Treating the symptoms and pain involves medications such as NSAIDS or acetaminophen, a wrist brace, or a strap over the upper forearm.

[10] Patients typically feel pain or burning around the outer part of the elbow (lateral epicondyle of the humerus), which can move down the forearm and sometimes up to the upper arm.

However, it is often linked to repetitive microtrauma resulting from excessive gripping, wrist extension, radial deviation, and/or forearm supination.

Repetitive stress causes microtears, scar tissue formation, and biomechanical changes, worsening symptoms over time.

The importance of this finding is that other conditions characterized by nocturnal or early morning symptoms may also be worsened by a “pathological sleep position.”[28] We know this applies to carpal and cubital tunnel syndrome, plantar fasciitis, shoulder/neck pain and Gerd[29].

[15] Cozen's test is a physical examination performed to evaluate for tennis elbow involving pain with resisted wrist extension.

[31] The test is said to be positive if a resisted wrist extension triggers pain to the lateral aspect of the elbow owing to stress placed upon the tendon of the extensor carpi radialis brevis muscle.

NOTE: With elbow flexed the extensor carpi radialis longus is in a shortened position as its origin is the lateral supracondylar ridge of the humerus.

[30] Medical ultrasonography and magnetic resonance imaging (MRI) can demonstrate the pathology, but are not helpful for diagnosis and do not influence treatment.

Although the term “epicondylitis” is frequently used to describe this disorder, most histopathologic findings of studies have displayed no evidence of an acute, or a chronic inflammatory process.

Histologic studies have demonstrated that this condition is the result of tendon degeneration, which replaces normal tissue with a disorganized arrangement of collagen.

Lifting with the palm up and avoiding palm-down movements can shift strain from the lateral to the medial epicondyle, easing pain.

[48] Research indicates that  corticosteroid injections improved outcomes more effectively than NSAIDs within four weeks but offered no long-term benefits at 12 months.

[41] Other studies suggest that, while helpful for short-term pain relief, corticosteroid injections are less effective than watchful waiting or physical therapy after one year.

[50] While many alternative treatments, such as shockwave, laser, low-frequency electrical nerve stimulation, ultrasound, and pulsed magnetic wave therapies, have been used, none have been proven effective.

[57] Additionally, variations in PRP preparation methods and injection techniques across different commercial systems add further complexity to assessing its effectiveness.

This technique has been demonstrated to be safe, reliable, and cost-effective[10][61] Good midterm outcomes in pain relief have been widely reported with a percutaneous surgical approach.

[10] However there is some limited evidence reported that arthroscopic and open techniques achieved a better prognosis than the percutaneous surgical approach for the treatment of lateral epicondylitis.

[62] In recent years, a new technique termed as ultrasound-guided percutaneous tenotomy has been reported as a safe and effective for the treatment of lateral epicondylitis, with improvements in symptoms, function, and ultrasound imaging at 1-year follow-up.

[62] In the past, studies have shown good long term effects and fewer complications with arthroscopic surgery compared to open or percutaneous approaches.

[62] However, the literature is currently mixed with some recent reviews suggest no significant differences among open, arthroscopic, and percutaneous methods regarding recovery time, complication rates, or patient satisfaction.

[64][62] While others state that arthroscopic surgery may allow for a quicker return to work, suggesting a potential advantage in the early postoperative period.

[65] While results are generally positive, arthroscopic surgery carries risks of injury to the radial nerve and lateral ulnar collateral ligament.

[66][67] The incidence of lateral elbow tendinosis has declined, which could be due to shifts in diagnostic practices or an actual drop in cases.

[69] The shortcomings of the evidence that addresses the relationship between symptoms and occupation/sport include: variation in diagnostic criteria, limited reliability of diagnosis, confounding association of psychosocial factors, selection bias due to a high non-response rate, and the fact that exposures are usually by subjective patient reports and symptomatic patients might receive greater exposure.