Pain and tenderness along the lateral or outer edge of the elbow is a common problem that is seen in my office. It usually occurs after an activity where overuse or excessive demand has been placed on the elbow. Many times it becomes chronic in nature. It occurs in up to half of all tennis players, but most of the patients I see present after repetitive wrist and elbow movements.
One of the first symptoms is pain with decreased grip strength. I will have the patient shake my hand and often it will cause lateral elbow pain. Also placing the wrist into extension (bending backwards) against resistance will cause pain.
X-rays are almost universally negative and there is no need for an MRI intially.
The treatment is almost always conservative: rest with activity changes, ice, non-steroidal anti-flammatory medication, physical therapy, tennis elbow brace and sometimes a steroid injection.
I always counsel patients that tennis elbow can take months up to a year to resolve. In the 1% that do not respond to conservative treatment then surgery which involves a small incision may be necessary.