Tennis elbow overview

Overview

Tennis elbow is a painful condition where the tendons that attach to the outside of your elbow become irritated or damaged. It is caused by repeated or forceful movements of your wrist and arm, not just by playing tennis.

Yes, tennis elbow is quite common. It affects about 1 to 3 in 100 people each year.

It mainly affects adults between 40 and 60 years old, but it can happen at any age. People whose jobs or hobbies involve repetitive arm movements are at higher risk.

Symptoms

Common symptoms

• Pain on the outside of the elbow that may spread down the forearm
• Pain when you lift or bend your arm, or when you grip something (like a coffee cup or doorknob)
• Tenderness to touch on the bony bump on the outside of the elbow
• Stiffness in the elbow, especially in the morning
• Weakness in the affected arm

Symptoms in children

• Tennis elbow is rare in children. If a child has elbow pain, it is more likely from an injury or growing pains.

Symptoms in older adults

• Older adults may have more trouble with daily tasks like opening jars or lifting groceries.
• Pain may be less sharp but more constant.

Causes

Main causes

• Repeated use of the wrist and arm muscles, especially gripping or twisting motions
• Overusing the tendon that connects the forearm muscles to the elbow
• Doing activities with poor technique or using tools that are too heavy or vibrating

Risk factors

• Jobs that involve repetitive arm movements (e.g., plumbing, painting, carpentry, cooking)
• Hobbies like tennis, racquet sports, or gardening
• Using poor form or equipment that is the wrong size
• Age between 40 and 60
• Smoking may increase risk

When to see a doctor

See a doctor urgently if:

• Your pain is sudden and severe after an injury
• Your elbow is swollen, red, or feels hot to touch
• You have a fever along with elbow pain

Book a routine appointment if:

• Pain does not improve after 2 weeks of rest and home care
• The pain is making it hard to do everyday tasks
• You have questions about how to manage the condition

Diagnosis

A doctor will ask about your symptoms and when they started. They will check your elbow for tenderness and ask you to move your wrist and arm in certain ways to see what hurts.

Tests that may be done

• Usually no tests are needed. The diagnosis is based on your history and physical exam.
• Sometimes an ultrasound or MRI scan may be used to rule out other problems if the pain is unusual.

What to expect at your appointment

Your doctor will explain the condition and help you plan a course of rest, exercises, and pain relief. They may show you stretches to do at home.

Treatment

Treatment focuses on resting the tendon, reducing pain, and gradually strengthening the arm. In most people, tennis elbow gets better within 6 to 12 months. Many treatments can help speed up recovery.

Self-care at home

• Rest the arm and avoid the activity that caused the pain
• Apply an ice pack (wrapped in a towel) to the painful area for 10-15 minutes, several times a day
• Slowly stretch and exercise the arm once the pain starts to improve
• Use a counterforce brace (a strap just below the elbow) to take pressure off the tendon
• Over-the-counter pain relievers like ibuprofen or paracetamol can help with pain and swelling

Medical treatments

If self-care is not enough, your doctor may suggest physiotherapy (exercises and manual therapy) or steroid injections (a medication given into the painful area). These can provide short-term relief. Other treatments like shockwave therapy or platelet-rich plasma injections may be considered in persistent cases.

When is surgery considered?

Surgery is rarely needed. If pain lasts more than a year despite other treatments, a doctor might recommend a small operation to remove damaged tissue from the tendon. Most people recover well after surgery.

Living with this condition

Avoid lifting or gripping with the affected arm. Use your other arm when possible. Try using larger tools with padded handles to reduce strain. Take breaks from repeated movements.

Lifestyle tips

• Use proper technique during sports or work activities
• Warm up and cool down before physical activity
• Use equipment that is the right size and weight for you

Diet and exercise

Eating a balanced diet with protein, vitamin C, and omega-3 fatty acids may help tendon healing. Gentle stretching and strengthening exercises (as advised by a physiotherapist) are important for recovery.

Mental health and emotional wellbeing

Chronic pain can be frustrating and affect mood. It may feel discouraging if activities you enjoy are painful. Talking to a friend or counselor can help. Remember that most people recover fully.

Prevention

You can reduce the risk by using proper techniques, taking breaks during repetitive tasks, and gradually increasing activity levels. Keeping the forearm muscles strong helps prevent injury.

Complications

If left untreated

• Chronic pain that may make it hard to use your arm for everyday tasks
• Weakening of the forearm muscles
• Difficulty returning to sports or work activities

Long-term outlook

The outlook for tennis elbow is excellent. With rest and self-care, most people feel better within 6 weeks to a year. Even if it takes longer, treatments and exercises can help you return to your normal activities.

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