Ask a Doctor: Lateral Epicondylitis (Tennis Elbow)

Dr. Noah Raizman answers your questions about Lateral Epicondylitis, sometimes known as tennis elbow.

Q: What is Lateral Epicondylitis, and is it the same thing as “Tennis Elbow?”
A: Lateral Epicondylitis and Tennis Elbow are one and the same. Lateral Epicondylitis is a painful condition caused by damage to the elbow where the tendons that extend your wrist and fingers originate from. That area is called the lateral epicondyle. Tendons attach muscle to bone. The primary muscle that allows your wrist to extend, the ECRB (extensor carpi radialis brevis), is usually the tendon involved.

Q: What causes it?
A: Lateral Epicondylitis can be caused by trauma, repetitive mild trauma and overuse, but truly, we are not sure why some people get it and others do not. We consider it a “tendinopathy of middle age” because it typically happens in patients in their 40s and 50s, though it can occur at any age. Sometimes it is due to sports activities like golf or racquet sports and sometimes from work activities, but, just as often, it seems to happen after lifting or carrying objects.

Q: What are the symptoms?
A: Lateral Epicondylitis typically includes symptoms such as pain over the outside (lateral) part of the elbow. There is typically no clicking, popping or feeling of instability. There typically is no pain over the back or inside of the elbow. The pain is worst with gripping, grasping and wringing activities and can be provoked by typing or using a computer mouse with the wrist extended. There is not usually any numbness or tingling associated with it.

Q: How is the diagnosis made?
A: Typically, we make the diagnosis clinically, by listening to the patient’s complaints and physically examining the patient. Sometimes we have to rule out other associated conditions with x-rays or MRI scans.

Q: How is Lateral Epicondylitis treated?
A: The initial treatment of the condition is non-operative, meaning we try using a wrist splint, changing the way you do certain activities like gripping/grasping and typing, and avoiding painful activities. This often relieves the pain. Occasionally, some therapy is utilized for stretching and strengthening, and injections of cortisone may be utilized as well. Cortisone injections may be effective at relieving pain in the short term. In cases where patients do not respond to these treatments, surgery may be effective for relieving symptoms.

Q: What is the likely outcome of Lateral Epicondylitis?
A: Studies suggest that most patients, approximately 80-90%, will get rid of their symptoms within a year. So, overall, the prognosis of Lateral Epicondylitis is good; however, the 10% who fail non-operative treatment may have surgery.

Learn more about Lateral Epicondylitis at www.handcare.org.

At Orthopaedic Medicine and Surgery in Washington, D.C., Noah M. Raizman, MD, MFA has areas of particular interest that include microsurgical reconstruction of injured limbs; nerve transfers and peripheral nerve surgery; hand, wrist and elbow arthritis; brachial plexus injuries; and joint replacement of the shoulder, elbow and wrist. He specializes in minimally invasive approaches to hand and elbow surgeries for carpal tunnel syndrome, cubital tunnel syndrome and Dupuytren’s contracture.