Lateral epicondylitis (Tennis Elbow)

Lateral epicondylitis typically follows unaccustomed activity such as house painting or use of a screw driver and playing tennis ('tennis elbow'). It is most common in people aged 45-55 years and typically affects the dominant arm.

results from tears/ degeneration in the common extensor tendon of the forearm, particularly the tendon of the extensor carpi radialis brevis

Much more common than medial epicondylitis

S/S

radiating pain from the outside of the elbow to the forearm and wrist, weakness of the forearm, exacerbated by wrist extension, a painful grip while shaking hands or torquing a doorknob, and not being able to hold relatively heavy items in the hand.

Features

• pain and tenderness localised to the lateral epicondyle
• pain worse on wrist extension against resistance with the elbow extended or supination of the forearm with the elbow extended
• episodes typically last between 6 months and 2 years. Patients tend to have acute pain for 6-12 weeks

Management options

• advice on avoiding muscle overload
• simple analgesia
• steroid injection
• physiotherapy

Radial tunnel syndrome

Radial tunnel syndrome can be difficult to distinguish from lateral epicondylitis as both conditions present with lateral elbow pain. Radial tunnel syndrome however typically presents with tenderness distal to the common extensor origin in comparison to lateral epicondylitis where there is pain over the common extensor origin. It is most common in gymnasts, racquet players and golfers who frequently hyperextend at the wrist or carry out frequent supination/pronation. Patients can also complain of hand paraesthesia or aching at the wrist.

Compare:

Cubital tunnel syndrome patients experience tingling and numbness in the 4th and 5th finger.