Conditions & Treatments

Tennis Elbow

What is

Tennis Elbow (Lateral Epicondylitis)?

Lateral epicondylitis, commonly known as tennis elbow, is a painful condition involving the tendons that attach to the bone on the outside (lateral) part of the elbow. Tendons anchor the muscle to bone. The muscle involved in this condition, the extensor carpi radialis brevis, helps to extend and stabilize the wrist.

With lateral epicondylitis, there is degeneration of the tendon’s attachment, weakening the anchor site and placing greater stress on the area. This can then lead to pain associated with activities in which this muscle is active, such as lifting, gripping, and grasping. Sports such as tennis are commonly associated with this, but the problem can occur with many different types of activities, athletic and otherwise.

Causes of the


Overuse is one of the primary causes of tennis elbow, and it can be both non-work and work-related. An activity that places stress on the tendon attachments, through stress on the extensor muscle-tendon unit, increases the strain on the tendon. These stresses can be from holding too large a racquet grip or from “repetitive” gripping and grasping activities, i.e. meat-cutting, plumbing, painting, weaving, etc.

Trauma is another main cause of lateral epicondylitis. A direct blow to the elbow may result in swelling of the tendon that can lead to degeneration. A sudden extreme action, force, or activity could also injure the tendon.

Signs &


Elbow pain is the main symptom of lateral epicondylitis. The pain is located over the outside aspect of the elbow, over the bone region known as the lateral epicondyle. This area becomes tender to touch. Pain is also produced by any activity which places stress on the tendon, such as gripping or lifting.

With activity, the pain usually starts at the elbow and may travel down the forearm to the hand. Occasionally, any motion of the elbow can be painful.

The most common age group that this condition affects is between 30 to 50 years old, but it may occur in younger and older age groups and in both men and women.

Surgeries &

Other Treatments

There are several options for tennis elbow treatment. In addition to surgery for extreme cases of lateral epicondylitis, they include activity modification, physical therapy, shockwave treatment, injections, and the use of medication and braces.

Activity Modification

Initially, the activity causing the condition should be limited. Limiting the aggravating activity, not total rest, is recommended. Modifying grips or techniques, such as use of a different size racket and/or use of 2-handed backhands in tennis, may relieve the problem.


Anti-inflammatory medications may help alleviate the elbow pain.

Elbow Brace

A tennis elbow brace — a band worn over the muscle of the forearm, just below the elbow — can reduce the tension on the tendon and allow it to heal.

Physical Therapy

Physical therapy for the elbow may include stretching exercises, strengthening exercises, and ultrasound or heat treatments.

Steroid Injections

A steroid is a strong anti-inflammatory medication that can be injected into the area. No more than three injections should be given.

Shockwave Treatment

A new type of treatment, available in the office setting, has shown some success in 50–60% of patients. This is a shockwave delivered to the affected area around the elbow, which can be used as a last resort prior to the consideration of surgery.


Surgery is only considered when the pain is incapacitating, has lasted for more than six months, and has not been alleviated by other treatment options. Surgery involves removing the diseased, degenerated tendon tissue.

Two surgical approaches are available: traditional open surgery (incision) and arthroscopy, which is a procedure performed with instruments inserted into the joint through small incisions. Both options are performed in the outpatient setting.

Recovery from surgery includes physical therapy to regain motion of the arm. A strengthening program will be necessary in order to return to prior activities. Recovery can be expected to take 4–6 months.

If you are experiencing elbow pain and believe it may be lateral epicondylitis, Dr. Arora can evaluate your condition for a thorough diagnosis. Braces for tennis elbow treatment are also available right at each of the southeast Michigan offices, and they can be obtained via insurance or by cash pay.

Make an appointment to see him in Warren or Macomb Township in Macomb County, West Bloomfield in Oakland County, or Howell in Livingston County.

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Dr. Aroras office from my first call to schedule my appointment was friendly. Walking in the first day, I felt like I was in a nice atmosphere. Dr. Arora was EXCELLENT in taking great care of my hand injury. He was gentle and very understanding to the concerns I had about my hand. His expertise was admirable and I would recommend anyone with an injury to their hand to his office to be under his care. Because of him, I have healed faster than expected and will make an 100% recovery! Thank you Dr.

Jackie S.

I first thought I was going to have to have painful injections or surgery, but Dr. Arora suggested physical therapy may do the trick. I was doubtful, but I agreed to do it. Now, my pain is gone, and with the help of an ergonomic keyboard at work to keep my hands in the correct position, I am virtually pain free. The therapy strengthened my wrists and shoulders, and built more flexibility into my wrists.

Jerry T.

My experience with this doctor was positive from the outset. Dr. Arora was kind and spent a great deal of time with me. Staff was friendly. The office was nice and bright.

Ariel G.

Very friendly and helpful Great staff!!! Doctor Arora was very professional and did great work. I was very happy with everything!

L B.