Lateral epicondylitis, or tennis elbow, is an overuse injury to the tendons that connect the forearm muscles to bone located on the outer aspect, the thumb side, of the elbow.
These tendons help you move your wrist and fingers. When the tendon is over stressed or strained and repeatedly pull and tug at their point of attachment on the bone, lateral epicondylitis may develop. As with medial epicondylitis, lateral epicondylitis is not a tendinitis, but rather, a tendinopathy.
As result, the tendons become inflamed (tendinitis). Repeated, tiny tears in the tendon tissue cause pain and over time, the tendonitis becomes a tendinopathy, when the continued damage and stress to the tendons causes the tendons to weaken and break down.
The symptoms of lateral epicondylitis are basically pain on the outside of the elbow, usually during or after intense use. Pain increases during wrist extension and often radiates to the forearm. Other symptoms include pain while grasping objects, and weakness.
Tennis elbow can be caused by using your arm the same way over and over. This can happen when you paint, use a hammer, or play racquet sports or golf. In racket sports, overuse of the forearm extensor muscles along with repeated impact can increase the risk of tennis elbow.
Other factors that may contribute to tennis elbow include lack of strength, poor technique, and increases in duration or intensity of play. In some cases, damage to the tendon is caused by a direct impact which causes the muscles and tendons to partially tear.
Tennis elbow is usually diagnosed through an examination by medical personnel or athletic training staff. X-rays may be taken, but are usually not necessary for diagnosis.
The first step in treatment of tendinitis is to stop the activities that cause the pain and follow the RICE method (rest, ice, compression and elevation) to help decrease inflammation and swelling as well as providing temporary pain relief.
This conservative treatment usually resolves tendinitis in a few days to a few weeks. Sometimes a strap that is worn just below the elbow joint will help alleviated the stress on the tendons. However, if the activities that aggravate the pain are continued and the problems become chronic, it may develop into a tendinopathy, and may take 2-to-6 months or as much as a full year to recover.
Physical therapy may help to heal lateral epicondylitis and other tendinopathies, by using ultrasound, medications, massage, bracing or splinting.
Rehabilitation will include strengthening and flexibility exercises. Recurrence of this condition is common, so return to activity should not occur too quickly, and preventive exercises that strengthen the muscles should be done consistently, even after pain resolves.
Medications used to treat tennis elbow are primarily anti-inflammatory and in certain cases a cortisone steroid injection may help relieve the pain. In rare cases, surgery may be recommended as a final option and last resort.
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