Elbow Pain Physio

Extensor Tendinopathy A Cause Of Lateral Elbow Pain

Diagnosis Of Extensor Tendinopathy

Tennis elbow is a fairly easy clinical diagnosis to make. Your physiotherapist following taking a history of the injury and some assessment techniques can usually make the diagnosis without any need for medical investigations. The injury history and reported behavior of symptoms will give clues to the presence of extensor tendinopathy and following some clinical assessment of the elbow and associated areas a provisional diagnosis of extensor tendinopathy of the elbow can usually be confidently made.

Are Investigations Required For Diagnosing Extensor Tendinopathy?

Generally investigations such as X-ray imaging, ultrasound scans, or an MRI are not necessary to diagnose the condition. The injury history and physical examination performed by your physiotherapist are enough to confirm the diagnosis. However, the presence of, or lack of inflammation coupled with the presence (and potential size of), or lack of tendon tears can dictate the best management of an individuals extensor tendinopathy. These variables and then their varied management, means that frequently investigations are still used when treating tennis elbow, particularly the stubborn episodes. MRI and ultrasound imaging are the best tests to identify tendon tears, inflammation, location and severity of tendon pathology and therefore are usually the go to investigations used when treating extensor tendinopathy. An X-ray can examine any joint changes, or help identify more sinister causes of elbow pain, but in my experience are not routinely used in tennis elbow symptom management.

The Cervical Spine And Lateral Elbow Pain

There is a high incidence of lateral elbow pain referred to the elbow from your neck (cervical spine). Meaning that there will be a percentage of people who are suffering with tennis elbow symptoms that are not actually experiencing tennis elbow, but have referred pain mimicking an extensor tendinopathy. The mid, to low cervical spine levels C5-6 are the common joint levels in the neck that refer to the outside of your elbow, as they will pass their pain signals along what is know as the radial nerve. Irritation to these nerve roots and/or the radial nerve can cause symptoms very similar to tennis elbow.
What this means, is that it is important if you are suffering with lateral elbow pain suspected to be from tennis elbow it is still a sensible idea to have your neck and upper limb nerve function assessed by your physiotherapist. A physiotherapist should be able to help confirm (or exclude) any neck, or neural involvement in your elbow pain. Failure to recognise involvement of the neck in a tennis elbow condition and applying only local treatment to the elbow when the neck is a contributor, or cause of symptoms will most likely lead to inferior results in recovery.

Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Extensor Tendinopathy A Cause Of Lateral Elbow Pain should consult his or her physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.