Tennis elbow is a common condition that causes pain in the forearm and outside of the elbow. Despite its name, most people don't get it from playing tennis. It is usually caused by repeated movements. For example, participating in various sports or performing repetitive activities such as tapping or typing. Rest and over-the-counter pain relievers usually get better.
Tennis elbow is a tendinopathy, which means it affects your tendons. It develops when your common extensor tendon (which connects the forearm muscle to the outside of the elbow) produces a tiny tear that then thickens and swells. This can cause pain and tenderness.
Tennis elbow is a common condition that affects one to three people out of every 100. Anyone can get tennis elbow, but you're most likely to get tennis elbow in your 40s and 50s. You can get it on both arms, but it usually develops on the arm you use the most.
It usually develops gradually and, depending on its severity, can last from six months to two years. Sometimes, it may reappear in the future.
Symptoms of tennis elbow
The most common tennis elbow symptoms are pain and tenderness in the outer elbow and forearm muscles. This usually gets worse when you bend and extend your elbows. You may be able to move your elbow completely and it will feel normal except for pain. The pain can range from mild discomfort to severe pain that keeps you awake at night.
You can link the onset of symptoms to specific tasks or movements using your forearm or elbow. Doing this movement usually makes the pain worse. Grasping can also make the pain worse. So, you may find it painful to do things like hold a cup or open a jar.
Causes of tennis elbow
Tennis elbow develops when the muscles and tendons of the forearm are damaged. This can happen if you repeat the same action over and over. Tiny tears can develop in the muscle, which can lead to swelling and thickening over time.
Certain activities, situations, and jobs make developing tennis elbow more likely. These include:
Any job that requires heavy lifting or the use of heavy tools
- Your work in awkward positions with repetitive movements - for example, squeezing or twisting movements - may include typing and using the mouse
- Forearm exercises you are not used to - for example, taking up a new hobby, doing DIYs like hammering or painting, or moving to a new house
- Physical discomfort or poor technique when playing racket sports such as tennis - for example, not holding the racket properly
Tennis Elbow Remedy
Most people with tennis elbow find that their symptoms get better when they rest their arms and take over-the-counter pain relievers. If you do this and still have symptoms after six weeks or so, see your GP.
There are many things you can do to treat symptoms yourself, especially if the pain is mild. These include the following.
Rest your elbows and arms as much as possible. Try not to perform activities and actions that make your pain worse—for example, lifting, grasping, or twisting your arms. If you need to lift something heavy, bend your elbows and make sure your palms are facing up.
Use over-the-counter pain relievers, such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are drugs such as ibuprofen and votalol. You can use them as a gel to apply to the painful area, or you can take ibuprofen as a tablet. Be sure to read the Patient Information Leaflet that came with your medicine. If you have any doubts, ask your pharmacist.
Cold compresses on your elbow may temporarily relieve pain. You can use a bag of frozen peas wrapped in a tea towel or ice pack. Alternatively, a warm compress may help. You can buy reusable ice packs, heating pads, and microwave heat packs. Don't put ice cubes or heat packs directly on your skin, as these can damage your skin without a covering. Only use it for about 15 minutes every few hours.
You can try wearing special tennis elbow straps, buckles, splints, or braces to support your forearm when you do activities that can make your pain worse. These braces are sometimes called epicondylitis buckles, and you can buy them from some chemists and sporting goods stores.
If your symptoms are worsened by activities you do at work, contact your employer's occupational health counselor or talk to your employer. Ask if you can change your tasks, take more breaks or mix up your work patterns to give your arms time to recover.
Diagnosis of tennis elbow
If you think you have tennis elbow, you probably don't need to see a doctor. You may be able to treat it at home. However, if your symptoms worsen and self-help and over-the-counter pain relievers do not work, contact your GP for advice.
Your doctor will ask about your symptoms and examine your elbow. You'll be asked to move your arms and elbows in different ways to see which ones are painful. Your GP may ask about your medical history, your job and any hobbies that may be causing your symptoms. Your GP can usually diagnose tennis elbow without additional tests.
If your GP is not sure if you have tennis elbow, they may order tests such as an X-ray, ultrasound, CT scan or MRI scan. These provide detailed images of the elbow joint and can help identify what is causing the symptoms.
Treatment of tennis elbow
If you've tried resting your arm and taking pain medication but still have symptoms after six weeks, your GP may recommend other treatments for tennis elbow.
If other treatments, such as physical therapy and pain relievers, don't work, your doctor may recommend steroid injections to help relieve pain. Steroids can be injected directly into your most painful area. These injections may help reduce inflammation and relieve symptoms for a few weeks. But steroid injections are less used now because they may not be very effective in relieving pain in the long run.
Your GP may refer you to a physiotherapist to help you manage your pain. Physical therapists are health professionals who specialize in maintaining and improving movement and mobility. They may use a variety of techniques, including deep tissue massage, ultrasound therapy, and tape. You may need physical therapy exercises to improve your strength and flexibility and reduce your pain.
Other tennis elbow treatments
Your GP may refer you to an orthopaedic consultant if self-help, medication and physiotherapy do not seem to be working after six months or so. This is a specialist in the treatment of musculoskeletal problems, including those affecting the elbow. They will discuss other treatment options with you, such as surgery and other types of injections. These are specialized treatments and are only used when other options have not worked.
Prevention of tennis elbow
You can prevent tennis elbow by taking steps to protect your arm muscles and tendons. If your activity involves repetitive arm and wrist movements, make sure you're doing it the right way, resting, and using the right equipment. If you've had tennis elbow in the past and want to prevent it from happening again, you may need to change some of the activities you do.
If you play sports, especially racket sports, you may find it helpful to have a coach to make sure you're using the correct technique.
Frequently Asked Questions
How long can tennis elbow last?
How long your tennis elbow can last depends on how severe it is. Most people with tennis elbow will feel better within a year. But it can last from six months to two years. Tennis elbow can sometimes reappear. In some cases, it may require further treatment. There are many things you can do to help relieve symptoms. See our self-help section above for more information on these.
What does tennis elbow feel like?
The most common tennis elbow symptoms are pain and tenderness in the outer elbow and forearm muscles. This can range from mild discomfort to severe pain that will keep you awake at night. You may find that the pain increases when you bend or extend your elbow or grasp objects. You may also find it difficult to do things without pain, such as holding a cup or opening a jar. For more information, see our section on symptoms above.
How long can you wear a tennis toggle or brace?
Some people find that wearing a tennis elbow or brace helps relieve symptoms. It is recommended that you wear support during activities that can worsen tennis elbow, such as typing on a computer for extended periods of time. Then take it off while you rest. While this won't get rid of your tennis elbow, it may help relieve your pain in the short term.
Can tennis elbow be treated with acupuncture?
Some people use acupuncture to treat tennis elbow. This is a complementary therapy in which thin needles are inserted into your skin at specific points to relieve pain.
The results of studies on acupuncture for tennis elbow have been mixed. Some people think acupuncture may help relieve pain for a while, but others find no benefit.
If you want to try acupuncture for elbow pain, check to see if your therapist is registered with a professional body. The British Acupuncture Council and the Acupuncture Association of Chartered Physiotherapists (AACP) have a list of members trained in acupuncture.
What is the difference between tennis elbow and golfer's elbow?
Tennis elbow and golfer's elbow are different conditions, but they are very similar. Both can be caused by repetitive motion and both cause elbow pain. But in tennis elbow, the pain is on the outside of the elbow, while in a golfer's elbow, the pain is on the inside.