Tennis Elbow



Background

  • Overuse tendinopathy of common extensor origin at the elbow
  • Mostly recent new exercise/activity
  • If tennis - backhand painful

Clinical

  • Pain on (resisted) extension of wrist/fingers
  • Pain on (resisted) supination of the forearm/wrist
  • Tenderness at the lateral epicondyle
  • Normal elbow ROM

Management

  • Avoid steroid injections (ahrmful long term)
  • NSAIDs
  • Avoid triggering exercise (or occupation)
  • Remove tendon overload
  • Education and exercise are treatment of choice
  • Trial of (expensive, unproven) physiotherapy?
  • An elbow clasp may help in the short term [BestBets]
  • There is some weak evidence for electrotherapy (laser) [BestBets]
  • Consider hyaluronan gel injections and nitrate patches
  • Consider extracorporeal shockwave therapy for refractory tennis elbow [NICE P1773]
  • Consider botulinum toxin injections for the worst cases
  • Many cases of tennis elbow cases will naturally resolve in 6-12 months
Common Extensor Origin at the elbow


Content By Dr Íomhar O' Sullivan 13/05/2011. Last review Dr ÍOS 5/10/19