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  1. Christian David Mallen, senior lecturer in general practice ,
  2. Linda S Chesterton, lecturer in physiotherapy,
  3. Elaine M Hay, professor of community rheumatology
  1. 1Arthritis Research Campaign National Primary Care Centre, Keele University, Keele, Staffordshire ST5 5BG
  1. Correspondence to: C D Mallen c.d.mallen{at}cphc.keele.ac.uk
  • Accepted 26 June 2009

A 47 year old decorator presents with a two month history of right elbow pain. The pain is worse when he grips a paintbrush or uses a paint roller on the ceiling.

What issues you should cover

Tennis elbow (lateral humeral epicondylitis) is common, peaking at age 35-55 and typically affecting the dominant arm. Men and women are equally affected. It is probably an overload injury related to minor or unrecognised injury (microtrauma). A careful taken history can exclude differential diagnoses, including referred pain and local elbow causes such as olecranon bursitis and osteoarthritis.

Tennis elbow pain is often mild. Episodes typically last six months to two years and usually resolve within 12 months. Acute pain typically lasts 6-12 weeks. Analgesics, such as over the counter paracetamol, co-codamol, or topical non-steroidal …

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