Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, also known as lateral epicondylitis, is the most common cause of elbow pain. It occurs when the tendons that join the forearm muscles to the elbow joint become inflamed due to repetitive movements, injury, or degeneration over time.

“Tennis elbow is the most common source of elbow pain.”


Tennis elbow usually causes pain that starts in the outside of the elbow and moves down the forearm and wrist. This pain can be accompanied by weakness in the forearm and hand and may cause difficulty with

  • Gripping an object
  • Turning a doorknob
  • Shaking a person’s hand


The causes of tennis elbow are similar to the causes of tendonitis anywhere in the body. Common culprits are repetitive use, injury, wear and tear over time, and underlying conditions like rheumatoid arthritis. Athletes are at particular risk; and though you don’t need to be a tennis player to develop this condition, racket sports like tennis, pickleball, badminton, and squash do increase the risk. Common occupational risks for tennis elbow include painting, using plumbing tools, and repetitive use of a computer mouse.


Tennis elbow is typically diagnosed by asking patients about outer elbow pain, occupation, past injuries, and risk factors, as well as a specialized physical exam. The doctor or physiotherapist will bend the patient’s wrist with the palm facing down and then slowly straighten the arm. If there is pain at the outside, or lateral edge, of the elbow, then the test indicates tennis elbow. In some cases, additional tests such as an MRI, an x-ray, or an EMG (a test that sees how well muscles are receiving signals from nerves) may also be used.

Nonsurgical treatment options

For minor cases of tennis elbow, there are many nonsurgical options available. These include anti-inflammatory medications, a brace to ease the pain, physical therapy, or a cortisone injection. Both stretches and strengthening exercises are commonly recommended for the at-home treatment of tennis elbow. It is important to stretch the muscles and tendons of the hand, wrist, forearm, and elbow as well as follow a therapist-recommended muscle strengthening program. This will help relieve symptoms like pain and weakness, as well as prevent future injury. However, in extreme cases, where there is immense pain (such as difficulty picking up something light or shaking someone’s hand), then an outpatient arthroscopic procedure may be required.

How surgery is performed

Elbow arthroscopy is a minimally invasive surgery that takes less than an hour. A small cut is made on both the inside and outside of the arm, and a tiny camera called an arthroscope is used in order to see inside the elbow area to pinpoint injury. Another small cut is made on the outside of the elbow, and then specialized tools remove or repair areas of tissue inflammation and damage. 

“The anticipated recovery time for returning to full strength is three to four months.”

Recovery time

The patient can go home the same day of the surgery and may move the elbow as much as they can tolerate. Resistance or strengthening activities should be avoided for approximately four weeks. During this time, patients should instead do an at-home range-of-motion program involving their hand, wrist, and elbow. After four weeks, patients will be referred to an occupational therapist to start a rehabilitation program. An occupational therapist helps people adapt to difficulties in their day-to-day function.

Lateral/Medial Epicondylitis Release Patient Protocol


Many patients will notice pain relief just a few days after the procedure. The anticipated recovery time for returning to full strength is three to four months.


What risk factors are associated with tennis elbow?

  • Age. While it’s true that tennis elbow can affect people of all ages, it’s most common in people aged 30 to 50.
  • Occupation. Tennis elbow is often an overuse injury, so people who are painters, plumbers, butchers, or working at a computer all day are at increased risk of the condition.
  • Sports. Racket sports like tennis, badminton, and racquetball increase the risk of this injury.
For more information about the causes and treatment of elbow tendonitis, please request an appointment with experienced Chicago orthopaedic surgeon Dr. Anthony Romeo. Call or email our office today to schedule your visit.

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