Tennis elbow
Your health expert: Mr Damian McClelland, Trauma and Orthopaedic Surgery Consultant, Bupa UK
Content editor review by Victoria Goldman, July 2023
Next review due July 2026
Tennis elbow is a common condition that causes pain in your forearm and around the outside of your elbow. It’s often caused by repeated movements, such as typing on a keyboard or playing sport. Tennis elbow usually gets better if you rest and take painkillers.
What is tennis elbow?
Tennis elbow is a type of tendinopathy, which means it affects your tendons. The condition is sometimes called lateral epicondylitis. It may develop if overusing your forearm causes damage to your extensor tendons. These tendons join your forearm muscles to the outside of your elbow. The tendon gets tiny tears and then thickens and swells. This causes pain, tenderness or a burning sensation.
Most people don’t get tennis elbow from playing tennis. But you can get it from doing other sports or repetitive activities such as typing – for more information, see our Causes of tennis elbow section below.
Tennis elbow affects between one and three people in every 100. Anyone can get tennis elbow, but you’re most likely to get it between the ages of 35 and 54. You can get it in both arms, but it usually develops in the arm you use the most.
Tennis elbow symptoms usually develop gradually. They can be mild or severe. Tennis elbow can last between six months and two years. Sometimes, it can come back in the future.
Symptoms of tennis elbow
The most common tennis elbow symptom is pain with tenderness on the outside of your elbow and in the muscles of your forearm. This usually gets worse as you bend and extend your elbow. You’ll probably be able to move your elbow fully, and it will feel normal apart from the pain. The pain can vary from mild discomfort to severe pain that keeps you awake at night.
You may be able to link the start of your tennis elbow pain to:
- a specific injury
- a particular job
- using your forearm or elbow in a particular way
Doing certain movements, such as shaking hands or raising a cup, usually makes the pain worse. Gripping actions can make the pain worse, too. 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 in your forearm get damaged. This can happen if you’re repeating the same motion over and over again. Tiny tears develop in the muscles, and over time this leads to swelling and thickening.
You may be more likely to get tennis elbow if you:
- have a job where you’re doing a lot of heavy lifting or using heavy tools
- have a job where you’re making repeated movements in an awkward position – such as squeezing or twisting movements (eg typing and using a mouse)
- make forearm movements that you’re not used to – such as taking up a new hobby, doing DIY such as hammering or painting, or moving to a new house
- are unfit or have a poor technique when you’re playing racquet sports such as tennis – such as not holding the racquet properly
Self-help for tennis elbow
- There are plenty of things you can do to treat your symptoms yourself, especially if the pain is mild. If you still have symptoms after six weeks or so, see your GP.Rest your elbow and arm as much as you can. Try not to do activities and movements that make your pain worse – for example, lifting things, gripping things or twisting your arm. If you need to lift something heavy, bend your elbow and make sure the palms of your hands are facing upwards.
- Use over-the-counter painkillers, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs include ibuprofen, naproxen and diclofenac. You can use them as a gel, which you rub onto the painful area, or you can take ibuprofen as a tablet. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist for advice.
- A cold compress on your elbow may temporarily relieve the pain. You can use a bag of frozen peas wrapped in a tea towel or an ice pack. Or you may find that a heat pack eases the pain instead.You can buy reusable ice packs, heat pads and microwavable heat bags. Don’t put an ice or heat pack directly onto your skin because this could cause burning or irritation. Only use the pack for about 15 minutes every couple of hours.
- You could try wearing a special tennis elbow strap, clasp, splint or brace to support your forearm when you’re doing activities that can make the pain worse. These supports are sometimes called epicondylitis clasps. You can buy them from some pharmacies and sports shops.
- Some people find that acupuncture helps to ease their pain for a while. If you want to try acupuncture for elbow pain, check that your therapist is registered with a professional organisation.
If your symptoms get worse because of an activity you do at work, contact your employer's occupational health adviser or talk to your employer. Ask if you can:
- change your tasks
- take more breaks
- mix your work patterns to allow your arm time to recover
Diagnosis of tennis elbow
Tennis elbow often clears up on its own. You may be able to treat it at home. But if your symptoms get worse, and self-help and over-the-counter painkillers aren't working, contact your GP for advice.
Your doctor will ask you about your symptoms and examine your elbow. You’ll be asked to move your arm and elbow in different ways to see what’s triggering the pain. Your GP may ask about your:
- medical history
- job
- hobbies
Your GP may be able to diagnose tennis elbow without needing to do other tests. But if they’re not sure whether or not you have tennis elbow, they may arrange for you to have an X-ray, ultrasound, CT scan or MRI scan . These give detailed images of your elbow joint and can help to find out what’s causing your symptoms.
Treatment of tennis elbow
If you’ve tried resting your arm and taking painkillers but you still have symptoms after six weeks, your GP may suggest another treatment for tennis elbow.
Physical therapies
Your GP may refer you to a physiotherapist to help you manage pain. A physiotherapist is a healthcare professional who specialises in maintaining and improving movement and mobility. They may use various techniques, including deep tissue massage, ultrasound therapy and taping. You may be given physiotherapy exercises to improve your strength and flexibility and ease your pain.
Medicines
Your doctor may suggest a steroid injection to help ease your pain if physiotherapy and painkillers haven’t worked. Steroids can be injected directly into the area where you have the most pain. These injections may help to reduce inflammation and ease your symptoms for a few weeks. But steroid injections aren’t used so often these days, because they tend to work for only a short while.
Other tennis elbow treatments
If self-help, medicines and physical therapies don’t seem to be working after six months or so, your GP may refer you to an orthopaedic consultant. This is a specialist in treating musculoskeletal problems, including conditions affecting the elbow. They’ll talk to you about other treatment options, such as surgery and other types of injection. These are specialised treatments that are used only when other options haven’t worked.
Physiotherapy services
Our evidence-based physiotherapy services are designed to address a wide range of musculoskeletal conditions, promote recovery, and enhance overall quality of life. Our physiotherapists are specialised in treating orthopaedic, rheumatological, musculoskeletal conditions and sports-related injury by using tools including education and advice, pain management strategies, exercise therapy and manual therapy techniques.
To book or to make an enquiry, call us on 0345 850 8399
Prevention of tennis elbow
You may be able to prevent tennis elbow by taking steps to protect your arm muscles and tendons.
- doing them the right way
- taking breaks
- using the right equipment
If your activities involve repeated arm and wrist movements, make sure you’re:
If you’ve had tennis elbow before and you want to prevent it from happening again, you may need to change some of the activities you do.
If you’re playing sport, especially racquet sports, you may find it helpful to have a formal lesson with a coach to check you’re using the right techniques.
Tennis elbow develops gradually. But it can last between six months and two years. There are lots of things you can do yourself to ease your symptoms. See our self-help for tennis elbow section for more details.
If you have tennis elbow, you’ll usually have pain and tenderness around the outside of your elbow and in the muscles of your forearm. You may find it hard to do certain movements, such as unscrewing a jar lid, or holding things tightly. For more information, see our symptoms of tennis elbow section.
Some people find that wearing a tennis elbow clasp or brace helps to ease their symptoms. It’s recommended you wear your support when you’re doing an activity that makes your tennis elbow worse, like typing at a computer for a long period of time. Then take it off when you’re resting. Although this won’t get rid of your tennis elbow, it might help to ease your pain in the short-term.
Tennis elbow is often triggered by repeated movements, such as when you’re typing or doing DIY.It may also happen after heavy lifting or if you have poor technique when you’re playing a sport such as tennis. For more information, see our causes of tennis elbow section.
Tennis elbow and golfer’s elbow are separate conditions. But they’re also quite similar. Both can be caused by repetitive movements. In tennis elbow, the pain is on the outside of your elbow. In golfer’s elbow, it’s on the inside.
Tennis elbow can usually be treated with painkillers and self-help measures. You could see a physiotherapist for some suitable exercises. If your symptoms still don’t get better, speak to your GP. See our Self-help for tennis elbow and treatment of tennis elbow section for more details.
Physiotherapy
Steroid joint injections
If you have a painful joint from an injury or arthritis, for example, your doctor may offer you a joint injection of a corticosteroid (steroid) medicine.
Over-the-counter painkillers
Other helpful websites
Discover other helpful health information websites.
This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
Any information about a treatment or procedure is generic, and does not necessarily describe that treatment or procedure as delivered by Bupa or its associated providers.
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- Tennis elbow. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised November 2020
- Lateral epicondylitis (tennis elbow). Medscape. emedicine.medscape.com, updated March 2021
- Epicondylitis. BMJ Best Practice. bestpractice.bmj.com, last reviewed June 2023
- Tennis elbow and golfer’s elbow. Patient. patient.info, last updated September 2021
- Chartered Society of Physiotherapy. www.csp.org.uk, last reviewed May 2017
- Ibuprofen. NICE British National Formulary. bnf.nice.org.uk, last updated May 2023
- Elbow pain. Versus Arthritis. www.versusarthritis.org, accessed July 2023
- Diagnostic imaging and scans. Patient. patient.info, last updated November 2018
- Personal communication, Mr Damian McClelland, Trauma and Orthopaedic Surgery Consultant, July 2023
