Tennis Elbow (Lateral Epicondylitis)

Tennis elbow (lateral epicondylitis) is a tendon injury that causes pain and inflammation in your elbow. It gets its name from being common among tennis players. Overusing the tendon that connects your forearm muscles to your elbow causes it.

The medical name for tennis elbow is lateral epicondylitis. Epicondylitis is inflammation in that tendon. Lateral epicondylitis means the inflammation is on the lateral side. It’s the outside edge when you hold your arms at your sides with your palms facing forward.

It’s usually a repetitive strain injury. These happen when you use a part of your body to repeatedly do the same kind of motion so often that it damages your tissue.

Tennis elbow is one of the most common causes of elbow pain. Even though it’s named for tennis, that’s not the most common cause. Experts estimate that more than 9 in 10 people develop it for other reasons. Any motion that makes you grip or twist and swing your forearm often can cause lateral epicondylitis.

Visit a healthcare provider if you have an elbow injury or feel pain that doesn’t get better on its own in a week. Seeing a provider as soon as the pain starts can increase your treatment options and how well they work.

Tennis elbow symptoms

The most common lateral epicondylitis symptoms include:

• Elbow pain, usually concentrated on the outside of your elbow
• Stiffness
• Swelling
• A weakened grip, especially when you’re trying to hold something like a racket or pen

How do you know if you have tennis elbow?

You can’t know for sure you have tennis elbow without visiting a healthcare provider for a diagnosis. Lots of people with tennis elbow feel a specific kind of pain in their elbow and arm. The pain usually feels:

• Sharp or burning
• Worse when you twist or bend your arm
• Like it spreads from your elbow down to your forearm and into your wrist, especially at night

You might notice more pain when you use your arm for common motions. It might hurt when you turn a doorknob, open a jar or shake someone’s hand. Your grip may feel weaker in these motions, even if you’re not using a lot of strength.

Lateral epicondylitis causes

Any motion or activity that you do too often can trigger tennis elbow. Extra use from repetitive movements builds up over time. Eventually, that stress on your tendon causes damage. That leads to symptoms you can feel and notice.

A sudden arm or elbow injury can also cause lateral epicondylitis. But this is less common.

Risk factors

Anyone can develop tennis elbow. But you may be more likely to if you:

• Lift more than 45 pounds (22 kilograms) regularly
• Are over 40
• Smoke
• Have obesity
• Play sports that make you swing or twist your arms a lot
• Have a job or hobby that makes you use tools or get in positions that put a lot of stress on your elbows

Complications of this condition

Tennis elbow usually doesn’t cause serious complications. If you keep using your injured elbow before your tendon heals, you can increase your chances of rupturing (tearing) it.

How doctors diagnose tennis elbow

A healthcare provider will diagnose tennis elbow with a physical exam and tests. They’ll examine your injured elbow and ask about any symptoms you have. Tell your provider when you first noticed pain, stiffness or other issues. Let them know if any activities make the symptoms better or worse.

Your provider may use some of the following tests to check for damage inside your arm and take pictures of your elbow:

• X-ray
• Ultrasound
• MRI
• EMG

How to treat tennis elbow

Your provider will suggest treatments to help your tendon heal. The most common treatments include:

• The RICE method: This is usually the best way to fix tennis elbow. Taking a break from activities can help your tendon recover.
• Over-the-counter (OTC) pain relievers: OTC NSAIDs or acetaminophen can reduce swelling and relieve pain. Your provider might also suggest topical ointments or creams you rub into your skin.
• Physical therapy: A physical therapist will give you stretches and exercises to strengthen your tendon and the muscles around your elbow.
• Wearing a brace: Wrist and elbow braces allow your tendon to rest so it can heal. Your provider will tell you which kind of brace you’ll need and how often to wear it.
• Checking your form or technique: Sometimes, how you hold a tool or piece of equipment can lead to tennis elbow. For example, you may need to change your golf grip or how you hold a racket.

If you’re still feeling pain after trying the most common treatments, your provider can suggest different options. These can include:

• Corticosteroids: These are prescription anti-inflammatory medications. Your provider may give you a corticosteroid injection. Corticosteroids aren’t as common as other treatments because they may not provide relief if you’ve had symptoms for more than six weeks.
• Platelet-rich plasma: Your provider will take a sample of your blood and then process it to concentrate platelets. These cells encourage healing. Then, they’ll inject that blood sample back into your body.
• Tenotomy: Your provider will make a small cut in your skin. Then, they’ll use an ultrasound to guide a small tool that repairs damage to your tendon.
• Shockwave therapy: Your provider will direct a specific pressure frequency where your tendon is injured. The shockwaves encourage your body to speed up the healing.
• Surgery: It’s very rare to need surgery. Your provider may suggest it if you’re still having severe symptoms after several months of conservative treatments. A surgeon will remove damaged tissue and repair your tendon.

When should I see my healthcare provider?

Visit a healthcare provider if you think your elbow is injured or you notice any of the following signs:

• It’s hard to move your elbow or arm.
• Your elbow is swollen or discolored.
• You’re in severe pain that makes it hard to do your usual activities.
• The pain is bad enough to affect your sleep.
• The pain lasts more than a week.

What can I expect if I have lateral epicondylitis?

You should expect to take a break from the activities that caused tennis elbow. You may have to modify some activities by wearing a brace or resting more often. There’s a small chance you need to stop doing some activities completely.

People almost always make a full recovery. You should be able to resume all of your usual activities once your tendon heals, even if you need surgery.

How long tennis elbow lasts

Tennis elbow can last anywhere from a few months to more than a year. It usually takes around six months to recover. But some people need longer, up to 18 months.

How long it’ll take you to recover depends on a few factors:

• What caused the tennis elbow
• How damaged your tendon is
• Which treatments you need