Epicondylitis

What is this condition?

The term “epicondylitis” refers to an elbow tendinopathy, even though the inflammatory phase is rarely observed. It is more accurate to describe it as an elbow tendinopathy. The medial or lateral epicondyle is a bony prominence of the humerus, the upper arm bone, near the elbow. Lateral epicondylitis affects the outer side of the elbow, where the common tendon of the wrist extensor muscles attaches.

The muscles originating from the lateral epicondyle include:

• Extensor carpi radialis brevis
• Extensor carpi radialis longus
• Extensor carpi ulnaris
• Extensor digitorum
• Extensor digiti minimi
• Supinator
• Brachioradialis

Epicondylitis affects muscles of the wrist and hand. Contrary to popular belief, “tennis elbow” does not only occur in athletes. It can develop over time through repetitive tasks such as keyboard use, or suddenly with changes in daily or sports activities—like using a new mouse, starting a DIY project, or spending many hours assembling furniture.

 

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Symptoms

The first sign of epicondylitis is a dull or sharp pain at the elbow, which usually worsens with wrist movement and may radiate down the forearm and wrist. Individuals may have difficulty using the arm—for example, lifting a coffee cup or shaking hands. Grip strength may be reduced since the tendons of the wrist and hand are affected at the elbow. If not managed promptly, epicondylitis can become chronic.

 

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Possible Treatments

Initially, it is important to rest the affected tendons for a few days to reduce irritation. Rest does not usually mean complete immobilization of the elbow or wrist. Physiotherapists will provide guidance on appropriate rest and identify movements that should be temporarily limited. Adjusting the workstation ergonomics is important to reduce tendon stress, considering hand position and head posture.

Movement should continue within acceptable limits to optimize blood flow and maintain an active lifestyle—rest is needed, but not too much.

During the first session, patients may begin pain-free eccentric exercises, which are highly effective in tendinopathy management. Gradually reloading the tendon promotes tendon fiber reorganization, leading to a stronger and more functional tendon. A progressive plan with proper movement quality is essential to avoid re-irritation. Motor control is key in physiotherapy for prevention.

Manual therapy is also part of treatment. Physiotherapists can work on joint mobility or muscle tension, including the cervical spine or shoulder. Massage or myofascial release can reduce forearm and upper limb pain. Tendon-specific techniques can improve blood flow and fiber organization. Mulligan techniques may also be used.

Cryotherapy and thermotherapy involve applying cold or heat to the elbow for a set period to reduce pain and facilitate early movement. These are secondary tools in epicondylitis management.

Corticosteroid injections may be considered by a physician to reduce elbow pain, but long-term they do not promote tendon fiber reorganization, which is crucial for true healing.

Whether the goal is to regain grip strength for opening jars or power for tennis strokes, physiotherapists adjust the treatment plan according to your goals to ensure recovery from this condition.

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