Tennis Elbow (Lateral Epicondylopathy)
Tennis elbow is a common condition that causes pain on the outside of the elbow and can spread into the forearm.
Despite its name, most people with tennis elbow have never played tennis. In fact, only around 5% of cases are linked to racquet sports. Although the pain can be severe, tennis elbow does not usually mean you have seriously damaged your elbow.
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What are the symptoms?
- Pain on the outside of the elbow, especially when gripping or lifting
- Pain when twisting, such as opening jars or turning a door handle
- Tenderness when pressing on the outside of the elbow
- Morning stiffness that improves with movement
What causes tennis elbow?
The muscles that move your wrist and fingers attach to the outside of your elbow through a common tendon. Overusing these muscles, especially during sudden or repetitive tasks, can cause tendon overload. Repetitive activities like an increase in manual work, gardening, cleaning, or DIY can cause changes within the tendon that lead to pain.
Anyone can get tennis elbow. It affects both men and women equally. It is most common in adults aged 40 to 60.
This is a condition that can take 12–18 months to settle. Around 90% of people achieve complete recovery within one year.
Scans such as MRI or ultrasound are not usually needed to diagnose tennis elbow.
Steps to take to recovery
Most people recover with time, although improvement can be slow. There are several things you can do to help reduce pain and improve function.
Self-Management
Activity Modification
If symptoms have recently worsened it may be worth reducing or changing activities that make your pain worse. Trying to get a balance between rest and activity can help your pain to settle down. Pacing your activities may help. Reduce painful movements like gripping, lifting, or twisting and use ergonomic equipment if available. You may find it more comfortable to lift objects with the palm facing upwards. Gradually returning to normal activities as your symptoms improve can help your recovery.
Pain Relief
Over-the-counter medicines: Over-the-counter pain relief may help you stay active. Always follow the advice provided with the medicine.
Topical creams: Some people find topical creams or gels helpful for short-term relief of pain and stiffness.
It is important to check whether you can take these medicines. If you are unsure whether you can take these medicines, speak to a pharmacist or another healthcare professional.
Exercises
Exercises are the main treatment for tennis elbow. They help the tendon become stronger over time, although improvement is often gradual. The British Elbow and Shoulder Society tennis elbow exercises may help reduce your pain.
Splint
A splint (also called brace or strap) can help relieve pain, especially if it's severe. It works by reducing tension on the tendon. Wear the brace around your forearm, about two to three finger widths below the bony part of your elbow. It should rest just under the painful area. Use the brace during activities that involve your arm. Take it off at night or when you're resting. You may need to adjust its position slightly to find what feels most comfortable.
Further Treatment
Physiotherapy
If your symptoms aren't improving or you feel you need more help, then please refer yourself to physiotherapy. We will work with you to develop a treatment plan. You can have one-to-one physiotherapy and have access to our gym classes. We can also refer you to other services to access other treatments listed if appropriate.
Injections
In some cases, injections may reduce severe inflammation and pain for a short period. Steroid injections may reduce pain in the short term, but research suggests they may delay recovery over the longer term. They are therefore only suitable for some people.
Surgery
Considered only if symptoms are severe and don’t improve with other treatments. It is rare for people to need surgery for tennis elbow.
Lifestyle factors that influence health
Tennis elbow is influenced by how tendons are loaded, by the body’s ability to recover and our overall health. Smoking, diabetes, poor sleep, and long-term stress levels are known to negatively affect tendon health and healing. Staying active, gradually strengthening the tendons, and addressing lifestyle factors can help reduce pain and improve function. More support with health and lifestyle factors can be found on our Your Musculoskeletal Health webpage.
When to seek further advice
Some elbow problems need urgent medical assessment rather than physiotherapy. Please read the information below.
This information may not be appropriate for you if you have any of the following:
- A recent injury or fall that has caused severe pain or a sudden loss of movement.
- You cannot move your elbow after a fall or injury.
- Your elbow is hot, red or swollen, especially if you also have a fever or feel generally unwell.
- You felt or heard a pop while lifting something heavy and noticed a sudden change in the shape of your arm.
If you have any of these symptoms, contact NHS 111 as soon as possible for advice.
