Topic Overview
What is tennis elbow?
Tennis elbow is soreness or
pain on the outer part of the elbow. It happens when you damage the
tendons that connect the muscles of your forearm to
your elbow. The pain may spread down your arm to your wrist. If you don't treat
the injury, it may hurt to do simple things like turn a key or open a
door.
Your doctor may call this condition lateral epicondylitis.
What causes tennis elbow?
Most of the time tennis
elbow is caused by overuse. You probably got it from doing activities where you
twist your arm over and over. This can stress the tendon, causing tiny tears
that in time lead to pain. A direct blow to the outer elbow can also cause
tendon damage.
Tennis elbow is common in tennis players, but most
people get it from other activities that work the same muscles, such as
gardening, painting, or using a screwdriver. It is often the result of using
equipment that is the wrong size or using it the wrong way.
Anyone
can get tennis elbow, but it usually occurs in people in their 40s.
How is tennis elbow diagnosed?
To diagnose tennis
elbow, a doctor will examine your elbow and ask questions about the elbow
problem, your daily activities, and past injuries. You probably won't need to
have an
X-ray, but you might have one to help rule out other
things that could be causing the pain.
If your symptoms don't get
better with treatment, you might have an imaging test, such as an
MRI. This can tell your doctor whether a bone problem
or tissue damage is causing your symptoms.
How is it treated?
You can start treating tennis
elbow at home right away.
- Rest your arm, and avoid any activity that
makes the pain worse.
- As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice a long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
-
Take over-the-counter pain relievers such as ibuprofen or naproxen (NSAIDs) or acetaminophen if you need them.
Or try an NSAIDs cream that you rub over the sore area.
- Wear a counterforce brace when you need to grasp or twist
something. This is a strap around your forearm placed about an inch below your
elbow. It eases the pressure on the tendon and spreads force throughout your
arm.
After the pain eases, your doctor or
physical therapist can teach you rehabilitation (rehab) exercises to
stretch and strengthen your tendon. Doing these exercises at home can help your
tendon heal and can prevent further injury.
When you feel better,
you can return to your activity, but take it easy for a while. Don't start at
the same level as before your injury. Build back to your previous level slowly,
and stop if it hurts. To avoid damaging your tendon again:
- Take lessons or ask a trainer or pro to
check the way you are doing your activity. If the way you use a tool is the
problem, try switching hands or changing your grip. Make sure you are using the
right equipment for your size and strength.
- Always take time to
warm up before and stretch after you exercise.
- After the activity,
apply ice to prevent pain and swelling.
Be patient, and stay with your treatment. You will
probably feel better in a few weeks, but it may take 6 to 12 months for the
tendon to heal. In some cases, the pain lasts for 2 years or longer.
If your symptoms don't improve after 6 to 8 weeks of home treatment, your
doctor may suggest a shot of
corticosteroid. This could give you some short-term
relief so you can start rehab exercises. Surgery is seldom needed for tennis
elbow.
Frequently Asked Questions
Learning about tennis elbow: | |
Being diagnosed: | |
Getting treatment: | |
Ongoing concerns: | |
Cause
Overuse of the forearm muscles
using a repeated twisting motion is the most common cause of
tennis elbow. These movements are common to various
jobs such as carpentry or plumbing, and many daily activities such as yard work
and lifting objects. Racquet sports, swimming, and throwing sports (such as
baseball) can also lead to tennis elbow.
Tennis elbow injuries can result from:
- Overuse. Repeated movements that involve
twisting of the elbow cause small tears in the tendon, weakening it. Overuse
depends on how hard or how long you do something.
- Technique, or the
way you do an activity. This includes holding equipment or a tool in a awkward
position while you use it.
- Equipment. This can happen, for example,
if you use a tool or sports equipment that is too heavy for you or that has a
grip that is the wrong size for your hand.
- A single accident, such
as a direct hit to the side of the elbow (lateral epicondyle), or falling on an outstretched arm.
Symptoms
Tennis elbow
symptoms usually begin gradually. The main symptom is pain, which may begin
with a dull aching or soreness on the outer part of the elbow that goes away
within 24 hours after an activity. As time goes on, it may take longer for the
pain to go away. The condition may further progress to pain with any movement,
even during everyday activities, such as lifting a jug of milk. Pain may spread
to the hand, other parts of the arm, shoulder, or neck.
Tennis
elbow pain:
- Usually occurs in the dominant arm (your right
arm if you are right-handed, left arm if you are
left-handed).
- Affects the outside of the elbow (the side away from
your body). Pain increases when that area is pressed or when you are grasping
or twisting objects.
- May increase in the evening and make sleep
difficult. The elbow might be stiff in the morning.
- Over time may
occur with mild activity, such as picking up a coffee cup; turning a jar lid,
doorknob, or key; or shaking hands. Simply starting your car could hurt. You
may even have pain when you aren't using your elbow.
Other parts of the arm, shoulder, and neck may also become
sore or painful as the body tries to make up for the loss of elbow movement and
strength.
Swelling rarely occurs with tennis elbow. If your elbow
is swollen, you may have another type of condition, such as
arthritis.
Radial tunnel syndrome is an unusual type of nerve entrapment that is sometimes
confused with or can develop at the same time as tennis elbow.
What Happens
Tennis elbow
pain is a symptom of tendon injury.
Overuse or stress can cause microtears in the
tendon. This usually occurs because of repetitive motions of the arm or wrist.
The longer you use an injured tendon, the more damaged it becomes.
The most common symptom of tennis elbow is pain on the outside of the
elbow. Given enough rest, the tendon can mend on its own. But if you continue
the activity, the weakened tendon may become more vulnerable to tear or rupture
from a sudden accidental blow, fall, or forceful movement.
With
early rest and treatment, an injured tendon is likely to heal with minimal scar
tissue and maximum strength. While a recent, mild tendon injury might need a
few weeks of rest to heal, a severely damaged tendon can take months to mend.
Corticosteroid injections may give you short-term pain relief to allow you to
start a rehabilitation (rehab) program. But they may weaken tendon tissue if given
too often.
- Mild soreness in the elbow that comes and goes
may improve in 6 to 8 weeks.
- Prolonged elbow pain and soreness may
improve in 6 to 12 months. In some cases, the pain lasts for 2 years or
longer.
- Severe elbow pain or tennis elbow that doesn't improve with
6 to 12 months of tendon rest and rehab may benefit from surgery.
What Increases Your Risk
Risk factors for
tennis elbow include:
- Activities that involve repeated movements of
the forearm, wrist, and fingers. This includes grasping and twisting arm
movements done in jobs (such as carpentry, plumbing, or working on an assembly
line), daily activities (such as lifting objects or gardening), and sports
(such as racquet sports, throwing sports, or swimming).
- Improper
techniques while doing certain movements, such as gripping a handle or twisting
an object.
- Improper equipment for work, daily activities, and
sports, such as using a hammer or a tennis racquet with a grip that is the
wrong size for your hand.
- Age. Tennis elbow is most common in
people who are in their 40s.
- History of tendon injuries. Some
people seem
susceptible to tendon injury, based on a history of
various tendon injuries such as
rotator cuff disorders.
If you think that your workplace activity is causing elbow
pain or soreness, talk to your human resources department for information on
other ways of doing your job, equipment changes, or other job assignments. For
more information, see the topic
Office Ergonomics.
When To Call a Doctor
Call your doctor immediately if you had an injury to your elbow and:
- You have severe elbow pain.
- You
cannot move your elbow normally.
- Your elbow looks
deformed.
- Your elbow begins to swell within 30 minutes of the
injury.
- You have signs of damage to the nerves or blood vessels.
These include:
- Numbness, tingling, or a "pins-and-needles"
sensation below the injury.
- Pale or bluish skin.
- The
injured arm feeling colder to the touch than the uninjured one.
Call your doctor if you have:
- Pain when grasping, twisting, or lifting
objects.
- Work-related problems caused by your elbow
pain.
- Elbow pain after 2 weeks of home treatment or if treatment is
making your elbow pain worse.
Watchful waiting
Watchful waiting is when you and your doctor
watch your symptoms to see if your health improves on its own. If it does, no
treatment is needed. If your symptoms don't get better or they get worse,
then it's time to take the next treatment step.
Home treatment
often helps mild
tennis elbow pain. You may want to try resting the
elbow and applying ice or heat several times a day for 1 to 2 weeks before you call your
doctor.
Who to see
For evaluation, diagnosis, or treatment of
tennis elbow, you may see:
You may be referred to a:
- Physical therapist (for stretching and
strengthening exercises).
- Tennis or other sports instructor (for
training in sports).
- Specialist in job-related safety or ergonomics
(for work-related activities).
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Your doctor can usually determine if
you have
tennis elbow by talking to you about the
history of your symptoms, daily activities, and past
injuries. You'll have a
physical exam too.
X-rays aren't usually needed for diagnosis of tennis
elbow but can sometimes rule out other causes of elbow pain, such as
arthritis, signs of another type of injury, or a
buildup of calcium crystals in a tendon or ligament. X-rays can show unusual
bone structure that might cause soft-tissue damage (such as to tendons or
muscles), but they don't show soft tissues very clearly. If your elbow pain
isn't severe and can't be linked to a specific injury, your doctor may
recommend starting treatment without doing X-rays to see whether the problem
clears up in a few weeks.
If nonsurgical treatment (such as rest,
the use of ice and anti-inflammatory drugs, rehabilitation exercises, and changing or
stopping certain activities) hasn't helped relieve elbow pain, or if the
diagnosis is unclear, other tests may be helpful.
- Magnetic resonance imaging (MRI) can show problems in soft tissues such as tendons and
muscles.
- Arthroscopy allows the doctor to see
inside the elbow and get information that can be used with what he or she knows
from your X-rays or physical exam. (Doctors can surgically treat tennis elbow
with arthroscopy.)
- Bone scans
are done in rare cases. They can show stress fractures in the bone or certain
disease conditions, such as a tumor or infection.
If your doctor thinks you have nerve damage,
electromyogram and nerve conduction tests can check
how well your nerves are working.
Treatment Overview
Tennis elbow treatment is most often successful. The
most important part of treatment is tendon rest. A long rest from aggravating
activity allows the small tears in the tendon to heal. Depending on how severe
your condition is, you may need to rest your tendon for weeks to months.
Surgery is a last resort if other treatment isn't helpful.
Initial home treatment
Treatment for
tennis elbow works best when it starts as soon as
symptoms appear. If your condition is just starting, rest may be all you need.
But in most cases, more treatment is needed to protect and heal the
tendon.
You can treat your tennis elbow
by:
- Reducing
pain.
- As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice a long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
- You can also
take
nonsteroidal anti-inflammatory drugs (NSAIDs), including
aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as
Aleve). Do not give aspirin to anyone younger than 20 because of the risk of
Reye syndrome, a serious illness. Or try an NSAIDs cream that you rub over the sore area. Acetaminophen (such
as Tylenol) can also help with pain.
- Stopping or changing
activities that may irritate the tendon. Learn new techniques for certain
movements, and use different equipment that may reduce the stress on your
forearm muscles.
Wrist and elbow splints can be used in the treatment of
tennis elbow. Splints are sometimes helpful for other bone, joint, and tendon
problems. But splints have not been shown to help with pain or recovery for
tennis elbow injuries.
Ongoing treatment
Over the first months of
recovery from
tennis elbow, continue your initial treatment and
begin:
- Rehabilitation (rehab). This can include
exercise and other
physical therapy treatments to decrease pain and
increase range-of motion.
- Exercises for flexibility and arm muscle strength
include:
- Warm-up exercises for tennis elbow
- Stretching exercises for tennis elbow
- Strengthening exercises for tennis elbow
- Wearing a special counterforce brace. This
strap, worn around your forearm just below the elbow, may spread pressure
throughout the arm instead of putting it all on the tendon. With a counterforce
brace, you may do some grasping and twisting activities. It won't help, though,
if you continue using a poor technique or the wrong equipment that originally
caused your tennis elbow. You don't need a doctor's advice before trying a
counterforce brace. You can find these braces in most drugstores or sporting
goods stores.
- Working with an expert to see whether you need to
change how you do an activity or what equipment you use. A sports trainer can
help with sports activities and equipment. An
ergonomic specialist,
occupational therapist, or
physical therapist can help with your workplace,
including what tools you use, how your workspace is set up, and how you do your
job.
Treatment if the condition gets worse or does not improve
The longer you continue activity that harms the tendon
after
tennis elbow symptoms begin, the longer rehab will
take. This ongoing activity can cause severe
tendon damage and may someday require surgery. If your
symptoms don't go away, your doctor may suggest:
- Corticosteroid
injections, which can help relieve pain for a short time.1 This treatment is sometimes used when you still have pain after 6
to 8 weeks of rest and rehab. Corticosteroids may be harmful to the tendon. But
this is usually only a problem after having many injections in the same
year.
- Ultrasound therapy. Ultrasound may help
your tendon heal and stop pain.
- Surgery, which is seldom used to treat tennis elbow (less than
5 out of 100 cases).2 Surgery may be a treatment option if
persistent elbow pain doesn't improve after 6 to 12 months of tendon rest and
rehab. Surgery usually involves cutting (releasing) the tendon, removing
damaged tissue from the tendon, or both. In some cases, tendon tears can be
repaired.
What to think about
Your treatment choices will
depend in part on whether elbow pain affects your job or daily life.
It also depends on whether you are willing or able to change habits
or activities that are causing your elbow pain.
Non-surgical
treatment is usually started if the injury is:
- A result of overuse.
- A sudden
(acute) injury that doesn't have large tears in the tendon or other severe
damage in the elbow.
Most cases of tennis elbow respond to rest, ice, rehab
exercises, pain medicine, and counterforce braces. This injury does take from 6
months to 12 months to heal. Patience helps.
Surgery is considered
as a last resort when all other nonsurgical treatments have failed. You may be
referred for surgery if:
- The injury is from a sudden (acute) injury
that left large tears in the tendon or other severe damage in the
elbow.
- The injury is from chronic overuse and more than 6 to 12
months of tendon rest and rehab haven't relieved elbow pain. (If the tendon is
very weak, surgery may not improve your situation much.)
- Pain
continues despite other treatment.
- You have had a corticosteroid
shot and it hasn't helped.
In as many as 9 out of 10 people who have tennis elbow,
symptoms go away and the people can return to their normal activities whether
they have had surgery or not.3
Prevention
The best way to prevent
tennis elbow is to stretch and strengthen your arm
muscles so that they are flexible and strong enough for your activities.
- Warm-up exercises for tennis elbow
- Stretching exercises for tennis elbow
- Strengthening exercises for tennis elbow
Other ways to prevent tennis elbow include:
- Staying in good overall physical
shape.
- Using the correct techniques and movements during
activities.
- Using equipment appropriate for your ability, body
size, and body strength.
- Not overusing your arm with repeated
movements that can injure your tendon. For example, alternate hands during
activities, if possible.
- Strengthening the muscles of your arm,
shoulder, and upper back to help take stress off of your
elbow.
- Wearing a counterforce brace during activities that
require grasping or twisting arm movements. A counterforce brace is a strap
worn around your forearm just below your elbow. This brace may distribute
pressure from muscle use throughout the arm, easing pressure on the
tendon. The brace is not usually used for prevention. But it may be recommended for someone who is at very high risk for tennis elbow. Talk to your doctor if you are thinking of using one of these braces for prevention. A counterforce brace is not a substitute for
rehab exercises or an excuse to continue overuse activities.
If you feel that certain activities at your job are causing
elbow pain or soreness, talk to your human resources department for information
on other ways of doing your job. They can help with changes to equipment or
other job assignments.
Consider taking lessons to learn the proper
technique for sports, such as tennis and golf, that require grasping and
twisting motions in the arm. Have a sports trainer or a person who is familiar
with sports equipment check yours to make sure it suits your level of ability,
body size, and body strength.
In daily routines or hobbies, look
for activities that use repeated arm movements that strain your fingers, wrist,
or forearm, such as in gardening, cooking, or playing musical instruments.
Train yourself to use techniques that won't stress your elbow. For example,
when you lift objects, lift with the palm of your hand facing upwards.
Home Treatment
If you have
tennis elbow, follow these simple steps to reduce pain
and start
tendon healing. A rehab program such as this will
prevent further injury by making your arm muscles stronger.
- Rest your fingers, wrist, and forearm muscles
to allow your tendon to heal. Stop any activity that you think may be causing
your elbow pain and soreness. Depending on the severity of tendon damage, you
may have to avoid this activity for weeks to months.
- As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice a long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
- Wear a counterforce brace
during activities that require grasping or twisting arm movements. A
counterforce brace is a strap worn around your forearm just below your elbow.
This brace may spread pressure throughout the arm instead of putting it all on
the tendon. These braces are not a substitute for rehab
exercises.
- Try elevating your elbow to help ease pain and reduce
swelling in your wrist or forearm.
- Take
nonsteroidal anti-inflammatory drugs (NSAIDs) to
reduce pain and inflammation. NSAIDs come in pills and in a cream that you rub over the sore area. Acetaminophen (such
as Tylenol) can also help with pain.
- Do simple
warm-up and
stretching exercises to keep your tendons from getting stiff. If you have any pain,
stop the exercises.
- When your pain is gone,
start doing
stretching and strengthening exercises, then gradually
increase these exercises. Learn the correct techniques and which equipment is
best for your activities.
Medications
Along with tendon rest, people often use
medicine to treat
tennis elbow. Medicine can help with pain and relieve
or reduce swelling.
Medication choices
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the
most commonly used medicines for treating tennis elbow. NSAIDs are available
with or without a prescription. NSAIDs come in pills and in a cream that you rub over the sore area. Acetaminophen (such
as Tylenol) can also help with pain.
Your doctor may suggest
corticosteroid injections (shots) if you are still in
pain after at least 6 to 8 weeks of tendon rest and rehab. Corticosteroids are
a class of powerful anti-inflammatory medicine. Even though inflammation isn't
usually present in long-term (chronic) tennis elbow, corticosteroid shots may
ease elbow pain.
What to think about
Nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroid shots
don't cure tennis elbow. But they can reduce pain and give you enough relief to
start rehab.
Avoid taking NSAIDs or other pain relief medicine to
control pain if you are continuing activities that can further damage your
tendon. If you don't feel the pain, you won't know that your elbow is getting
worse.
Surgery
Most cases of
tennis elbow are treated without surgery. Less than 5 out of 100 cases
require surgery.2 You and your doctor might consider
surgery if several months of
tendon rest and rehabilitation (rehab) haven't stopped pain or returned
the flexibility and strength to your forearm.
Consider surgery
if:
- Your elbow is still sore and painful after more
than 6 to 12 months of tendon rest and rehab.
- Your doctor has ruled
out other possible causes of elbow pain, such as nerve problems, arthritis,
muscle injury, or injury to another tendon.
- Your corticosteroid
shots have given good short-term pain relief, but the pain has
returned.
- You can't do normal daily activities and job tasks
because of elbow pain.
During surgery, a doctor will most likely cut (release) the
tendon, remove damaged tissue from the tendon, or both. In some cases, tendon
tears can be repaired.
After surgery, rehab is needed to restore
flexibility and strength in the forearm.
Tennis Elbow: Should I Have Surgery?
Surgery choices
Surgery for tennis elbow involves
cutting (releasing) the tendon and removing damaged tissue from the tendon. In
some cases, tendon tears are repairable (reattached) if the repair can be done
without overtightening the tendon. These procedures can be done both
arthroscopically and through a larger incision (open
surgery) or with a combination of the two techniques.
What to think about
There are different approaches
to surgery for tennis elbow, such as where to enter the elbow and what type of
reconstruction or repair on the tendon is done. Surgical technique is
determined by the type, location, and severity of the injury and by the
doctor's preference and experience.
There is no strong medical
research that shows that one type of surgery is better than another or that
surgery is better than other treatment.4
The success of surgery depends in large part on the amount of time and
effort you put into a rehab program.
Other Treatment
Other treatment for
tennis elbow pain includes physical rehabilitation (rehab),
acupuncture, topical nitric oxide, shock wave therapy, and
transcutaneous electrical nerve stimulation
(TENS).
Physical rehab is combined with
tendon rest to restore flexibility and build muscle
strength. Rehab is needed after surgery too.
Other treatment choices
A physical rehab program includes:
- Relieving pain.
- Maintaining good
overall physical fitness.
- Exercises, including
warm-ups,
stretching, and
strengthening.
- Learning new techniques for
certain movements; using equipment that best suits your ability, body size, and
strength; and limiting activities that require grasping or twisting arm
movements.
- Retraining and ergonomic changes at your work site. For
more information, see the topic
Office Ergonomics.
Complementary or alternative medicine treatments
Complementary or alternative treatments are
sometimes used along with traditional therapy to treat tennis elbow. Although
there is no solid scientific evidence that these therapies relieve pain and
restore elbow flexibility and strength, some people report them as helpful.
Complementary or alternative treatments may include:
- Acupuncture. Small studies report
tennis elbow relief after acupuncture treatment. But there is not enough strong evidence to support or refute
this treatment.5
- Topical nitric oxide. In a patch form, nitric oxide is
applied to the elbow to speed recovery. This medicine has been used as a
treatment for tennis elbow for a short time. One study showed positive
results.6
- Transcutaneous electrical nerve stimulation (TENS).
TENS is sometimes used to treat tennis elbow, usually in a physical therapy
setting.
- Extracorporeal shock wave therapy. A review of shock wave
therapy for tennis elbow had conflicting findings. Some studies reported that
shock wave therapy improved tennis elbow recovery. But others found that it
offered no therapeutic benefit when compared to
placebo treatment.7
What to think about
A physical rehab program not
only helps heal injured tendons and muscles but also helps prevent further
injury.
Physical rehab combined with tendon rest is the main
tennis elbow treatment. Corticosteroid shots are only considered if several
weeks of rest and rehab have not reduced symptoms. Surgery may be considered
after 6 to 12 months of nonsurgical treatment.
If the type of work
you do is causing your injury,
an occupational therapist may help you change how you
are working or the kind of work that you do.
Other Places To Get Help
Organizations
| American Academy of Orthopaedic Surgeons
(AAOS) |
| 6300 North River Road |
| Rosemont, IL 60018-4262 |
| Phone: | (847) 823-7186 |
| Fax: | (847) 823-8125 |
| Email: | orthoinfo@aaos.org |
| Web Address: | www.orthoinfo.aaos.org |
| |
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise. |
|
| American College of Sports Medicine (ACSM)
|
| P.O. Box 1440 |
| Indianapolis, IN 46206-1440 |
| Phone: | (317) 637-9200 |
| Fax: | (317) 634-7817 |
| Web Address: | www.acsm.org |
| |
The American College of Sports Medicine (ACSM) provides general
information and publications about exercise and sports medicine. |
|
| American Society for Surgery of the Hand
(ASSH) |
| 6300 North River Road |
| Suite 600 |
| Rosemont, IL 60018-4256 |
| Phone: | (847) 384-8300 |
| Fax: | (847) 384-1435 |
| Email: | info@assh.org |
| Web Address: | www.assh.org |
| |
ASSH is a professional organization of hand surgeons
that provides education to the public about hand problems, such as Dupuytren's
disease, carpal tunnel syndrome, and tennis elbow. ASSH also provides education
about surgery, preventive tips to keep your hands safe, and an online tool to
find a hand surgeon. |
|
References
Citations
- Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751–1767.
- Griffin LY, ed. (2005). Medial and lateral
epicondylitis. In Essentials of Musculoskeletal Care,
3rd ed., pp. 105–108. Rosemont, IL: American Academy of Orthopaedic
Surgeons.
- Rasouli A, Gupta R (2007). Elbow pain section of
Elbow, wrist, and hand injuries. In PJ McMahon, ed., Current Diagnosis and Treatment in Sports Medicine, pp. 146–154. New York:
McGraw-Hill.
- Buchbinder R, et al. (2002). Surgery for lateral elbow
pain. Cochrane Database of Systematic Reviews (1).
Oxford: Update Software.
- Buchbinder R, et al. (2008). Tennis elbow, search date
August 2006. Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.
- Paoloni J, et al. (2003). Topical nitric oxide
application in the treatment of chronic extensor tendinosis at the elbow.
American Journal of Sports Medicine, 31(6): 915–920.
- Buchbinder R, et al. (2005). Shock wave therapy for
lateral elbow pain. Cochrane Database of Systematic Reviews (4). Oxford: Update Software.
Other Works Consulted
- Regan WD, et al. (2010). Tendinopathies around the elbow. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice, 3rd ed., pp. 1197–1213. Philadelphia: Saunders Elsevier.
- Hertling D, Kessler RM (2006). Common lesions section
of Elbow and forearm. In Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods, 4th ed., pp.
370–374. Philadelphia: Lippincott Williams & Wilkins.
- Nadler SF, et al. (2005). Epicondylitis section of
Cumulative trauma disorders. In JA DeLisa et al., eds., Physical Medicine and Rehabilitation: Principles and Practice,
4th ed., vol. 1, pp. 619–620. Philadelphia: Lippincott Williams and
Wilkins.
- Wise C (2008). Elbow pain section of Back pain and
common musculoskeletal problems. In DC Dale, DD Federman, eds., ACP Medicine, section 15, chap. 12. Hamilton, ON: BC
Decker.
Credits
| By | Healthwise Staff |
|---|
| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
|---|
| Specialist Medical Reviewer | David Bardana, MD, FRCSC - Orthopedic Surgery, Sports Medicine |
|---|
| Last Revised | January 21, 2011 |
|---|
Coombes BK, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: A systematic review of randomised controlled trials. Lancet, 376(9754): 1751–1767.
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