CONTEMPORARY DIAGNOSTIC APPROACHES AND THERAPEUTIC OPTIONS FOR LATERAL EPICONDYLITIS: A COMPREHENSIVE REVIEW
Abstract
Lateral epicondylitis (LE), commonly known as tennis elbow, is a prevalent tendinopathy involving the extensor origin at the lateral humeral epicondyle. It represents a frequent cause of pain and functional limitation in adults performing repetitive upper-limb activities.
This review aims to summarize current evidence regarding the diagnosis and management of LE, integrating findings from clinical, radiological, and therapeutic studies.
A systematic search of the PubMed database and manual review of relevant literature were conducted, including studies published in English and Polish that addressed diagnostic techniques and treatment strategies for LE.
Diagnosis is primarily clinical, supported by imaging modalities such as ultrasound and MRI in refractory or atypical cases. Conservative treatment - comprising patient education, ergonomic modification, and progressive loading - remains first-line management. Pharmacological interventions, including topical NSAIDs and short-term corticosteroid injections, offer temporary symptom relief but limited long-term benefit. Adjunctive modalities such as extracorporeal shock wave therapy and acupuncture may improve pain and function in selected patients, whereas low-level laser therapy shows inconsistent results. Surgical intervention, reserved for chronic and treatment-resistant cases, yields favorable outcomes with both open and arthroscopic approaches. Emerging regenerative therapies, particularly mesenchymal stem cell injections, demonstrate encouraging preliminary outcomes but require further validation through large-scale clinical trials.
The management of lateral epicondylitis should follow an evidence-based, stepwise approach emphasizing conservative care and individualized escalation. While novel regenerative modalities show promise, robust randomized data are needed to confirm their efficacy and establish standardized treatment protocols.
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