From the Guidelines
Lateral epicondylitis, commonly known as tennis elbow, is best treated with a combination of rest, physical therapy, and pain management. Initially, reduce activities that cause pain and apply ice to the affected area for 15-20 minutes several times daily. Over-the-counter NSAIDs like ibuprofen (400-600mg three times daily with food) or naproxen (220-440mg twice daily) can help manage pain and inflammation for short periods, typically 1-2 weeks, as suggested by 1. Physical therapy focusing on eccentric strengthening exercises is crucial for recovery—start with 3 sets of 15 repetitions daily using light weights and gradually increase. A counterforce brace worn just below the elbow can provide symptom relief during activities. For persistent cases, a corticosteroid injection may be considered, though benefits are often temporary, as noted in 1. Most cases resolve within 6-12 months with conservative treatment. Surgery is rarely needed and reserved for cases that don't respond to 6-12 months of conservative management. This condition results from overuse causing microtears in the tendon that attaches forearm muscles to the lateral epicondyle, so addressing the underlying mechanics through proper technique and equipment modification helps prevent recurrence, as discussed in 1.
Some key points to consider in the treatment of lateral epicondylitis include:
- Reducing activity to decrease repetitive loading of the damaged tendon, as recommended in 1
- Using ice to reduce pain and inflammation
- Implementing eccentric strengthening exercises as part of physical therapy
- Considering the use of a counterforce brace for symptom relief
- Reserving corticosteroid injections for persistent cases and surgery for cases that do not respond to conservative management
It's also important to note that lateral epicondylosis is more common in individuals who participate in activities that require repetitive wrist extension, such as racquet sports, and is most common after 40 years of age, as mentioned in 1. By understanding the causes and implementing appropriate treatment, individuals can effectively manage their symptoms and prevent recurrence.