Tennis Elbow (Epicondylitis)

Tennis elbow is the inflammation * of the tissue connecting the muscles of the forearm to the elbow.

What Is Tennis Elbow?

Tennis elbow, also called epicondylitis (eh-pih-kon-dih-LYE-tis), is the irritation or inflammation of the flexible band, or tendon, that connects the muscles of the forearm to the elbow. There are two types of epicondylitis: lateral * , also called tennis elbow, and medial * , also called golfer's elbow.

How Common Is Tennis Elbow?

Epicondylitis is very common, affecting as many as 3 million people in the United States each year.

What Are the Causes of Tennis Elbow?




The classic tennis elbow is caused by repeated forceful contractions of wrist muscles located on the outer forearm. The stress created at a common muscle origin causes microscopic tears leading to inflammation.





The classic tennis elbow is caused by repeated forceful contractions of wrist muscles located on the outer forearm. The stress created at a common muscle origin causes microscopic tears leading to inflammation. Persons who are most at risk of developing tennis elbow are those whose occupations require strenuous or repetitive forearm movement.
Illustration by Electronic Illustrators Group. © 2016 Cengage Learning®.

Who Is at Risk for Tennis Elbow?

People who are at risk for developing tennis elbow are athletes and those working in occupations that place repetitive stress on the muscles and tendons of the lower arm. They have a high activity level, participating in the activity three or more times per week for 30 minutes or more per session. People 35 years of age or older are most at risk. Epicondylitis affects men and women equally.

What Are the Signs of Tennis Elbow?

The major sign of epicondylitis is pain in the elbow, wrist, and forearm (arm below the elbow). Pain will occur when the person is performing the activity that caused the problem and will continue after. Pain may also occur while doing other daily activities, such as shaking hands or turning door knobs. Pain is usually only on one side of the body, in the affected arm, and has developed gradually over time.

How Is Tennis Elbow Diagnosed and Treated?

Diagnosis

The healthcare provider makes the diagnosis based on the person's medical history, specifically asking questions about the various activities in which they participate, such as sports and work occupations. Physical examination of the arm, especially in the area of the elbow and wrist joints, while the arm is at rest and while it is moving can provide information about whether the problem is lateral or medial epicondylitis. X-rays of the elbow and lower arm will also be done to visualize the bones and tissues of the arm. The person may be referred to a specialist in orthopedics and sports medicine.

Treatment

Treatment usually consists of applying ice packs to the affected elbow and resting the arm and hand (avoiding the activities that caused the problem). When the pain decreases, the patient can start a rehabilitative therapy * program of exercises to strengthen the muscles that support the elbow joint. Nonsteroidal pain medications such as ibuprofen or naproxen may be recommended to manage pain associated with the problem. When pain is severe and does not get better with ice and rest, the healthcare provider might recommend injection of a steroid medication into the elbow joint. A person with epicondylitis might have surgery if symptoms persist after a year of rest and treatment.

Professional Tennis Players Who Had Tennis Elbow

Can Tennis Elbow Be Prevented?

The best way to prevent epicondylitis is to limit activity with the affected arm. Athletes can work with a physician specialist in sports medicine or an athletic trainer to design exercises and other strategies to strengthen the muscles of the arm to avoid or minimize the problem of epicondylitis.

See also Repetitive Stress Syndrome • Tendinitis

Resources

Books and Articles

Wolf, Jennifer Moriatis. Tennis Elbow: Clinical Management. New York: Springer, 2015.

Websites

American Academy of Orthopaedic Surgeons. “Tennis Elbow (Lateral Epicondylitis).” OrthoInfo. http://orthoinfo.aaos.org/topic.cfm?topic=a00068 (accessed April 4, 2016).

American College of Sports Medicine. “Tennis Elbow.” ACSM Current Comment. https://www.acsm.org/docs/current-comments/tenniselbow.pdf (accessed April 4, 2016).

Merck Manual: Consumer Version. “Lateral Epicondylitis (Tennis Elbow).” http://www.merckmanuals.com/home/injuries-andpoisoning/sports-injuries/lateral-epicondylitis (accessed April 4, 2016).

Merck Manual: Consumer Version. “Medial Epicondylitis (Golfer's Elbow).” http://www.merckmanuals.com/home/injuries-andpoisoning/sports-injuries/medial-epicondylitis (accessed April 4, 2016).

Organizations

American Academy of Orthopaedic Surgeons. 9400 West Higgins Rd., Rosemont, IL 60018. Toll-free: 847-823-7186. Website: www.AAOS.org (accessed April 4, 2016).

American Association of Sports Medicine. 401 West Michigan St., Indianapolis, IN 46202-3233. Telephone: 317-637-9200. Website: www.acsm.org (accessed April 4, 2016).

* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.

* lateral (LAT-er-al) means the side of something.

* medial (MEE-dee-al) means located near the middle or midline.

* rehabilitative therapy a treatment program that helps people return to more normal physical, mental, or emotional function following an illness or injury. Rehabilitative therapy also helps people find ways to better cope with conditions that interfere with their lives.

  This information is not a tool for self-diagnosis or a substitute for professional care.