About Lateral Epicondylitis

Overview

Lateral epicondylitis, also known as tennis elbow, is a painful condition that affects the elbow. It is characterized by pain and tenderness on the outer part of the elbow, specifically at the bony part of the elbow called the lateral epicondyle. This condition is commonly caused by repetitive strain or overuse of the forearm muscles, particularly the extensor tendons that help straighten the wrist and fingers. Despite its name, tennis elbow can occur in individuals who do not play tennis, but rather anyone that engages in activities that involve repetitive wrist and forearm movements. The pain from lateral epicondylitis can range from mild to severe and may interfere with daily activities such as lifting, gripping, and grasping objects. It is important to seek medical attention for an accurate diagnosis and appropriate management of this condition.

Causes and Risk Factors

Lateral epicondylitis is usually caused by chronic overuse of the forearm muscles. The specific muscles involved are the extensor carpi radialis brevis, which is a muscle that helps move the wrist. It connects to the bony bump (lateral epicondyle) on the outer part of the upper arm bone, the humerus. The disease mechanism of this condition is not fully understood, but it is believed to involve wear and tear or small tears in the area where the common extensor tendon starts, as well as in the group of ligaments on the outer side of the elbow that help stabilize the joint.

The non-modifiable risk factors for lateral epicondylitis, which are factors that cannot be changed to reduce the risk of developing the condition, include:

Age: Lateral epicondylitis is more common in individuals aged 40 and above
Sex: Women were found to have a higher risk of developing the condition

The modifiable risk factors for lateral epicondylitis, which are factors that can be controlled to reduce the risk of developing the condition, include:

Occupational factors: Repetitive forceful activities, poor posture, and prolonged gripping or grasping can increase the risk
Psychological factors: Symptoms of depression have been linked to lateral epicondylitis
Lifestyle factors: Smoking and obesity are known risk factors
Physical activity: Vigorous physical activities and sports participation can contribute to the development of lateral epicondylitis

It's important to note that while these risk factors have been identified, they do not guarantee the development of lateral epicondylitis. Each individual's situation may vary, so it's best to consult with a healthcare professional for personalized advice.

Symptoms

Lateral epicondylitis is a condition characterized by pain and inflammation on the outside of the elbow. The most common early symptoms of lateral epicondylitis include:

Pain on the outside of the elbow: This pain is typically worsened by gripping objects or bending the wrist backward against resistance.
Weak grip strength: The affected individual may experience difficulty gripping objects firmly.
Tingling and numbness in the hand: Some individuals may experience sensations of tingling or numbness in their hand, which can extend from the elbow to the fingers.

It's important to note that these symptoms can vary from person to person, and not everyone will experience all of them. If you suspect you may have lateral epicondylitis or are experiencing any of these symptoms, it is advisable to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

Diagnosis

To diagnose lateral epicondylitis, the following examinations, tests, and procedures are commonly performed:

Physical examination: A thorough physical examination is typically conducted to assess the symptoms and tenderness in the lateral epicondyle area.
Cozens test: This is a physical test where the patient tries to lift their hand up at the wrist while keeping their elbow still. The goal is to see if this movement causes pain on the outer part of the elbow.
Mills test: Another clinical test where the examiner turns the patient’s forearm inward while the elbow is bent. This is done to check if it triggers pain on the outer part of the elbow.
Ultrasound: This imaging test is considered the go-to diagnostic tool for confirming lateral epicondylitis. It can detect changes in thickness, how well it reflects sound waves, the presence of calcium deposits, and tears in the affected area.

To determine the stage or severity of lateral epicondylitis, additional examinations, tests, and procedures may include:

Quantitative magnetic resonance imaging (MRI) assessment: This assessment can provide valuable information about the extent and severity of tendon tissue breakdown associated with lateral epicondylitis
Arthroscopic examination or examination under anesthesia: These detailed diagnostic tests may be done to check for any ligament instability or other issues within the joint that might be contributing to the problem

It's important to consult with a healthcare professional who can evaluate your specific condition and recommend appropriate examinations or tests.

Treatment Options

The goals of treatment for lateral epicondylitis are to reduce pain, improve functionality of the affected limb, and prevent future recurrence. Here are some recommended treatments and how they work to achieve these goals:

At home treatments: This includes rest, changing activity level, and stretching exercises. Resting the affected arm helps reduce pain and inflammation. Activity modification helps avoid repetitive movements that can make the condition worse. Stretching exercises help improve flexibility and strength in the affected muscles and tendons.
Physical therapy: Physical therapy may involve various techniques such as ultrasound therapy, shock wave therapy, or laser therapy. These physical methods aim to reduce pain, promote healing, and improve tissue function through targeted application of energy or stimulation.
Medications: Over-the-counter pain relievers and anti-inflammatory medications can help reduce pain and inflammation associated with lateral epicondylitis. However, it's important to consult with a healthcare professional before taking any medication.
Therapeutic procedures: Corticosteroid injections may be recommended by a doctor to reduce inflammation in severe cases. Plasma-rich protein injections may also be used to promote healing.
Health behavior changes: Making certain lifestyle modifications can help with the management of lateral epicondylitis. This may include avoiding activities that exacerbate symptoms, using proper posture and form during work or sports activities, and using braces or supports for extra stability.

It's important to note that the effectiveness of these treatments may vary for each individual. Consulting with a healthcare professional is essential for personalized treatment recommendations.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation.Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.