Lateral epicondylitis
Lateral epicondylitis is an overuse syndrome affecting the common extensor tendon at the lateral epicondyle of the humerus, most commonly the extensor carpi radialis brevis (ECRB).
Etiology
- Repetitive wrist extension and forearm supination
- Microtrauma to the ECRB origin
- Common in:
- Tennis players
- Manual laborers (e.g., carpenters, mechanics)
- Office workers (e.g., typing, mouse use)
Clinical Presentation
- Pain and tenderness over lateral epicondyle
- Pain exacerbated by:
- Gripping
- Lifting with pronated forearm
- Wrist extension against resistance
- Positive special tests:
- Cozen’s test
- Maudsley’s test
Diagnosis
- Clinical diagnosis
- Imaging (if needed to rule out other causes):
- Ultrasound: hypoechoic areas in tendon
- MRI: tendinosis, partial tearing
Treatment Options
| Treatment Type | Examples | Notes |
|---|---|---|
| Conservative | Rest, ice, NSAIDs, physical therapy | First-line; effective in most cases |
| Bracing | Counterforce brace or wrist splint | Reduces stress on tendon |
| Injections |
PRP (platelet-rich plasma) | Corticosteroids = short-term relief;
PRP = possible long-term benefit (mixed evidence) |
| Surgery | Tendon debridement and ECRB release | For refractory cases >6–12 months |
Prognosis
- Most patients improve with conservative management
- Symptoms can persist for several months
- Recurrence if overuse continues