Tendons attach muscles to bones. The elbow has an upper arm bone (humerus) and two bones in the forearm (ulna and radius). Bony bulges on the inside and outside of the elbow are the epicondyle part of the upper bone. Tendons of forearm muscles, responsible mainly for flexing and extending the wrist, attach to these bulges.
Inflammation of the outer tendons (for extending the wrist) has the medical name lateral epicondylitis. The common name “tennis elbow” is used because the problem often results from playing tennis or similar repetitive motion. Inflammation of inner tendons (for flexing the wrist) is medial epicondylitis, or “golfer’s elbow.”
The usual cause is overusing the arm, often related to work or sports. Carpenters, factory workers, musicians, and cashiers, who use their hands repeatedly, can have this problem. An injury, such as from lifting something that’s too heavy, can also cause it.
The forearm becomes tender and painful. Burning feelings going down the arm from the elbow also occur. Pain may first be felt only when using the arm, but later pain may be constant, even at rest. The hand grip may be weak, and it may be hard to lift or grasp objects, or to do simple tasks (writing, brushing teeth).
The health care provider makes a diagnosis by the medical history and physical examination (shoulder, arm, and wrist). Resistance against extending the wrist or flexing it can bring on pain.
The health care provider may order other tests or x-rays to rule out other conditions with similar symptoms. These conditions include arthritis, cervical spine disease, neuropathy, and pinched nerve. The health care provider may also order magnetic resonance imaging (MRI) to get a better view of inflamed tendons and to rule out a ruptured tendon.
Treatment involves rest and restricting activities that may have started the problem. Using ice after exercise and rest and special stretching and strengthening exercises often help. People should also lift objects with their palms facing upward to decrease stress on the elbow.
Wrapping the elbow with an elastic sleeve keeps the arm warm and helps flexibility. A physical therapist may oversee treatment and prescribe ultrasound treatment.
The health care provider may prescribe antiinflammatory medicines (ibuprofen, naproxen).
If the pain continues, cortisone injections can be tried.
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