Lateral epicondylitis: Current concepts

BACKGROUND: Lateral epicondylitis, more commonly referred to as 'tennis elbow', is a common condition seen in general practice. It effects approximately 4-7 per 1000 individuals. Despite this, the aetiology and pathophysiology remain poorly understood. Often presenting as lateral elbow pain, the differential diagnosis includes entrapment syndromes, cervical radiculopathy, osseous pathology and inflammatory conditions. Though in 90% of cases the condition is self-limiting, persistent symptoms can be difficult to manage. OBJECTIVE: In this article, a review of recent English-language journal articles explores current concepts related to lateral epicondylitis and examines the evidence behind the recommendation for the use of non-operative and operative treatment modalities. DISCUSSION: Lateral epicondylitis is an enthesopathy associated with the origin of the extensor carpi radialis brevis (ECRB) muscle. A clinical history and examination is usually sufficient to make a diagnosis. Maudsley's and Cozen's clinical tests have a high sensitivity in diagnosing lateral epicondylitis. The available evidence supports the use of non-operative treatment modalities in managing this condition. When comparing the different operative treatments described, there appears to be no significant advantage of intervention over the natural history of lateral epicondylitis.