Tennis elbow is a lay person’s term that represents a medical condition called lateral epicondylitis. This refers to an inflammation of the lateral epicondyle of the elbow (on the same side as the thumb when the palm is up). The condition is primarily one of overuse of the wrist in sports, frequent lifting or repetitive movement of the forearm.
Anatomy and pathophysiology
The lateral epicondyle is the bony prominence on the distal (far) end of the humerus. While it is near the elbow joint, the purpose of the lateral epicondyle is the insertion point of multiple tendons that involve the extension of the wrist. Whenever there is stress on the extensor muscles of the forearm or frequent pronation (putting the palm down) and supination (putting the palm up), the muscle tendon can become inflamed at the insertion point in the lateral epicondyle. The bony insertion point on the lateral epicondyle becomes inflamed as well.
Often the first symptom is pain with movement of the wrist, particularly with lifting something. There is point tenderness on the lateral epicondyle and pain that radiates down the forearm on the extensor (back) side. Even simple actions like picking up a cup of coffee can cause elbow pain. The pain usually improves with rest or immobility of the forearm.
In mild cases, treatment with ice, anti-inflammatory medication and rest will resolve the symptoms. Gradually strengthening and stretching the forearm muscles will help prevent recurrences. An elastic band-like brace that supports the proximal forearm can relieve the pain as well. In serious cases, a doctor can inject a small amount of a cortisone-like agent into the tendon near the lateral epicondyle to promote more rapid relief. While injecting steroids into the inflamed area generally helps considerably, doing such a procedure on a frequent basis can weaken the tendon and lead to a possible rupture of the tendon.