Tennis Elbow (Lateral Epicondylitis)

Tennis elbow is a painful overuse condition of the tendons that anchor your wrist-extensor muscles to the bony bump on the outside of your elbow. Despite the name, only about 5% of cases happen to tennis players — it's far more common in people aged 35 to 55 who do repetitive gripping or twisting motions: carpenters, painters, plumbers, and a lot of computer workers. The underlying issue is actually tendon degeneration rather than active inflammation — the collagen fibers in the tendon have broken down and lost their organized structure.

The signature symptom is pain on the bony bump on the outside of your elbow — especially when you grip, twist a doorknob, shake hands, or lift something with your palm facing down. The pain often radiates into the forearm. You may notice your grip weakening: dropping a coffee mug or struggling to open a jar are common early complaints.

Symptoms typically come on gradually over weeks and worsen with repetitive arm use. The outer elbow is tender to press, and the pain flares when you extend your wrist against resistance. Morning stiffness at the elbow is common, and the pain may wake you at night if you sleep with the arm bent and pressed against the mattress.

Pain on the outside of the elbow, right where the tendon attaches to the bony bump — made worse by gripping (especially with the arm straight) or by resisting someone pulling your wrist down. Your surgeon will use a couple of standard tests (the Cozen test and Mill's test) that reproduce the pain. X-rays are usually normal. Ultrasound and MRI show the thickened, degenerated tendon when imaging is needed.

1. NSAIDs / Topical Diclofenac

   Oral or topical anti-inflammatory medication for short-term symptom relief during a flare.

2. Corticosteroid Injection

   A cortisone shot gives fast short-term pain relief, but it doesn't change the long-term course and may even slow tendon healing — used sparingly when other steps haven't worked.

3. PRP Injection

   A PRP (platelet-rich plasma) injection — concentrated growth factors taken from your own blood and injected into the degenerated tendon. Solid evidence shows better long-term outcomes than cortisone for tennis elbow.

Surgery is reserved for the small minority of patients (under 5%) with persistent, disabling symptoms after a real trial of non-operative care including PRP. The procedure cleans out the degenerated portion of the tendon.

External patient-education references and related OSI pages for additional background:

• Britannica — Tendinitis
• Britannica — Joint (anatomy)
• AAOS OrthoInfo — patient education library
• OSI glossary — orthopedic terminology in plain language