Epitrochlear bursitis
Key points
- Tennis elbow is an inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow.
- This injury is caused by repetitively twisting the wrist or forearm.
- The diagnosis is made by clinical signs and symptoms, since X-rays are usually normal.
- Treatment is aimed at pain relief and reducing inflammation.
Alternative names
Tennis elbow; Lateral epicondylitis; Epicondylitis - lateral
Definition
Tennis elbow is an inflammation, soreness, or pain on the outside (lateral) side of the upper arm near the elbow. There may be a partial tear of the tendon fibers, which connect muscle to bone, at or near their point of origin on the outside of the elbow.
Causes, incidence, and risk factors
This injury is caused by repetitively twisting the wrist or forearm. The injury is classically associated with tennis playing, hence the name "tennis elbow," but any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to lateral epicondylitis.
Symptoms
- Elbow pain that gradually worsens
- Pain radiating from the outside of the elbow to the forearm and back of the hand when grasping or twisting
- Weak grasp
Signs and tests
The diagnosis is made by clinical signs and symptoms, since X-rays are usually normal. Often there will be pain or tenderness when the tendon is gently pressed near where it attaches to the upper arm bone, over the outside of the elbow
There is also pain near the elbow when the wrist is extended (bent backwards, like revving a motorcycle engine) against resistance.
Treatment
Treatment is aimed at pain relief and reducing inflammation. Treatment methods include:
- Nonsteroidal anti-inflammatory medications (such as ibuprofen, naproxen or aspirin)
- Local injection of cortisone and a local anesthetic into the affected area
- Immobilization of the forearm and elbow with a splint for 2 to 3 weeks
- Heat therapy
- Physical therapy
To prevent the recurrence of the injury, a splint may be worn during aggravating activities, or the activities may need to be modified. If the pain persists despite these nonoperative treatments, surgery may be necessary.
Expectations (prognosis)
Over 90% of people improve with non-surgical treatment. Of the 10% that need surgery, 90% of these experience subsequent relief.
Complications
- Recurrence of the injury with overuse
Written and revised by
Gerald Hurowitz, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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