Hyaluronate Injection for Lateral Epicondylitis

Inclusion Criteria: * Included will be patients older than 18 years with lateral epicondylitis. The criteria for diagnosis will include pain and tenderness at the lateral epicondyle worse with resisted wrist or finger extension (with the elbow in the extended position). Exclusion Criteria: * Excluded will be patients with history of prior elbow surgery, history of fracture or dislocation, known inflammatory or autoimmune disorders, or known hypersensitivity to HA. * Exclusion will also include a known allergy to birds, feathers or egg products. If the patient has complaints of pain or tenderness on exam in the area of the radial neck, then a component of radial tunnel syndrome will be assumed and these patients will be excluded from study. * Patients that are pregnant will be excluded. * Patients with medial epicondylitis * Prior elbow surgery * Elbow steroid injection in the past 3 months * Inflammatory condition, like rheumatoid arthritis or lupus