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MusculoskeletalICD-10: M77.10Affects 1-3% of the general population; up to 50% of tennis players experience it

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, or lateral epicondylitis, is a painful condition caused by overuse of the forearm muscles and tendons that attach to the lateral epicondyle (bony bump on the outside of the elbow). Despite its name, tennis elbow affects many people who never play tennis—it is common in any activity involving repetitive gripping, twisting, or lifting motions. The condition results from microtears and degeneration in the extensor carpi radialis brevis (ECRB) tendon.

Symptoms

Pain and tenderness on the outer side of the elbow
Pain that radiates from the elbow into the forearm and wrist
Weak grip strength
Pain worsened by gripping objects, shaking hands, or turning doorknobs
Stiffness in the elbow, especially in the morning
Difficulty fully extending the forearm

Causes

  • Repetitive forearm and wrist motions causing microtrauma to the extensor tendons
  • Overuse from racquet sports with improper technique or equipment
  • Occupational activities involving repetitive wrist extension (typing, painting, plumbing)
  • Direct trauma or sudden forceful extension of the wrist

Risk Factors

  • Age between 30 and 50 years
  • Occupations requiring repetitive arm and wrist movements (painters, plumbers, carpenters, butchers)
  • Racquet sports with poor technique or heavy racquet
  • Smoking, which impairs tendon healing
  • Obesity

Diagnosis

  • Physical examination with specific provocation tests (Cozen's test, Mill's test)
  • Assessment of pain with resisted wrist extension
  • X-rays to rule out other causes of elbow pain such as arthritis or fracture
  • MRI or ultrasound in chronic or atypical cases to evaluate tendon damage

Treatment

  • Rest and activity modification to avoid aggravating movements
  • Ice application and NSAIDs (ibuprofen, naproxen) for pain and inflammation
  • Counterforce brace or forearm strap to reduce tendon strain
  • Physical therapy focusing on eccentric strengthening exercises
  • Corticosteroid injections for short-term pain relief (limited use)
  • Platelet-rich plasma (PRP) injections for chronic cases
  • Surgical debridement or repair for cases unresponsive to 6-12 months of conservative treatment

Prevention

  • Use proper technique and appropriately sized equipment in sports
  • Strengthen forearm muscles with regular conditioning exercises
  • Take frequent breaks during repetitive tasks
  • Use ergonomic tools and workstations to reduce forearm strain
  • Warm up before activities that involve repetitive arm movements

When to See a Doctor

  • Elbow pain persists despite rest and over-the-counter treatment for several weeks
  • You have significant weakness in your grip or difficulty performing daily tasks
  • The elbow appears inflamed, swollen, or you develop a fever

Frequently Asked Questions

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