs and symptoms, since x-rays are usually normal. Often there will be pain or tenderness when the tendon is gently pressed near where it attaches to the upper arm bone, over the outside of the elbow

There is also pain near the elbow when the wrist is extended (bent backwards, like revving a motorcycle engine) against resistance.

Treatment    Return to top

The goal of treatment is to relieve pain and swelling. Treatment may include:

To prevent the injury from happening again, a splint may be worn during activities that aggravate the condition. Or, you may need to limit certain activities. If the pain persists despite non-surgical treatments, surgery may be necessary.

Outlook (Prognosis)    Return to top

Most people improve with non-surgical treatment. The majority of those who do have surgery show an improvement in symptoms.

Possible Complications    Return to top

When to Contact a Medical Professional    Return to top

Apply home treatment (over-the-counter anti-inflammatory analgesics and immobilization) if symptoms are mild or if you have had this disorder before and you know this is what you have.

Call for an appointment with your health care provider if this is the first time you have had these symptoms, or if home treatment does not relieve the symptoms.

Prevention    Return to top

Maintain good strength and flexibility in the arm muscles or avoid repetitive motions. Rest the elbow when flexion and extension (bending and straightening) are painful. An ice pack applied to the outside of the elbow after repetitive motion may help alleviate symptoms.

References    Return to top

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders, and sports medicine. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 284.

Geiderman JM. Humerus and elbow. In: Marx, JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2006: chap 49.

Johnson GW, Cadwallader K, Scheffel SB, et al. Treatment of Lateral epicondylitis. Am Fam Physician. 2007;76(6):843-8.

Update Date: 8/11/2008

Updated by: Linda Vorvick, MD, Seattle Site Coordinator, Maternal & Child Health Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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