Lateral Epicondylitis

In this condition, also known as tennis elbow, pain is noted at the origin of extensors of the distal arm. While it occurs from racquet sports and repetitive manual labor, it may also occur spontaneously. When it is from racquet sports, a faulty backhand stroke is usually to blame. The extensor mass, especially the deep extensor carpi radialis brevis, rubs and rolls over the lateral epicondyle and radial head. In addition, there is pulling on the extensor origin, resulting in microtears.

Pain is increased over the lateral epicondyle with pronation of the forearm and concomitant dorsiflexion of the wrist against resistance. Lifting a chair with the affected hand in pronation should also exacerbate symptoms. Picking up a full cup of liquid also reproduces the pain.

Treatment includes avoidance of the painful activity and use of NSAIDs. Utilizing supination in daily grasping activities will aid in rest of the area. In the case of racquet sports, instruction in a quality backhand should be sought after the acute injury heals. Those who use a two-handed backhand are rarely afflicted. Orthopedic referral is advised for further evaluation and treatment.

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