Tennis Elbow (Lateral Epicondylitis)

Tennis elbow (lateral epicondylitis) is a tendon injury that causes pain and inflammation in your elbow. It’s usually a repetitive strain injury.

Repetitive strain injuries 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 gets its name from being a common injury among tennis players. It happens when you overuse the tendon that connects your forearm muscles to your elbow. The medical term 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.

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.

Symptoms of tennis elbow

The most common lateral epicondylitis symptoms include:

• Elbow pain, especially 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.

Does tennis elbow affect one or both arms?

Most people develop lateral epicondylitis in their dominant arm. That’s the side you naturally use for most activities. You’re most likely to have tennis elbow in whichever arm you use the most for a repetitive activity. It’s the arm you hold a racket or tools with.

It’s less common, but it’s possible to develop tennis elbow in both arms at the same time.

Lateral epicondylitis causes

Any motion or activity that you do too often can trigger tennis elbow. Extra stress from repetitive movements builds up over time. Eventually, that added use and stress on your tendon causes tiny tears. Those lead 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 older than 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 lots 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 this condition

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

Lateral epicondylitis tests

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

What are tennis elbow treatments?

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.
• Over-the-counter (OTC) pain relievers: Over-the-counter NSAIDs or acetaminophen reduce swelling and relieve pain. Talk to your provider before taking these medications for more than 10 days in a row.
• Physical therapy: A physical therapist will give you stretches and exercises to strengthen the muscles around your elbow and increase your flexibility.
• Wearing a brace: Wrist and elbow braces will 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.
• Platelet-rich plasma: Your provider will take a sample of your blood and then process it to concentrate platelets. These proteins encourage healing. Then, they’ll inject that blood sample into your elbow.
• Corticosteroids: These are prescription anti-inflammatory medications. Your provider may give you cortisone shots. Corticosteroids aren’t as common as other treatments because they may not relieve pain. Especially if you’ve had it for more than six weeks.
• Tenotomy: Your provider will poke a needle through your skin and into your injured tendon using an ultrasound to guide them. They’ll break down and remove damaged tissue to encourage your body’s natural healing process.
• 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 rare to need surgery. Your provider may suggest surgery 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.
• You have pain that’s bad enough to affect your sleep.
• The pain lasts more than a week.

What can I expect if I have tennis elbow?

You should expect to take a break from the physical activities that caused tennis elbow. You may need to stop doing some activities completely, or do them with modifications (like wearing a brace while you work or taking breaks more often).

People almost always make a full recovery from tennis elbow. You should be able to resume all 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

What’s the difference between tennis elbow and golfer’s elbow?

Tennis elbow and golfer’s elbow are similar conditions. They’re both repetitive strain injuries caused by overusing your arm and elbow.

Tennis elbow affects the tendon on the outer (lateral) part of your elbow. Golfer’s elbow affects the tendon on the inner (medial) part of your elbow. The medical term for golfer’s elbow is medial epicondylitis.