Tennis elbow
Your health expert: Damian McClelland, Clinical Director for Musculoskeletal Services at Bupa
Content editor review by Sarah Smith, March 2021
Next review due March 2024
Tennis elbow is a common condition that causes pain in your forearm and around the outside of your elbow. Despite its name, most people don’t get it from playing tennis. It’s usually caused by repeated movements. For example, from playing a whole range of sports or doing repetitive activities like hammering or typing. It usually gets better with rest and over-the-counter painkillers.
What is tennis elbow?
Tennis elbow is a type of tendinopathy, which means it affects your tendons. It develops when your common extensor tendon (which joins your forearm muscles to the outside of your elbow) develops tiny tears and then thickens and swells. This causes pain and tenderness.
Tennis elbow is a common condition that affects between one and three people in every 100. Anyone can get tennis elbow, but you are most likely to get it in your 40s and 50s. You can get it in both arms, but it usually develops in the arm you use most.
It usually develops gradually and, depending on how severe it is, 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 and 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 symptoms to doing a particular job or an action using your forearm or elbow. Doing this action usually makes the pain worse. Gripping actions can also make the pain worse. So, you might 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 become damaged. This happens if you’re repeating the same motion over and over again. Tiny tears develop in the muscles and over time that leads to swelling and thickening.
Some activities, situations and jobs make developing tennis elbow more likely. These include:
- any job where you are doing a lot of heavy lifting or using heavy tools
- jobs where you are making repeated movements in an awkward position – for example, squeezing or twisting movements – that can include typing and using a mouse
- movements in your forearm that you’re not used to – for example, taking up a new hobby, doing DIY such as hammering or painting, or moving to a new house
- being unfit or having a poor technique when you’re playing racquet sports such as tennis – for example, not holding the racquet properly
Self-help for tennis elbow
Most people who have tennis elbow find that their symptoms get better when they rest their arm and take-over-the counter painkillers. If you do this and still have symptoms after six weeks or so, see your GP.
There are plenty of things you can do to treat your symptoms yourself, especially if the pain is mild. These include the following.
- 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 are medicines such as ibuprofen and voltarol. You can use them as a gel, which you rub onto the area where the pain is, 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. Alternatively, a heat pack may help. You can buy reusable ice packs, heat pads and microwavable heat bags. Don't put an ice or a heat pack directly onto your skin because without a covering these could damage your skin. Only use it 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 and you can buy them from some chemists and sports shops.
- 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 or mix your work patterns to allow your arm time to recover.
Diagnosis of tennis elbow
You may not need to see a doctor if you think you have tennis elbow. 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 which are painful. Your GP may ask about your medical history, what job you do and any hobbies you have which may have caused your symptoms. Your GP will usually be able to diagnose tennis elbow without needing to do other tests.
If your GP isn’t sure whether or not you have tennis elbow, they may arrange for you to have tests such as 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 other treatment for tennis elbow.
Medicines
Your doctor may suggest a steroid injection to help ease your pain if other treatments such as 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 are used less often now because they may not be very effective at easing your pain over the long term.
Physical therapies
Your GP may refer you to a physiotherapist to help you manage pain. A physiotherapist is a health 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 do to improve your strength and flexibility and ease your pain.
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 that affect the elbow. They will 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.
Prevention of tennis elbow
You may be able to prevent tennis elbow by taking steps to protect your arm muscles and tendons. If your activities involve repeated arm and wrist movements, make sure you’re doing them the right way, taking breaks and using the right equipment. 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, particularly racquet sports, you might find it helpful to get a coach to make sure you’re using the right techniques.
Looking for physiotherapy?
You can access a range of treatments on a pay as you go basis, including physiotherapy.
To book or to make an enquiry, call us on 0370 218 6528∧
How long your tennis elbow lasts, depends on how severe it is. Most people with tennis elbow feel better within a year. But it can last between six months and two years. Tennis elbow can sometimes come back again. And in some cases, it may need further treatment. There are lots of things you can do to help ease your symptoms. For more information on these, see our section on self-help above.
The most common tennis elbow symptom is pain and tenderness around the outside of your elbow and in the muscles of your forearm. This can vary from mild discomfort to severe pain that keeps you awake at night. You might find that the pain gets worse when you bend or extend your elbow or when gripping objects. You might also find it hard to do things like hold a cup or open a jar without pain. For more information, see our section on symptoms above.
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.
Some people use acupuncture as a treatment for tennis elbow. It’s a complementary therapy where fine needles are put into your skin at specific points to relieve pain.
Studies into acupuncture as a treatment for tennis elbow have had mixed results. Some suggest that acupuncture may help relieve pain for a little while, but others found there was no benefit.
If you want to try acupuncture for elbow pain, check that your therapist is registered with a professional body. The British Acupuncture Council and the Acupuncture Association of Chartered Physiotherapists (AACP) have lists of members trained to provide acupuncture.
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
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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.
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- Personal communication, Laura McKay, Lead Physiotherapist at Bupa, 13 April 2021.
