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Tennis elbow

Key points

  • Tennis elbow is a condition that causes pain and tenderness on the outside of your elbow.
  • It’s caused when muscles and tendons become damaged from overuse. This can happen if you’re repeatedly moving the same way over and over again.
  • Most people who get tennis elbow don't play tennis.
  • For most people, tennis elbow gets better using treatments such as painkillers, rest and wearing a brace or splint.

Tennis elbow is the common name for a condition that causes pain around the outside part of your elbow.

About tennis elbow

The medical term for tennis elbow is lateral epicondylitis because it often affects the outside of your elbow bone, which is called the lateral epicondyle. This is the bony area you can feel on the outside of your elbow.

Tennis elbow develops when the tendons that join your forearm muscles on the outside of your elbow become inflamed. This causes pain and tenderness. The tendon is called the common extensor tendon.

Illustration showing the elbow joint

 

Tennis elbow is a common condition that affects between one and three people in every 100. Anyone can get tennis elbow, but it's most likely to develop when you’re between the age of 40 and 50. Depending on how severe your tennis elbow is, it can last between six weeks and two years.

Tennis elbow usually develops in the arm you use most; for example if you’re left-handed it usually develops in your left elbow.

Tennis elbow is usually caused when the muscles and tendons become damaged from overuse. This can happen if you’re repeatedly doing the same motion over and over again. It can get worse if you keep doing the activity that causes your pain.

Symptoms of tennis elbow

The most common symptom is pain and tenderness on the outside of your elbow and in the muscles of your forearm. Your symptoms can develop gradually over time and you may not be able to link them to any particular event or injury. The pain can vary from mild discomfort to severe pain which can disrupt your sleep.

Your pain may get worse when you:

  • grip something, for example holding a pen or shaking someone's hand
  • twist your forearm, for example turning a door handle
  • use your keyboard or mouse
  • fully lengthen (extend) your arm

Many people with mild symptoms of tennis elbow find that their pain eases with rest and self-help treatments. However, if your symptoms don't improve after a couple of weeks, see your GP or physiotherapist for advice.

If you have severe elbow pain, can't move your elbow joint or have any loss of feeling, you should see your GP straight away.

Causes of tennis elbow

If you play a racquet sport, such as tennis or badminton, it can cause tennis elbow. However, most people who get tennis elbow don't play tennis.

The most common cause of tennis elbow is doing activities where you’re repeatedly gripping and twisting your wrist. For example, if you’re a carpenter or plasterer, or if you use a computer mouse, you’re more likely to develop tennis elbow.

Diagnosis of tennis elbow

You may not need to see your GP if you think you have tennis elbow, as you may be able to treat it at home. However, if your symptoms get worse and aren't helped by self-help measures and over-the-counter painkillers, see your GP or physiotherapist for advice.

Your GP or physiotherapist will ask you about your symptoms and examine you. He or she may also ask you about your medical history. Your GP can usually diagnose tennis elbow by examining your arm and finding out how your symptoms developed.

You probably won’t need further tests. However, your GP or physiotherapist may recommend having an X-ray to rule out other conditions, such as arthritis, that cause elbow pain.

Treatment of tennis elbow

The treatment for tennis elbow depends on how severe it is and how much it affects your day-to-day life. To make a full recovery, you may need to change the way you use your arm. This is so your tendon can rest and has time to heal.

Self-help

You can treat your symptoms yourself if they are mild. Some of the main self-help treatments are described below.

  • Rest your elbow and tendon by changing the activity that caused the problem. If the problem has developed as a result of an activity at work, contact your employer's occupational health adviser, if available, or talk to your employer. They can give you advice on how to change the activity that caused the problem, allowing your arm to heal, and preventing the injury from recurring in the future.
  • Putting a cold compress or a heat pack on your elbow can help to ease your pain. Hold this against your elbow for 10 minutes every two hours. Don't apply ice or a heat pack directly to your skin as it can damage your skin.
  • Wear a strap, splint or brace around your forearm to help relieve the strain through your tendon. You can buy braces and splints from some physiotherapists, pharmacies and sports shops. Don't wear a strap or splint all the time. (See our FAQs for more information)
  • If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Non-steroidal anti-inflammatory painkillers (also known as NSAIDS), such as ibuprofen, are available as a cream or gel that you can put directly on your skin, or you can take them as a tablet. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
  • Gentle exercises, specifically for tennis elbow, can help to ease stiffness, strengthen your joint and help you to get the full amount of movement back.

Medicines

If over-the-counter painkillers and other treatments don't ease your pain, or your pain is severe, your GP may suggest a steroid joint injection. A steroid (a type of hormone) is injected into the painful area of your arm.

Most people find steroid joint injections ease their pain initially. However, they can stop working over a long period of time. If you have had tennis elbow for more than six weeks then a steroid injection may not work.

Physical therapies

Your GP may refer you to a physiotherapist. He or she may try various techniques to reduce your pain. These may include exercises, deep tissue massage, ultrasound therapy and laser therapy.

Complementary therapies

Acupuncture is sometimes used to treat tennis elbow, and may help to relieve your symptoms. However, there is conflicting evidence to show whether it works, or not. See our FAQs for more information. Speak to your GP or physiotherapist before trying acupuncture. If you decide to try it, check that your therapist belongs to a recognised professional body.

Non-surgical treatments

Extracorporeal shock wave therapy passes high-energy shock waves through the skin of the painful area, which can help to ease pain. Research has shown that shock wave treatment is safe but how well it works isn’t known and further research is needed. This treatment is often only used if other treatments haven't worked for you. Speak to your physiotherapist for advice.

Surgery

Tennis elbow usually gets better using the treatments listed above. However, if it doesn’t get better after other treatments, or if your pain is severe, your doctor may suggest surgery. This aims to repair or remove the damaged part of your tendon.

Prevention of tennis elbow

You may be able to prevent tennis elbow by taking steps to protect your elbow. A few sensible precautions are listed below.

  • Think about the actions you do. Be aware of your position or grip style and change them if necessary.
  • Take a short break during or between tasks that involve twisting your wrist or gripping.
  • Try using a splint. If you play sports such as tennis, make sure you have the right racquet and that you're using the right technique when you're playing.

 

Reviewed by Dylan Merkett, Bupa Health Information Team, July 2013.

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For answers to frequently asked questions on this topic, see FAQs.

For sources and links to further information, see Resources.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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