Tennis elbow is an inflammation, soreness, or pain on the outside (lateral) side of the elbow. The condition is typically caused by overuse or overstressing the elbow joint or the muscles. The pain starts near the elbow joint but may radiate up to the forearm. The pain may be related to small tears in the ligaments or muscles which connect to the elbow. The tears induce inflammation which is responsible for the pain and swelling in the elbow joint.

Epitrochlear bursitis, Lateral epicondylitis, Epicondylitis.

Tennis elbow most frequently affects people in their 30-40s, is more common in women and in individuals who overuse their hand.

Tennis elbow affects tennis players, baseball players, typists, computer operators and all others who have work/hobbies that involve repetitive movements. This injury is caused by repetitively twisting the wrist or forearm.

The classic features of tennis elbow are pain and limited range of motion of the joint. The pain is often sharp and be present all the time. The pain often radiates to the upper arm. With time, there is weakness of the elbow joint because of the increased pain. The pain is aggravated with any activity of the hand.

The diagnosis is made by the clinical history and an examination of the arm. There are no x rays features which are diagnostic of tennis elbow. However, x rays may reveal the presence of coincidental fractures or bone spurs. Examination of the elbow will reveal localized tenderness around the joint.

The essentials of treatment include pain control and decreasing the inflammation in the elbow. Soon after the acute injury, the arm is placed in a splint for 2-3 weeks. After this, ultrasound, various stretching and strengthening activities may help with the recovery. Additional therapy may include application of heat and physical therapy. The majority of cases resolve with this basic management.

Pain control can be managed with non-steroidal anti-inflammatory drugs (NSAIDs). These medications help decrease the pain and swelling. In some recalcitrant cases of tennis elbow, the pain is severe and unresponsive to the pain killers. In such cases, injection of corticosteroids into the elbow joint may help decrease the pain. These injections can only be repeated 2-3 times as the chance of a tendon rupture increases with more injections.

For those with recurring elbow pain, a splint should be worn during the times when the elbow is being used. One should also limit the exercises that worsen the elbow pan. Wearing of the splint at night is highly recommended.

Enrolling in a physiotherapy program will help maintain good strength and flexibility in the arm muscles. When not in use, the elbow should be rested and a splint worn. After repetitive elbow actions, rest and ice rapidly help decrease the symptoms of pain.

The majority of individuals improve with non surgical management. Less than 1-3% of individuals require surgery. Surgery is the last resort of treatment and if surgery is recommended early by any health care professional, a second opinion should be obtained.

In some individuals recurrence is a major problem and produces chronic long lasting pain. The tendons along the elbow can also rupture after repeated injection with corticosteroids. Some individuals develop nerve entrapment and may require surgery to release the nerve.