Tennis Elbow

Tennis elbow, also called lateral epicondylitis or lateral elbow tendinopathy, affects the tendon origin where the wrist extensor muscles attach to the outside of the elbow. The problem is usually degenerative tendon overload rather than a simple short-term inflammation.

Many patients have never played tennis. Symptoms can follow racquet sports, pickleball, weight training, tool use, keyboard and mouse strain, carpentry, painting, plumbing, or any activity that repeatedly combines gripping with wrist extension. Mountain Spine & Orthopedics evaluates the tendon, elbow joint, radial nerve, and neck when symptoms do not fit the typical pattern.

The classic symptom is outer elbow pain that becomes sharper when the wrist and fingers resist force.

• Pain over the lateral epicondyle, the bony point outside the elbow
• Aching that travels into the top of the forearm
• Grip weakness when lifting a coffee mug, pan, suitcase, or tool
• Pain with shaking hands, turning a doorknob, or opening a jar
• Worsening discomfort after racquet sports, pickleball, rowing, or repetitive work
• Less commonly, numbness or burning that suggests radial tunnel syndrome or a cervical source

Diagnosis is usually clinical. The exam looks for tenderness at the tendon origin and reproduces pain with resisted wrist or middle-finger extension. We also check elbow motion, grip strength, neck mobility, and nerve signs because radial tunnel syndrome, elbow arthritis, ligament injury, and cervical radiculopathy can mimic tennis elbow.

Ultrasound can show tendon thickening or partial tearing in real time. MRI is useful when symptoms are severe, persistent, traumatic, or atypical; patients may request a complimentary MRI review when prior imaging is available.

Most cases improve without surgery when the tendon is unloaded and gradually rebuilt. Care may include temporary activity changes, counterforce bracing, ergonomic changes, anti-inflammatory medication when appropriate, and outside rehabilitation guidance emphasizing progressive wrist extensor and shoulder mechanics.

Persistent tendon pain may be treated with image-guided injections or biologic options such as PRP when appropriate. Surgery is reserved for chronic, function-limiting cases with confirmed tendon degeneration or tearing after a full course of non-surgical care.