What is Tennis Elbow?
Lateral epicondylitis “Tennis Elbow” is an age-related pain phenomenon that exists at the lateral side of the elbow. The wrist extensor muscle, called the extensor carpi radialis brevis (ECRB), inserts on the lateral epicondyle of the elbow. This muscle stabilizes the wrist in extension and more importantly gives it the strength and stability necessary for a “power grip.” It is thought that degeneration or tearing of the tendon, either acutely or over time, at the attachment to the elbow bone is the cause of symptoms in lateral epicondylitis. However, the exact pathophysiology of symptoms is unknown.
Symptoms & Causes
One of the classic symptoms of lateral epicondylitis is pain with pressure on the bony prominence of the elbow. Lateral elbow pain with power grip and pain with wrist extension are also hallmarks of lateral epicondylitis. There is often pain with passive wrist flexion as well.
One of the most common questions we hear regarding lateral epicondylitis is “I don’t play tennis, why do I have tennis elbow?” You have to keep in mind that this nickname is just that, a nickname; the condition is by no means limited to people who play tennis! Lateral epicondylitis is most common in individuals between the ages of 35-65 years old, regardless of their activity level. Sometimes a patient will report a sudden increase in pain, or it can be a more insidious onset. Furthermore, lateral epicondylitis is thought to be an overuse injury, but the actual pathogenesis is not fully understood.
Even in the evidence-based literature, there are hundreds of papers studying different treatment modalities for lateral epicondylitis, but almost all treatment results are equal to placebo (in essence, doing nothing). This includes bracing; injections of blood, platelets, or bone marrow; shock wave treatment; ultrasound-guided methods, etc. We do know that steroid injections into the elbow are worse than doing nothing and anti-inflammatory medications won’t work because lateral epicondylitis is not an inflammatory condition.
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