
Tennis elbow

Definition
Tennis elbow
is an inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a
partial tear of the tendon fibers, which connect muscle to bone, at or near their point of origin on the outside of the elbow.

Alternative Names
Epitrochlear bursitis;
Lateral
epicondylitis; Epicondylitis - lateral

Causes
This injury
is due to repeated motions of the wrist or forearm. The injury is typically associated with tennis playing, hence the name "tennis elbow." However, any activity that involves repetitive twisting of the wrist
(like using a screwdriver) can lead to this condition.

Symptoms
- Elbow pain
that gradually worsens
- Pain radiating from the outside of the elbow to the forearm
and back of the hand when grasping or twisting
- Weak grasp

Exams and Tests
The diagnosis
is made by clinical signs and symptoms, since x-rays are usually normal. Often there will be pain or tenderness when the tendon
is gently pressed near where it attaches to the upper arm bone, over the outside of the elbow
There is also pain near the elbow when the wrist
is extended (bent backwards, like revving a motorcycle engine) against resistance.

Treatment
The goal of treatment is to relieve pain and swelling
. Treatment may include:
- Nonsteroidal anti-inflammatory medications (such as ibuprofen, naproxen
or aspirin)
- Local injection of cortisone and an numbing medicine
- Using a splint to keep the forearm and elbow still
for 2 to 3 weeks
- Heat therapy
- Physical therapy
- Pulsed ultrasound to break up scar tissue, promote healing
, and increase blood flow in the area
To prevent the injury from happening again, a
splint may be worn during aggravating activities. Or, you may need to limit certain activities. If the pain persists despite non-surgical treatments, surgery
may be necessary.

Outlook (Prognosis)
Most people improve with non-surgical treatment. The majority of those that do have surgery
show an improvement in symptoms.

Possible Complications
- Recurrence of the injury
with overuse
- Rupture of the tendon with repeated steroid
injections
- Failure to improve with nonoperative or operative treatment; these may be due to nerve
entrapment in the forearm

When to Contact a Medical Professional
Apply home treatment (over-the-counter anti-inflammatory analgesics
and immobilization) if symptoms are mild or if you have had this disorder before and you know this is what you have.
Call for an appointment with your health care provider
if this is the first time you have had these symptoms, or if home treatment does not relieve the symptoms.

Prevention
Maintain good strength and flexibility
in the arm muscles or avoid repetitive motions. Rest the elbow when flexion and extension is painful. An ice pack
applied to the outside of the elbow after repetitive motion may help alleviate symptoms.
Review Date: 9/26/2006
Reviewed By: Andrew L. Chen, M.D., M.S., Orthopedist, The Alpine
Clinic
, Littleton, NH. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any
medical emergency
or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for
diagnosis
and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for
information
only -- they do not constitute endorsements of those other sites. © 1997-
A.D.A.M., Inc. Any duplication or distribution of the
information
contained herein is strictly prohibited.