Tennis elbow – the causes and what helps

Tennis elbow can be painful and stop you from going about your work and life as normal. Here’s how to feel better.

What are the symptoms of tennis elbow?

Self-care for tennis elbow

What causes tennis elbow and who’s at risk?

When to see a doctor 

How is tennis elbow diagnosed?

Treatment for tennis elbow

How to prevent tennis elbow  

Have you noticed burning, aching pains on the outside of your elbow? Are these sensations traveling down your forearm and making it difficult to carry out everyday tasks? Tennis elbow could be to blame. Find out what the symptoms are, and how to recover.

If you’re getting a burning or aching pain on the outside of your elbow (the side facing outward when your palms face forward), coupled with stiffness and weakness, you might have tennis elbow (medically known as lateral epicondylitis).

It’s a type of [repetitive strain injury](https://www.livehealthily.com/health-library/conditions/repetitive-strain-injury) caused by overusing the same set of muscles and tendons around the elbow, for example with repeated swinging or twisting movements. 

Despite its name, the condition isn’t just caused by racket sports but any activity that involves repeat use of the elbow joint.

The good news is it’s possible to fully recover from tennis elbow. 


## What are the symptoms of tennis elbow?

The signs tend to come on gradually over a few months, with pain often getting worse over time, and include a combination of: 

- pain on the outside of your elbow, which might travel down to your lower forearm
- a weakness and difficulty when gripping things 
- stiffness and swelling.

This mix of symptoms makes it hard to do everyday things like shake hands with someone, turn a door handle, grip a tennis racket, or open a jar. 


Get help with this

## Self-care for tennis elbow

Most cases of tennis elbow will get better at home, without the need for medical treatment.  

Try these tips: 

- __avoid using your forearm and elbow__ for a few days, especially when it comes to the specific activity that’s causing your symptoms
- __apply ice__ – put an ice pack (or bag of frozen peas wrapped in a towel) on the problem area for 15 to 20 minutes, a few times a day. You can also use a heat pack
- __use a wrist or elbow brace__ to help support your elbow and lessen strain 
- __take painkillers__ such as acetaminophen (paracetamol) and ibuprofen to help ease mild pain and inflammation.

If your symptoms are caused by playing a racket sport, or some other form of equipment you use often, make sure it’s properly fitted to you (such as changing the size or switching to a looser-strung racket, for example). 


## What causes tennis elbow and who’s at risk?

You could develop symptoms from any activity that forces you to twist your wrist and bend your elbow repeatedly – from sports like tennis, baseball and golf, to activities such as painting and playing an instrument. 

An arm or elbow injury can also be the cause of tennis elbow symptoms, such as banging or knocking your elbow, but this isn’t as common. 

Over time, these repetitive actions put stress on your elbow, causing swelling of the tendons in and around the joint, which leads to tiny tears (also called microtraumas). 

It’s these micro tears that trigger the painful symptoms associated with tennis elbow.

Anyone can develop tennis elbow but you’re more likely to have the condition if you are between the ages of 35 and 54.


## When to see a doctor 

If your tennis elbow symptoms haven’t improved after rest and self-care, it’s time to see a doctor. 

You should also book an appointment if your: 

- elbow or arm is injured and you can’t move it
- pain has lasted longer than 1 week
- pain is very bad and getting in the way of day-to-day life
- elbow is discolored or swollen.


## How is tennis elbow diagnosed?

Your doctor will ask you about your medical history, how long you’ve had symptoms, what you do for work, and what seems to make the pain worse. 

This is usually followed by a physical exam. Your doctor will ask you to move your elbow and wrist in certain directions, check for swelling and tenderness, plus press on the problem area. 

If needed, you might be referred for further tests to examine different parts of your elbow and forearm, confirm a diagnosis and/or rule out other conditions. 

These tests may include: 

- __a magnetic resonance imaging (MRI) scan__ – it can reveal any damage to muscles and tendons
- __an electromyography (EMG) test__ – to show if nerve problems, such as pressure on the nerves, are causing your symptoms
- __an X-ray__ – it takes a close look at your bones to see if you have arthritis, or any other bone-related issues.


## Treatment for tennis elbow

There are a range of different treatment options available. These may include: 

- __physical therapy__ – your doctor might refer you to a specialist, who can help relieve pain and stiffness. They can also improve the flexibility around your elbow with stretches and exercises
- __platelet-rich plasma (PRP)__ – it means taking a sample of your blood and using a machine to separate healing platelets in it. These are injected into the affected area to help the healing process
- __shockwave therapy__ – when high-energy shock waves are directed to the problem area to help improve the pain. It may not work in all cases
- __tenotomy__ – when a needle is poked through your skin to the injured tendon using an ultrasound. It’s used to remove damaged tissue and speed up healing
- __steroid injections__ – sometimes these prescription medicines are recommended to reduce inflammation, especially if other methods haven’t helped. But these aren’t likely to work in the long-term 
- __surgery__ –  to remove damaged tissue might be recommended where you have very severe pain and nothing else has worked.


## How to prevent tennis elbow  

Most people with tennis elbow recover from the condition, but it’s better to stop it from happening in the first place. You could try: 

- stretching, warming up, and cooling down before or after any sports activity
- listening to your body and never ‘play through pain’ during exercise
- taking rest breaks in between activities 
- having the right equipment for the work, sport, or hobby that you do
- practicing proper technique with a coach, especially if you play a sport with repetitive movements.

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References

Amelia Glean

Jo Wheatley

Dr Tamer T Malak

Article information

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