Lateral Epicondylitis / Tennis Elbow (Pediatric)
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What is lateral epicondylitis?
Lateral epicondylitis, also known as tennis elbow, is a painful inflammation of the tendons located along and attached to the outside of the elbow. Tendons are rope-like structures that connect the ends of muscles to bones. Tendons affected in tennis elbow attach the muscles that extend the wrist and fingers to the upper arm bone (humerus). Lateral epicondylitis rarely affects children and is more likely to be seen in the adolescent and adult population.
What causes lateral epicondylitis?
Overuse of forearm muscles causes microtears and fraying of the tendons. Athletes engaged in activities that involve repeated motions of the wrist and forearm, including golf and racquet sports, are at risk for developing this condition. With tennis in particular, stress is greatest on the outer elbow of the dominant arm during a backhand swing. Incorrect grip size, inappropriate string tension, or swing mechanics can contribute to injury.
What are the symptoms of lateral epicondylitis?
Athletes may complain of pain in the elbow during or after activity. There is typically no great swelling or redness and the onset of pain is gradual. Pain may travel down the forearm toward the wrist and improve with rest, but it often returns when activity is resumed. Some athletes may also notice decreased grip strength in the affected arm.
How is lateral epicondylitis diagnosed?
Our doctors take a medical history and do a physical examination of the elbow, forearm, and wrist on the affected side. X-ray films are rarely needed to make the correct diagnosis, but we may order an X-ray or other imaging study to rule out other conditions.
What is the treatment for lateral epicondylitis?
Treatment depends on the severity of symptoms. The first step is activity modification and a period of relative rest (decreased activity using the forearm and wrist).
The rehabilitation technique found to be most helpful for treating this condition is eccentric strengthening. These exercises strengthen the muscle as it lengthens. They are shown to improve pain symptoms in patients with long-term tendon irritation and degeneration. Our doctors may recommend a visit to a physical therapist to learn eccentric strengthening and stretching exercises. Bracing the elbow with a counterforce strap or using a wrist brace may also help to decrease symptoms.
Ice can be helpful as a pain reliever. Additionally, nonsteroidal anti-inflammatory medications, either taken orally or used topically, can temporarily alleviate symptoms. If symptoms are prolonged and severe, we may recommend a corticosteroid injection to the area. Surgery is reserved for severe cases unresponsive to other treatments.