Lateral epicondylalgia or epicondylitis: what's in a name?

The condition first known as ‘‘tennis elbow’’ has been recognized for over a century. Typical signs and symptoms include pain and tenderness over the lateral epicondyle, exacerbated by resisted wrist extension and passive wrist flexion, and impaired grip strength. Although many tennis players may experience this condition, most cases are associated with work-related activities or have no obvious precipitating event. As a result, the term now most widely used is lateral epicondylitis. Yet, this name implies a pathological basis that is contrary to longstanding, albeit evolving, evidence that it is not an inflammatory condition. It is therefore recommended that it is time to adopt a new and more appropriate term, such as epicondylalgia (suffix algia means pain), that does not reflect such underlying pathology. This Journal has recently embraced this terminology. A review of the current histopathological evidence as detailed below provides a strong rationale for this change in nomenclature.