Lateral epicondylitis (LE) is a common painful condition that affects the extensor tendons that join the forearm muscles on the outside of the elbow. This condition is often referred to as “tennis elbow”.
LE is a degenerative process that results from repetitive stress, causing injury and inflammation in the tendons that join the forearm muscles. Although this condition is often referred to as “tennis elbow”, only 5% of cases actually result from racquet sports.
LE is the most common cause of elbow pain and typically occurs in patients of both genders in their 30s and 40s. Risk factors include faulty action mechanics, overexertion, or repetition with poor wrist and forearm positioning.
Pain is often sharp and localizes to the outside of the elbow, although it may radiate from the elbow. Pain may increase due to activities that involve gripping, straightening, or flexing the wrist. Swelling may be observed. If entrapment of the nerve that passes through the elbow (radial nerve) occurs, the patient may have numbness and weakness in the elbow, wrist, hand, and lower arm.
Physical Exam: The physical exam will involve inspection of the wrist, elbow, shoulder, and neck. Tenderness to the touch and range of motion will be assessed. Stretching ability and grip strength may be tested.
To diagnose nerve entrapment, sensation and motor responses, including reflexes, should be evaluated. Evaluation of the technique is helpful for athletes. X-rays, MRI, and ultrasound can help to diagnose LE and rule out any other problems.
Rehab Management: 80-95% of patients improve without the need for surgery. Rest of the involved arm and splinting or bracing may be used for severe cases. Topical and oral non-steroidal anti-inflammatories and cryotherapy (cold compression) are useful to alleviate pain. Injections of cortisone can help in the short term. Physical therapy, Low-Level Laser Therapy (LLLT), and Medical Acupuncture can facilitate healing. Exercise therapy should include wrist extension exercises, passive stretching, and progressive strength training.
