Management of Lateral Epicondylitis

Lateral epicondylitis, frequently termed “tennis elbow”, arises from overuse of the wrist extensors, leading to microscopic tendon degeneration at the lateral humeral epicondyle. Conservative management remains first-line and encompasses activity modification, physiotherapy (including eccentric loading), nonsteroidal anti-inflammatory drugs and bracing. Emerging modalities such as extracorporeal shockwave therapy, low-level laser therapy and biologic injections address persistent symptoms by modulating tissue repair. Corticosteroid injections yield rapid pain relief but may be associated with recurrence and tendon weakening. Platelet-rich plasma and autologous blood injections show promise for sustained improvement, though optimal preparation and administration protocols remain under investigation. Surgical intervention—open, arthroscopic or percutaneous—serves refractory cases by debriding degenerated tendon tissue; outcomes are generally favourable, and early mobilisation strategies accelerate return to function. High-resolution ultrasound and elastography facilitate diagnosis, guide treatment selection and monitor healing. A tailored, stepwise approach balancing symptom severity, duration and patient activity demands underpins contemporary management paradigms.

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Management of Lateral Epicondylitis publication trend

The graph below shows the total number of articles in management of lateral epicondylitis across all publications each year (not limited to Nature Index journals).

Technical terms

Lateral epicondylitis: Degenerative tendinopathy of the common extensor origin at the lateral humeral epicondyle, causing lateral elbow pain and functional impairment.

Tendinopathy: A spectrum of tendon disorders characterised by collagen degeneration, neovascularisation and altered mechanical properties rather than acute inflammation.

Neovascularity: The ingrowth of microvessels into tendon tissue, often associated with chronic degeneration and pain.

Shear-wave elastography: An ultrasound-based imaging modality that quantifies tissue stiffness by measuring the propagation speed of mechanically generated shear waves.

Platelet-rich plasma: An autologous concentration of platelets and growth factors obtained from centrifuged blood, used to enhance tendon healing and regeneration.

References

1. Assessing the treatment response of lateral elbow tendinopathy using time-dependent ultrasonography, Doppler imaging, and elastography. Insights into Imaging (2024).
2. Management of Lateral Epicondylitis: A Narrative Literature Review. Pain Research and Management (2020).
3. A systematic review with procedural assessments and meta-analysis of Low Level Laser Therapy in lateral elbow tendinopathy (tennis elbow). BMC Musculoskeletal Disorders (2008).
4. Corticosteroid or placebo injection combined with deep transverse friction massage, Mills manipulation, stretching and eccentric exercise for acute lateral epicondylitis: a randomised, controlled trial. BMC Musculoskeletal Disorders (2015).
5. Efficacy of physical therapy for the treatment of lateral epicondylitis: a meta-analysis. BMC Musculoskeletal Disorders (2015).
6. Chronic lateral epicondylitis: challenges and solutions. Open Access Journal of Sports Medicine (2018).
7. Mini-open Muscle Resection Procedure under Local Anesthesia for Lateral and Medial Epicondylitis. Clinics in Orthopedic Surgery (2009).
8. A comparative study of the efficacy of ultrasonics and extracorporeal shock wave in the treatment of tennis elbow: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research (2019).