The management of tennis elbow

Tennis elbow is a tendinopathy of the common extensor origin (fig 1⇓) of the lateral elbow. Although the pathology is in the elbow region, patients present with gradual onset of pain on extension movements of the wrist and fingers and supination of the forearm. The condition was formerly known as “lateral epicondylitis.” Because the pathology is no longer thought to be inflammatory, the “itis” suffix is a misnomer,1 2 and it is more accurately described as a partially reversible but degenerative overuse-underuse tendinopathy. Because of the length of this term, most clinicians prefer to use the informal name “tennis elbow.” The condition is usually easy to diagnose on clinical presentation (imaging is rarely needed to exclude coexisting elbow joint pathology) but much harder to cure. The clinical features are tenderness at the lateral epicondyle, normal elbow range of motion, and pain on resisted movements (particularly resisted third finger extension). If the elbow’s range of motion is restricted, other diagnoses should be considered because the loss of range suggests joint pathology.