Lateral epicondylitis, or ‘tennis elbow’ as it is more widely known, is a painful condition involving the muscles and tendons that attach to the outside (lateral) part of the elbow. The muscle affected in lateral epicondylitis (the extensor carpi radialis brevis), helps to extend and stabilize the wrist. This condition occurs when this muscle weakens, and the tendon attachment degenerates. Activities that use this muscle, such as lifting or gripping, will become painful with the pain occasionally radiating from the elbow to the hand, or whenever the elbow is moved. Sports such as tennis (hence the name) are commonly associated with lateral epicondylitis but there are many different causes.

Pain is the primary symptom of lateral epicondylitis, and the reason most patients seek medical advice. Symptoms, such as pain or burning on the outer part of the elbow or a weak grip strength, develop gradually. There is usually no specific injury involved. Symptoms are exacerbated by activities that use the forearm, such as racquet sports, turning a wrench, or shaking hands. It can involve both arms.

There appears to be a connection to overuse. Tennis elbow is particularly common in people in their forties and fifties. While often referred to as tennis elbow, most people who have it aren’t tennis players. Although we refer to the condition as inflammation, it is more accurately described as degeneration.

Pain on the outside of your elbow, often after increased activity level is the most common presentation of lateral epicondylitis. X-rays or MRIs are not usually necessary.

Once you have decided to seek a medical evaluation, your doctor will talk to you about your symptoms, what activities produce them, and where on your arm you can feel them. Factors will be taken into consideration in reaching a diagnosis including:

• How the symptoms developed
• Medical history of rheumatoid arthritis or nerve disease.
• Any occupational risk factors
• Any sports participation

During the examination, the doctor will use a variety of diagnostic tests, for example they may ask you to attempt to straighten your wrist and fingers while pushing against something with your arm fully extended. If this is painful it is an indication that those muscles may not be healthy.

At Florida Hand Center we have a three-pronged approach to the initial treatment of lateral epicondylitis including the use of a brace, occupational therapy, and activity modification. Response to treatment can be very slow, sometimes taking up to six months or longer. Anti-inflammatory medications and topical treatments like ice, heat, or creams may also be used. Cortisone injections should be reserved for patients that don’t improve with occupational therapy. The treatment goal is to teach symptom or pain management, as recurrence of pain will commonly occur.

Surgery is considered as treatment only when the pain is incapacitating, has not responded to good conservative care, and symptoms have lasted more than six months. Surgery involves removing the diseased, degenerated tendon tissue, and is usually performed in an ambulatory surgery center. Please note that the results of surgery are inconsistent, hence the motivation to do everything possible to avoid an operation. Sometimes permanent activity modifications including changing your job or hobbies are necessary to control the pain. Recent studies have suggested that in most cases the symptoms will improve over time.

If you or a loved one would like to know more about lateral epicondylitis, its causes and treatment, contact Florida Hand Center today!  We are an advanced medical facility dedicated to the treatment of hand and arm conditions with locations in Port Charlotte FL and Fort Myers FL and are proud to serve patients statewide. Call us or schedule an appointment today! We serve patients from Port Charlotte FL, Fort Myers FL, Cape Coral FL, Estero FL, Lake Suzy FL, Punta Gorda FL, Murdock FL, Charlotte Harbor FL, Harbour Heights FL, and Solana FL.