Q: My doctor says my elbow pain is due to tennis elbow. But I don't play tennis. Could you explain how this has come about and what I can do about it?
A: "Tennis elbow" is a common term for a condition doctors call lateral epicondylitis. It's caused by inflammation of the tendon that connects the extensor muscles of the wrist to the outside of the elbow.
Probably fewer than 10 percent of people get this by playing tennis. The usual causes are recreational activities such as gardening, job-related lifting, using a screwdriver or wrist overuse.
The medial epicondyle can also get inflamed. In this condition, called medial epicondylitis, the affected tendons connect the flexor muscles of the wrist to the inside of the elbow. It's commonly called "golfer's elbow" or "pitchers elbow." Tightening and twisting the wrist from activities such as golfing or throwing a baseball can cause it.
Most people with medial or lateral epicondylitis feel pain when their doctor applies direct pressure to the inflamed area. He or she might ask you to push your wrist against resistance, which could also cause pain. You might also feel pain with handshaking, lifting a briefcase or heavy pot or similar activities.
There is treatment for both conditions.
You could wear a wrist splint or forearm brace to prevent overuse of the muscles of the forearm.
You can also try a non-steroidal anti-inflammatory drug (NSAID such as ibuprofen or naproxen) and ice packs to help relieve symptoms. Your doctor may recommend physical therapy, especially if you need to return to a job or activity that caused the problem.
Sometimes doctors recommend one or two steroid shots over the affected epicondyle. But there is some risk of tissue loss around the elbow with repeated shots.
The symptoms of "tennis" or "golfer's" elbow normally get better within a few months with conservative therapy. Once the symptoms disappear, you should begin gradual stretching and strengthening of the tendon and muscle attachments.
Is a specific activity likely to have caused your condition? Try exploring a different swinging action or different equipment to avoid another episode.
Despite trying all the above, lateral or medial epicondylitis can sometimes persist for many months. If that happens, talk with your doctor about referral to an orthopedist.
(Howard LeWine, MD, is a practicing internist at Brigham and Women's Hospital, Boston, Mass., and Chief Medical Editor of Internet Publishing at Harvard Health Publications, Harvard Medical School.)
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