Lateral epicondylitis is an inflammation and irritation that develops in the forearm muscle tendons that extend (straighten) the wrist where these tendons attach to the outer elbow.
Symptoms
- Pain on the outside (thumb side) of the elbow and back of the forearm
- Swelling in the area of tendon attachment on outside of the elbow
- Shooting pain, numbness, a burning sensation, or tingling down the forearm when gripping objects which worsens with activity
- Weakness in wrist/finger extension and when gripping objects
- Instability of the wrist
- Stiffness of forearm muscles
Causes
- Repetitive extension of the wrist- overuse
- Excessive force placed on hand forcing it forward (forcing it to bend)
- Improper form lifting, throwing, or hitting
- Poor warm up or conditioning for upper body activities
- Forceful occupational or sport movements of the wrist
- Improperly fitting equipment
Risk factors
- Sports, activities, or occupations involving repetitive wrist extension (such as tennis, painters, plumbers, auto workers)
- One arm dominant sports or activities
- Weak forearm muscles
- Overweight/obese
- Smoking
- More likely to develop in someone over the age of 40
- Steroid use or multiple corticosteroid injections into the area
- High string tension on a tennis racket or playing tennis on very hard surfaces
Prevention
- Proper warm up and proper stretching before activity
- Maintaining proper form and technique
- Strengthen forearm muscles, specifically those that straighten the wrist
- Use properly fitting equipment –get professionally sized and fitted
- Know when to rest or discontinue repetitive action
Diagnosis
- Physician exam which will include resistive wrist extension
- X-rays will be taken to rule out other possible injuries/diagnosis
Treatment
- Non-surgical:
- Rest- stop repetitive action
- Change mechanics or fix form/technique
- Lifestyle modification
- Non-steroidal anti-inflammatory medications
- Physical therapy to strengthen forearm muscles
- A forearm or wrist brace
- Corticosteroid injection
- Ice
- Surgical:
- Surgery is rarely needed to treat this condition
- Lateral epicondylar release- removes the damaged tissue from the tendon and then reattach tendons to the elbow.
- Platelet rich plasma therapy
