Tennis Elbow

This factsheet is for people who have tennis elbow, or who would like information about it.

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

  • About tennis elbow
  • Symptoms of tennis elbow
  • Causes of tennis elbow
  • Diagnosis of tennis elbow
  • Treatment of tennis elbow
  • Prevention of tennis elbow

About tennis elbow


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

Tennis elbow may develop when the tendon that joins the muscles of your forearm to your upper arm (the humerus) becomes damaged and painful. The tendon is called the common extensor tendon (see diagram).


Tennis Elbow


Tennis elbow is a common condition that affects between one and three in 100 people. Anybody can get tennis elbow but it’s most common in people aged between 40 and 60. Depending on the severity, tennis elbow can last between six weeks and two years.

Tennis elbow is most often caused by repeatedly overusing the muscles in your arm or by minor injury. It often gets worse if you continue 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 will often develop gradually over time and your pain may become constant.

You may feel pain 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 doctor or physiotherapist (a health professional who specialises in maintaining and improving movement and mobility) for advice.

If you have severe elbow pain, can’t move your elbow joint or have any loss of feeling, you should seek urgent medical attention.

Causes of tennis elbow


Playing racquet sports, such as tennis or badminton, can cause tennis elbow. However, most people who get tennis elbow don’t play tennis. The most common cause of tennis elbow is repeated overuse of your arm.

A range of different activities that involve repeated hand, wrist and forearm movements can also cause tennis elbow. Examples of these include:

  • using a screwdriver
  • sewing or knitting
  • using a keyboard and mouse
  • painting
  • gardening

You may also get tennis elbow if the muscles in your shoulder are weak, which places more stress on the muscles around your elbow and wrist.

Rarely, you can damage your tendon after a single and often minor incident, such as lifting something heavy or taking part in an activity that you don’t do very often. These activities can cause small tears in your tendon.

Diagnosis of tennis elbow


You don’t usually need to see your doctor if you think you have tennis elbow. However, if your symptoms get worse and aren’t helped by self-help measures and over-the-counter painkillers, see your doctor or physiotherapist for advice.

Your doctor or physiotherapist will ask you about your symptoms and examine you. He or she may also ask you about your medical history. He or she can usually diagnose tennis elbow from examining your arm and finding out how your symptoms developed. Further tests are rarely needed, however your doctor or physiotherapist may recommend having an X-ray to rule out other conditions, such as arthritis, that can cause elbow pain.

If you have severe tennis elbow that hasn’t got better with normal treatment, your doctor or physiotherapist may recommend an ultrasound scan. An ultrasound scan uses sound waves to produce an image of the inside of your arm.

Treatment of tennis elbow


To make a full recovery, you will need to change the way you use your arm so that your tendon can rest and has time to heal. How you do this will depend on how you developed tennis elbow and how severe it is.

Physical therapies

Your doctor may refer you to a physiotherapist if he or she thinks physiotherapy will help to treat your tennis elbow. Your physiotherapist may try various techniques to reduce your pain. These may include exercises, deep tissue massage and acupuncture.

Your physiotherapist may give you a programme of exercises to do that stretches your muscles and that improves the movement and strength of your elbow and wrist. He or she will be able to advise you on this.

You may be given advice about your posture and ways to change an activity that may be causing your symptoms.

Non-surgical treatments

If over-the-counter painkillers and other treatments don’t ease your pain, your doctor may suggest an anti-inflammatory injection.

Extracorporeal shockwave therapy passes high-energy shockwaves through the skin of the painful area to relieve pain. Research has shown that shockwave treatment is safe. Speak to your doctor for advice

Surgery

It’s rare, but if you have severe tennis elbow that has been causing you problems for many months, you may have surgery. This aims to repair the damaged part of your tendon.

Prevention of tennis elbow


Tennis elbow is usually caused by overuse of your arm, so it can be prevented. A few sensible precautions include:

  • warming-up before activity with five minutes of gentle movements – this allows time for your muscles to adjust to the extra stresses and strains
  • trying not to do the same activity for long periods of time – take regular breaks
  • seeking advice early from your doctor or physiotherapist if you notice a problem
  • stopping the activity that’s causing the problem or find a different way to do it

To prevent a previous tennis elbow injury from coming back, you should:

  • rest between sessions
  • not play sport if your arm is painful
  • get professional advice on your technique and the equipment you’re using if you play racquet sports regularly
  • perform exercises to strengthen the tendon in your arm, as advised by your physiotherapist

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