Lateral & Medial Epicondylitis (Tennis & Golfer's Elbow)

Grip pain, forearm weakness, and elbow ache — not just for athletes

Conditions Treated

Neck Pain
Trigeminal Neuralgia
Back Pain
Knee pain
Buttock Pain
Shoulder Pain
Pain Due To Vascular Diseases
Hip Pain
Cancer Pain And Palliative Care

Overview

Lateral epicondylitis (Tennis Elbow) and medial epicondylitis (Golfer's Elbow) are among the most prevalent upper-limb tendinopathies, frequently affecting IT professionals, surgeons, homemakers, and manual workers — not just sportspeople. Lateral epicondylitis involves degeneration of the extensor carpi radialis brevis (ECRB) tendon at its origin on the lateral epicondyle; medial epicondylitis involves the flexor-pronator mass at the medial epicondyle. Both result in activity-limiting forearm and elbow pain.


Symptoms & Causes

Common Symptoms

  1. Lateral epicondylitis: pain on outer elbow radiating to forearm
  2. Medial epicondylitis: pain on inner elbow, sometimes with ulnar nerve tingling
  3. Weak grip strength and difficulty holding objects
  4. Pain with wrist extension (tennis elbow) or flexion (golfer's elbow)
  5. Tenderness to touch at the epicondyle
  6. Pain with handshake, opening jars, lifting kettles
  7. Stiffness in the morning or after rest
Common Causes

  1. Repetitive forearm use — typing, mouse work, assembly-line tasks
  2. Sports: racquet sports, golf, cricket bowling
  3. Occupational overuse — plumbers, painters, dentists, surgeons
  4. Eccentric overload and microtrauma to tendon origin
  5. Age-related tendon degeneration (collagen disorganisation)
  6. Poor ergonomic setup (screen and desk height)
  7. Sudden increase in training load without conditioning

Conservative & First-Line Treatment

  • Activity modification and ergonomic correction
  • Counterforce brace (epicondylitis clasp)
  • Eccentric strengthening exercises (Tyler Twist for lateral)
  • NSAIDs, topical diclofenac
  • Physiotherapy — manual therapy, deep friction massage
  • Shockwave therapy (ESWT)

How Vedant Pain Management Clinic Can Help

Our interventional pain specialists offer the following evidence-based procedures, all performed with real-time ultrasound guidance for precision and safety:

  • Ultrasound-guided PRP injection into the tendinopathic zone — supported by strong Level 1 evidence for chronic epicondylitis
  • Ultrasound-guided prolotherapy injections for recalcitrant cases
  • Ultrasound-guided dry needling of tendon pathology (tenotomy)
  • Diagnostic musculoskeletal ultrasound to assess degree of tendon degeneration and presence of neovascularity
  • Ultrasound-guided corticosteroid injection for acute flares (short-term relief)
  • Lateral cutaneous nerve of the forearm block for refractory cases

Newer Diagnostic Concepts & Advances

The term 'tendinopathy' has largely replaced 'tendinitis' as histology consistently shows collagen disorganisation (angiofibroblastic dysplasia) rather than inflammatory infiltrate. Additionally, posterior interosseous nerve entrapment (Radial Tunnel Syndrome) can perfectly mimic lateral epicondylitis — ultrasound-guided diagnostic nerve block helps differentiate the two at Vedant Pain Clinic.

Frequently Asked Questions

Corticosteroid injections provide short-term relief but can worsen the underlying tendon degeneration with repeated use. Chronic epicondylitis is primarily a degenerative condition, not inflammatory — which is why PRP (which promotes tendon regeneration) is now the preferred evidence-based treatment at Vedant Pain Clinic.

Most patients require 1–2 sessions, spaced 4–6 weeks apart. Clinical studies show 75–85% of patients with chronic refractory tennis elbow achieve significant improvement with 2 ultrasound-guided PRP injections.

Yes, with modifications. We will advise on ergonomic changes, grip force reduction, and bracing techniques that allow you to continue working through treatment. Complete rest is not necessary and can be counterproductive.

The principles are similar, but medial epicondylitis requires extra care due to proximity of the ulnar nerve. All our injections are performed under real-time ultrasound guidance to ensure precision and safety.

Acute cases (< 3 months) typically respond within 4–8 weeks. Chronic cases may take 3–6 months with a combined injection + physiotherapy protocol. Dry needling / tenotomy is an option for very resistant tendon degeneration.
Meet Our Specialist

Dr. Mohit Gupta

Interventional Pain Physician & Pain Specialist

Dr. Mohit Gupta is a highly experienced Interventional Pain Physician dedicated to helping patients overcome chronic pain and regain a better quality of life. He combines advanced, minimally invasive pain management techniques with compassionate, personalized care.

10+ Years Experience
Advanced Pain Therapies
Patient-First Care
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Dr Mohit Gupta