Hand Conditions

Tennis Elbow (Lateral Epicondylitis)


Insertional tendinopathies (tendon degradation/collagen breakdown) of the extensor tendon muscle groups of the backside of the forearm. This form of tendonitis is commonly known as tennis elbow (although most people with lateral epicondylitis have never played tennis).


  • Pain on the lateral (outside) aspect of the elbow with wrist extension.
  • Pain that increases with extended activity, gripping, and heavy lifting.


  • Recent studies demonstrate that lateral epicondylitis is more of a degenerative tendinosis (chronic microtrauma and tendon degradation) rather than an inflammatory process.
  • Common with repetitive wrist extension activities with the wrist in pronation, as in the work done by plumbers, painters, carpenters, and butchers.



  • Rest, activity modifications, removable wrist brace and/or forearm strap, ice and NSAIDs (ibuprofen)
  • Occupational or physical therapy
  • Corticosteroid injection


  • Indicated when non-operative treatment fails.
  • The Nirschl procedure involves resection of the tendinosis (degraded) tissue and anatomical repair of the surrounding normal tissue.