Tennis Elbow

Tennis elbow often affects players of tennis, pickleball, racquetball and squash players who use backhand strokes. But it's not limited t sports. Activities like golf, baseball, softball, bowling or weightlifting can also lead to tennis elbow. Anyone who strains the forearm muscles - at work or at home- could develop the condition. 

You’re more likely to get tennis elbow if you perform repetitive motions with your arms, wrists or hands, like typing, painting or heavy lifting. It’s especially common when you grip something while moving your elbow again and again.

Signs of lateral epicondylitis often develop slowly. You might notice mild pain at first, which gets worse over time if you continue using the affected arm. Common tennis elbow symptoms include: 

• Elbow pain and tenderness: Aching or burning in the outside part of the elbow, near the bony knob, especially when you lift objects or twist your forearm. The pain may feel like it spreads down your arm toward your wrist.
• Wrist pain: Pain that gets worse with activities like turning a doorknob or holding a cup of coffee or a pen.
• Weak grip strength: Trouble grasping objects firmly.
• Stiffness: Your elbow may feel stiff or hard to move in the morning.
• Burning sensation: A burning feeling that may radiate down the forearm.

If you notice these symptoms for more than a few weeks or if they affect your daily activities, consult a health care provider.

Conditions that may be mistaken for tennis elbow

These other conditions can cause pain around the elbow:

• Radial tunnel syndrome: When the radial nerve in the forearm is compressed, it causes pain like tennis elbow but typically further down the arm.
• Elbow arthritis: Arthritis in the elbow joint can cause swelling, stiffness and pain. Unlike tennis elbow, arthritis-related pain may happen even without specific movements.
• Cervical radiculopathy: Issues in the cervical spine, like a herniated disk, can pinch nerves and lead to radiating pain down the arm.
• Golfer’s elbow: Golfer’s elbow (medial epicondylitis) can cause pain in the elbow but the pain is located on the inside, not the outside.

Causes and risk factors of tennis elbow

The main cause of tennis elbow is overuse. When you repeatedly move and stress the forearm muscles and tendons, especially when you’re gripping something or extending your wrist, you can get small tears in the tendon tissue. 

You may be more at risk if your job or hobbies involve repetitive hand motions, including:

• Tradespeople: Plumbers, carpenters, mechanics and painters
• Musicians: Especially those who play string or keyboard instruments
• Office workers: Frequent typing and computer mouse use
• Food workers: Cooks, chefs and butchers who chop regularly
• Health care providers: Dentists and surgeons who grip instruments frequently 

Additional risk factors include smoking, obesity and certain medications. While most common in adults ages 30 to 60, tennis elbow can affect anyone who regularly uses their forearm muscles. In some cases, there’s no clear cause. 

Be sure to contact a health care provider if:

• Your symptoms aren’t getting better with home care.
• Your pain becomes severe, persistent or worse even if you rest your arm.
• You have swelling, numbness or a change in the color of your elbow or forearm.
• You have weakness that limits your daily activities.

To diagnose tennis elbow, your health care provider may:  

• Ask about your symptoms, medical history, job, hobbies and physical activity.  
• Perform a physical exam to check for tenderness and look for any trouble with your range of motion.  
• Recommend imaging tests such as X-rays to rule out arthritis or fractures and MRI or ultrasound to show any soft tissue damage like tendon tears or swelling.  
• Suggest an electromyography (EMG) test to check for nerve problems in your elbow 

Recovery can take several months depending on the damage and its cause. Treatment options may include: 

Rest and activity modification 

Avoid activities that make the pain worse. Adjust the way you perform tasks to reduce strain. 

Physical or occupational therapy 

A therapist can guide you through exercises that stretch and strengthen your forearm muscles and tendons. They can also teach you safer ways to move. 

Pain management 

Over-the-counter NSAIDs like ibuprofen (Advil, Motrin) and using ice packs (15–20 minutes a few times a day) may help reduce inflammation and pain. 

Bracing and supports 

A forearm strap, wrap or brace can reduce pressure on the tendon and help relieve symptoms. 

Injections and regenerative treatments 

• Corticosteroid injections: Anti-inflammatory medication delivered directly to the elbow 
• PRP (platelet-rich plasma): Growth factors from your own blood to aid healing 
• Ultrasound or shock wave therapy: May improve blood flow and speed up healing 
• Needle fenestration or ultrasonic tenotomy: Uses needles to stimulate tendon healing 

Surgery 

Surgery may be needed if other treatments don’t work after 6–12 months. It typically involves removing damaged tissue and repairing the tendon. Most people return home the same day. 

After symptoms improve, you can take these steps to help prevent tennis elbow from coming back:

• Make sure your workstation is set up to minimize strain on your wrist and elbow.
• Perform forearm stretching and strengthening exercises.
• If your hobbies or work involve repeat arm movements, take breaks or use different techniques to reduce stress on your elbow.
• Warm up before sports or activities that use your arm and give yourself time to recover between workouts.
• If you play tennis or another racquet sport, make sure you use the right racquet and technique.
• Use lighter tools, racquets or equipment with larger grips.

At Banner Health, our team is experienced in diagnosing and treating tennis elbow. We offer: 

• Expert care from orthopedic and sports medicine providers 
• Advanced imaging and diagnostic technology 
• Personalized physical therapy plans 
• Innovative treatments, including PRP and shock wave therapy 

Our goal is to help you feel better, recover faster and return to the activities you love—pain-free.