Evaluating concomitant lateral epicondylitis and cervical radiculopathy

Figure – Lateral epicondylitis, or tennis elbow, occurs most frequently in the extensor carpi radialis brevis tendon. The high incidence of lateral epicondylitis in patients with cervical radiculopathy suggests a correlation between C6 and C7 radiculopathy and the onset of lateral epicondylitis. Background A diagnosis of lateral epicondylitis, described as a condition causing pain in the lateral elbow of tennis players, was first made in 1883. This injury occurs most frequently in the extensor carpi radialis brevis (ECRB) tendon (Figure). The degree of injury may vary from a slight disruption of collagen fibers to a partial or full tear of the ECRB and its attachment to the lateral epicondyle.1-3 Patients with lateral epicondylitis present with pain at the lateral aspect of the elbow that often radiates down the forearm. Weakness in grip and arm strength often is reported. Tenderness is present with palpation of the lateral epicondyle over the extensor mass. The onset of symptoms often is gradual, but it may be related to a specific injury.4 Lateral epicondylitis may be managed nonsurgically or surgically. Nonsurgical treatment has a success rate of up to 90%.5 Operative treatment is indicated if extensive conservative care has not been successful or pain inhibits performance of activities of daily living. Surgical techniques include open surgery; arthroscopic lateral release; and percutaneous treatment to debride gray, friable, angiofibrotic tissue.5-7 Lateral epicondylitis may present concomitantly with cervical radiculopathy, which may radiate pain