Typically occurs during the 4th and 5th decades of life. Patients describe a history of activities contributing to overuse of the forearm muscles that originate at the elbow.
People with lateral epicondylitis are tender approximately 1 cm distal and anterior to the lateral epicondyle. They report pain during resisted wrist and digit extension, and during passive wrist flexion with the elbow extended.
People with medial epicondylitis have tenderness along the medial elbow, approximately 5 mm distal and anterior to the medial epicondyle. Pain is exacerbated with resisted forearm pronation and resisted wrist flexion.
Most patients will have complete resolution of symptoms with arm rest and nonsteroidal anti-inflammatory drug (NSAID) therapy. Patients with continued symptoms may require further treatment, including physical therapy, injection therapy, or surgical debridement.
The principal complication is continued pain. All other complications may arise from interventions attempting to alleviate the pain.
Epicondylitis of the elbow is a condition associated with repetitive forearm and elbow activities. Both lateral epicondylitis (commonly known as tennis elbow) and medial epicondylitis (commonly known as golfer's elbow) are characterized by elbow pain during or following elbow flexion and extension. A combination of poor mechanics, microtears in areas of hypoperfusion, and a delayed healing response contribute to the pathophysiology of the condition.
Consultant Hand and Upper Limb Surgeon
ACW is employed by Wrightington Wigan and Leigh NHS Trust, who research funding from Zimmer/Biomet, Integra, Lima, and Wright Medical.
Consultant Trauma and Orthopaedic Surgeon
Peterborough City Hospital
North West Anglia NHS Foundation Trust
PMR declares that he has no competing interests.
Dr Adam C. Watts and Dr Paul M. Robinson would like to gratefully acknowledge Dr Len Funk, Dr Iain Macleod, Dr Daniel J. Soloman, and Dr Hugo B. Sanchez, previous contributors to this monograph. LF, IM, DJS, and HBS declare that they have no competing interests.
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