Tennis elbow, or lateral epicondylitis, is pain at origin of the tendons that join the forearm muscles on the outside of the elbow. While common in athletes performing racket sports such as tennis and pickleball, any heavy use of the elbow with repetitive gripping and lifting can be a cause of this condition. It is most common in adults age 30 – 50. Generally, lateral epicondylitis develops gradually, but at times can occur acutely from an injury.
Often times, tennis elbow is self limiting and should resolve with non operative treatment. However, symptoms at times can be quite disabling and often wax and wane for 12 months or longer before resolution. Unfortunately, no treatment has shown to provide immediate relief for all patients, but there are many strategies that can help alleviate some of the pain and associated symptoms.
Treatment options include:
- Rest: Avoid aggravating activities if possible such a forceful gripping and lifting.
- Motion: Avoiding force is good, but make sure to keep your elbow moving to avoid stiffness.
- NSAID’s: A short course of oral NSAID’s (Aleve, Ibuprofen, Naproxen, Nabumetone) may provide temporary relief.
- Topical pain relief: Topical creams/gels applied to the area may alleviate some of the pain associated with tennis elbow.
- Heat/Ice: Alternate heat and ice over the affected area to maximize pain relief.
- Massage: Gentle massage over the painful area can increase blood flow and help desensitize the area.
- Counter-force brace: A “tennis elbow strap” may provide pain relief for some patients.
- Wrist brace: Wearing a wrist brace to immobilize the wrist may decrease tension on the elbow.
- Stretching: Follow this link for appropriate stretching exercises that should be performed 3 – 4 times daily.
- Physical/Occupational therapy: Dedicated therapy has been shown to improve pain associated with lateral epicondylitis; effective strategies may include eccentric strengthening, iontophoresis, and/or dry needling.
What about a steroid injection?
Our best evidence indicates that steroid injections for tennis elbow likely provide short-term pain relief but offer little to no long term benefit. In addition, steroid injections may actually worsen your symptoms long term, so it’s best to avoid them if possible.
What else can I do?
There may be a role for platelet rich plasma (PRP) injections. Research on PRP for tennis elbow is mixed, but some studies suggest improved pain relief with PRP injections compared to other treatments.
What about surgery?
While most patients can expect resolution of symptoms with time and conservative, in rare case the symptoms may be persistent and/or recalcitrant to non surgical treatment and surgery may be an option.
Learn more from Dr. David Holt in this short video covering the anatomy of our elbow, the causes of this painful condition, and possible treatment options. Dr. Holt specializes in a wide range of hand and upper extremity conditions, including sports injuries, acute trauma, arthritis, and nerve compression. He strives to provide the most up to date, evidence-based treatment for patients of all ages.