Tennis elbow / Golfer's elbow

Symptoms of epicondylitis can include:

• Pain on the outer or inner part of your elbow
• Point tenderness over the the prominent part of the bone on your elbow, either on the inside or outside
• Pain from gripping and movements of your wrist, especially wrist extension and lifting movements
• Pain from activities that use the muscles that extend your wrist (for example, pouring a container of liquid, lifting with the palm down)
• Occasionally morning stiffness

Your consultant will perform a clinical examination to check whether your symptoms correspond to either tennis or golfer's elbow. The best method to tell the difference is where the pain is located. If pain occurs on the inside of the elbow it is golfer's elbow. If pain occurs on the outside it is tennis elbow.

Symptoms that are assessed include whether you experience:

• a radiating pain from the outside of the elbow to the forearm and wrist
• pain during extension of the wrist
• weakness of the forearm
• a painful grip while shaking hands or turning a doorknob
• painful keyboard use
• not being able to hold relatively heavy items in your hand.

These injuries are caused by over use. The best treatment is to rest and make lifestyle changes. A number of treatments can alleviate the pain associated with epicondylitis:

• Taking painkillers and non-steroidal anti-inflammatory drugs (NSAIDs)
• Physiotherapy
• Surgery such as a tennis elbow release or an elbow arthroscopy 

Your consultant can advise you on these options and refer you for physiotherapy. In cases where the pain is not being eased, surgery may be offered. There are many variations on the exact surgical method which may involve removing or repairing a weakened area of tendon, either through a small incision or via keyhole techniques.