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Epicondylitis (tennis and golf elbow)

Neeru Jayanthi, MD
Section Editor
Karl B Fields, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


The lateral epicondyle of the elbow is the bony origin for wrist extensors; the medial epicondyle is the bony origin for wrist flexors. Pain at the myotendinous junction of these muscle groups is referred to as lateral and medial epicondylitis, respectively. Lateral epicondylitis is often called tennis elbow and medial epicondylitis, golfer's elbow. Although tennis and golf can cause these injuries, so can a number of other occupational and recreational activities.

Subacute and chronic symptoms of pain and disability at the lateral and medial epicondyles typically represent a tendinosis of the respective myotendinous group, and are referred to as elbow tendinosis. Other terms used to describe the constellation of symptoms at these locations include elbow tendinopathy, elbow tendonitis, and epicondylalgia. We refer to these conditions as medial and lateral epicondylitis throughout this topic review.

This topic will review the development, presentation, and management of epicondylitis. Other problems associated with elbow pain and the general treatment of tendinopathy are discussed separately. (See "Evaluation of elbow pain in adults" and "Radial head subluxation (nursemaid's elbow)" and "Elbow injuries in active children or skeletally immature adolescents: Approach" and "Overview of the management of overuse (chronic) tendinopathy".)


General population and occupational risk factors — According to an observational study of 5871 working age Finns, the prevalence of lateral epicondylitis is 1.3 percent and of medial epicondylitis, 0.4 percent [1]. The incidence may approach 1 to 3 percent in the general population, while the incidence in general practice is approximately 0.4 to 0.7 percent [2].

Smoking, obesity, age 45 to 54, repetitive movement for at least two hours daily, and forceful activity (managing physical loads over 20 kg) appear to be risk factors in the general population for the development of epicondylitis [1,3]. Factors that correlate with a poorer prognosis include high physical strain at work, dominant side involvement, concomitant neck pain (with or without signs of nerve root involvement), duration of symptoms greater than three months, and severe pain at presentation [4,5].


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Literature review current through: Sep 2016. | This topic last updated: Aug 8, 2016.
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