Pain on the outside of the elbow can be a significant burden and may severely impact your quality of life. While there are several potential causes of pain along the outer (lateral) aspect of the elbow, one of the most common conditions seen in orthopedics and sports medicine is lateral epicondylitis, more commonly known as “tennis elbow.” In fact, it is the most common cause of elbow pain treated in orthopedic offices in the United States. Let’s dive a little bit deeper into this condition…
Lateral epicondylitis is an overuse condition involving the common extensor tendon, which originates just above the elbow joint. Repetitive stress placed on this tendon (or collection of tendons) ultimately leads to irritation and pain over time. Despite its name, tennis elbow is rarely caused by playing tennis. Only about 10% of patients with this condition are tennis or racket‑sport athletes. The majority are everyday individuals—people just like you and me.
Most patients diagnosed with tennis elbow are in their 30s and 50s, and the condition can affect either the dominant or non‑dominant arm. Patients often report a history of repetitive wrist extension activities (like the repetitive motions many of us make while typing, where the wrist repeatedly lifts and bends upward off the keyboard) or forceful gripping tasks, such as using tools like a wrench or repeatedly carrying boxes with the palms facing downward. Less commonly, tennis elbow can develop suddenly after a new activity, such as a change in gym routine or an acute work‑related strain.
The pain associated with tennis elbow typically develops gradually over many weeks. Patients typically pinpoint tenderness along the outer elbow, where the wrist extensor muscles—particularly the extensor carpi radialis brevis—attach to the bone. While this condition is not life‑threatening, it can be incredibly frustrating and a bit of a nuisance, as it often interferes with daily activities and hobbies such as typing, pickleball, or household chores. The pain can become so bad it makes these tasks difficult or even impossible.
Fortunately, there are many effective non‑surgical treatment options available. When you visit an orthopedist or sports medicine provider, the initial evaluation focuses on identifying the cause of your pain. Your provider will ask detailed questions about the location, severity, and nature of your symptoms to ensure an accurate diagnosis. A physical examination is typically performed, during which the muscles and tendons around the elbow are examined and specific movements—such as wrist or finger extension—are tested to see if they correlate with your pain. X‑rays are often obtained to rule out any underlying bony abnormalities. Once tennis elbow is diagnosed, treatment options and expectations can be discussed.
Treatment generally starts with conservative measures, which are both safe and highly effective. This may include a trial course of medication to help manage pain and inflammation. Many patients benefit from using a tennis elbow strap, which redistributes force away from the injured portion of the tendon. In addition, I commonly recommend home exercises and/or formal physical therapy. There are numerous evidence‑based rehabilitation programs designed to strengthen the tendon and alleviate pain. These exercises are also helpful in reducing the risk of recurrence, especially when continued after symptoms have calmed down.
Occasionally, tennis elbow can be stubborn and may require additional treatment strategies. Injection therapies may be considered for some patients, including corticosteroid (cortisone) injections, platelet‑rich plasma (PRP) injections, or other injectable treatments. During your visit, we will carefully review the risks and benefits of each option to help you make an informed and confident decision about your care.
Surgery is rarely necessary, but it may be considered in particularly persistent cases. This is uncommon and would only be discussed if symptoms fail to improve despite appropriate non‑surgical treatment. Before considering surgery, an MRI is typically recommended to ensure no other underlying conditions are contributing to the ongoing pain.
Ultimately, I encourage anyone experiencing persistent elbow pain to seek evaluation by an orthopedic or sports medicine provider. Our goal is to deliver accurate, patient‑centered care tailored to your individual needs—helping you return to your daily activities as safely and quickly as possible.
