Lateral epicondylitis

Pathology
Lateral epicondylitis, commonly known as tennis elbow, is a tendinopathy affecting the extensor tendons of the forearm at their insertion on the lateral epicondyle of the humerus.

It is usually caused by repetitive wrist extension and gripping activities, leading to microtrauma and degeneration of the tendon rather than true inflammation.

Typical symptoms include pain on the outer side of the elbow, worsened by gripping or lifting, decreased strength, and sometimes radiation of pain into the forearm.

Examination
Diagnosis is primarily clinical.

Pain is reproduced with palpation of the lateral epicondyle and with resisted wrist or finger extension. Imaging (ultrasound or MRI) is rarely required but may be used in persistent or atypical cases.

Treatment

Non-surgical treatment
Treatment is mainly conservative:

• activity modification (avoiding aggravating movements)
• physiotherapy with eccentric strengthening exercises
• analgesics and anti-inflammatory medication if needed
• bracing (counterforce strap)
• corticosteroid or PRP injections in selected cases

Surgical treatment
Surgery is only indicated in cases of prolonged symptoms and a tendon tear confirmed on MRI:

• surgical debridement of the affected tendon (open or arthroscopic)

Recovery
The condition is often self-limiting but may take several months to resolve.

Most patients improve with conservative treatment. After surgery, recovery may take a few months, with gradual return to activities.