Tennis Elbow: Symptoms, Causes, Treatment and Recovery Time
Medically reviewed by Dr. Mohsin Merchant, Orthopaedic Surgeon | Pain Cure Ortho & Rehab Clinic, Mazgaon, Mumbai |
Quick answer
Tennis elbow (lateral epicondylitis) is pain on the outside of the elbow caused by overloaded forearm tendons. You do not need to play tennis to get it. Most cases improve with a break from the aggravating activity, physiotherapy and gradual strengthening. Recovery often takes several months and can take up to a year or two. See a doctor if the pain lasts beyond two to three weeks.
Tennis elbow at a glance
| Medical name | Lateral epicondylitis |
|---|---|
| Where it hurts | Outer side of the elbow, sometimes spreading into the forearm |
| Main cause | Repeated gripping, lifting or wrist movements that overload the forearm tendons |
| First treatment | Activity changes, physiotherapy, gradual strengthening, short-term support |
| Usual recovery | Several weeks to months. It can last 6 months to 2 years, and most people recover within a year |
| Surgery | Rarely needed, only after months of non-operative care has not worked |
What is tennis elbow?
Tennis elbow, medically called lateral epicondylitis, is pain on the outer side of the elbow. The muscles that lift your wrist and straighten your fingers are attached to a bony bump on the outside of the elbow by tendons. When these tendons are overloaded, they become irritated and, over time, can become worn and thickened. Despite the name, most people who get it have never played tennis.
What are the symptoms of tennis elbow?
- Pain or a burning feeling on the outside of the elbow, which may spread down the forearm
- Pain when gripping, lifting or carrying, especially with the palm facing down
- Pain when turning a door handle, shaking hands, wringing a cloth or using a screwdriver
- A weak grip, such as dropping a cup or a bag
- Tenderness when you press on the bony bump on the outside of the elbow
Symptoms usually start gradually and get worse if you carry on with the activity that causes them.
What causes tennis elbow?
Tennis elbow is an overuse problem. Common triggers include:
- Racket sports such as tennis, badminton and squash
- Repetitive work with the hands, such as typing, using a mouse, painting, plumbing, carpentry and using tools
- Lifting heavy bags or loads with the palm facing down
- A sudden increase in activity when the forearm muscles are not conditioned, such as a weekend of painting or a new gym routine
Sometimes there is no clear reason at all.
Is it tennis elbow, golfer's elbow or a neck problem?
Pain around the elbow has several causes. The location and the type of pain give useful clues, but only an examination can confirm which one you have.
| Condition | Where the pain is | Typical clue |
|---|---|---|
| Tennis elbow | Outer side of the elbow | Pain with gripping and with lifting the wrist against resistance |
| Golfer's elbow | Inner side of the elbow | Pain with bending the wrist and gripping. It affects different tendons. |
| Pain from the neck | Arm, elbow or forearm, often with neck pain | Tingling or numbness, and pain that changes when you move your neck |
How is tennis elbow diagnosed?
Diagnosis is mainly clinical. The doctor asks about your work, sport and symptoms, feels for tenderness over the outer elbow, tests the pain when you lift your wrist against resistance, and checks your grip strength. An X-ray may be done to rule out arthritis or a fracture. An MRI or ultrasound scan is rarely needed, and is used only when the diagnosis is unclear or another injury is suspected.
How is tennis elbow treated?
Most people improve without surgery. Treatment usually goes step by step:
- Rest from the trigger: Reduce or stop the activity that causes the pain, and change how you do the task. You do not need to rest the whole arm. Keep the shoulder and hand moving.
- Cold pack and pain relief: A cold pack wrapped in a cloth for 15 to 20 minutes can ease soreness. Anti-inflammatory painkillers, as tablets or gels, may help for a short time. Check with a doctor or pharmacist first, especially if you have stomach, kidney or heart problems or take blood thinners.
- Support: A forearm strap or elbow support can reduce strain on the tendon in the short term.
- Physiotherapy: A physiotherapist teaches stretching and graded strengthening exercises, and may use therapies such as ultrasound to ease pain.
- Injections in selected cases: See the next section.
- Surgery: Considered for a small number of people only.
Do steroid injections help tennis elbow?
A steroid injection can ease pain for a short time, which sometimes helps a person take part in physiotherapy. Research shows little difference in long-term results compared with other treatments, so injections are not a cure and are no longer a routine first choice. Platelet-rich plasma (PRP) injections may be offered when other treatments have not helped. Research on PRP is still ongoing and its long-term benefit is not yet known. Discuss the benefits and risks with your doctor before choosing any injection.
Which exercises help tennis elbow?
Gentle strengthening, started with a few repeats and built up over several days, is a core part of recovery. These are general examples. A physiotherapist should adjust them for you.
- Wrist curl: With your forearm supported on a table and a light weight in your hand, lift the wrist up, hold for 3 to 5 seconds and lower slowly. Do 5 to 10 repeats, 2 to 3 times a day.
- Hammer or stick turn: Hold a light weight or a hammer and slowly turn your forearm until your thumb points up. Do 5 to 10 repeats, 2 to 3 times a day.
- Ball squeeze: Squeeze a soft ball as firmly as you can without increasing the pain and hold for 30 seconds. Repeat 5 to 10 times a day.
Exercises should be fairly pain-free. If the pain gets worse, reduce the repeats or stop for a couple of days, and ask a physiotherapist to check your technique.
How long does tennis elbow take to heal?
Tendons heal slowly. Many cases settle over several weeks to months. In some people it lasts 6 months to 2 years, and most recover fully within a year. Without surgery, plan on at least about 3 months of steady care. Going back to heavy gripping too early can set recovery back.
When is surgery considered?
Surgery is considered when severe, persistent pain continues after several months of proper non-operative treatment, often 6 to 12 months. The surgeon removes the damaged part of the tendon, using an open or keyhole technique. Recovery after surgery can take several months, and some pain can remain. Only a small number of people need it.
When should you see an orthopaedic doctor?
- Elbow pain that lasts more than two to three weeks despite rest and activity changes
- Pain at night or at rest
- A weak grip that affects work or daily tasks
- Pain after a fall or injury, or a visible deformity
- Tingling or numbness in the hand or fingers
- Elbow pain together with neck pain, or pain that seems to come from the neck
- Symptoms in both elbows
Go to an emergency department for a hot, red and badly swollen elbow with fever, or for severe pain with deformity after a fall.
How can you prevent tennis elbow?
- Build up a new sport or work task gradually instead of doing a lot on the first day
- Strengthen your forearm muscles regularly
- Use the right grip size on rackets and tool handles
- Take a short break every 30 to 45 minutes from repetitive tasks such as typing or painting
- Keep your wrist in a neutral position when typing, and use both hands to carry heavy loads
Tennis elbow care in Mazgaon, Mumbai
At Pain Cure Ortho & Rehab Clinic, an elbow problem is assessed first and the treatment pathway is chosen after examination. The clinic's physiotherapy uses modalities such as IFT, TENS, short wave diathermy and ultrasound therapy, along with Theraband resistance exercises, and its Joint Care page covers the elbow, shoulder, wrist, hand, ankle and foot. Injections or surgery are discussed only when assessment shows they are appropriate.
Key takeaways
- Tennis elbow is pain on the outer elbow from overloaded forearm tendons, and it is not limited to tennis players.
- Most people improve without surgery, using activity changes, physiotherapy and gradual strengthening.
- Recovery is slow. Expect several months, and up to a year or two in some people.
- Steroid injections give short-term relief but little long-term benefit, so they are not a cure.
- See a doctor if the pain lasts beyond two to three weeks, or if you have numbness, tingling or pain after an injury.
Frequently asked questions
What is tennis elbow?
Tennis elbow, or lateral epicondylitis, is pain on the outside of the elbow caused by irritated forearm tendons. It usually comes from repeated gripping, lifting or wrist movements. It affects many people who have never played tennis.
What are the first signs of tennis elbow?
The first signs are usually a dull ache or burning on the outside of the elbow when you grip, lift or turn your wrist, such as when opening a door or shaking hands. A weak grip and tenderness over the bony bump on the outer elbow are also common.
What causes tennis elbow if I do not play tennis?
Repetitive hand and wrist work is a common cause. Typing, using a mouse, painting, plumbing, using tools and lifting heavy bags can overload the forearm tendons. A sudden jump in activity, such as a new gym routine, can also trigger it.
How long does tennis elbow take to heal?
It varies. Many cases settle over several weeks to months. In some people it lasts 6 months to 2 years, and most recover fully within a year. Heavy gripping too soon can slow recovery.
Can tennis elbow heal without surgery?
Yes. Most people recover without surgery, using activity changes, physiotherapy, strengthening exercises and short-term support such as a strap. Surgery is considered only when severe pain continues after several months of proper non-operative care.
Do steroid injections cure tennis elbow?
No. A steroid injection can ease pain for a short time, but research shows little difference in long-term results compared with other treatments. Discuss the benefits and risks with your doctor before choosing one.
Is tennis elbow the same as golfer's elbow?
No. Tennis elbow causes pain on the outer side of the elbow, while golfer's elbow causes pain on the inner side and affects different tendons. Pain that spreads from the neck can feel similar, so an examination is needed to tell them apart.
When should I see a doctor for elbow pain?
See an orthopaedic doctor if pain lasts more than two to three weeks, wakes you at night, weakens your grip, or comes with numbness or tingling. Seek urgent care for a hot, red, badly swollen elbow with fever, or severe pain with deformity after a fall.
Book a consultation for elbow pain in Mazgaon
If elbow pain is affecting your work, sport or daily life, you can book a consultation at Pain Cure Ortho & Rehab Clinic, 42/44 Patra Chawl New Compound, Love Lane, Opp. Sahakari Bhandar, Mazgaon, Mumbai 400010. The clinic is open Monday to Saturday, 10:00 AM to 10:00 PM, and closed on Sunday. Call or WhatsApp +91 79778 68264, or use the consultation form.
References
- HSE (Ireland): Tennis elbow, treatments: https://www.hse.ie/conditions/tennis-elbow/treatments/
- NHS Scotland patient information leaflet: Tennis elbow (lateral elbow pain): https://rightdecisions.scot.nhs.uk/patient-information-leaflets/primary-community-services/physiotherapy/tennis-elbow
- Columbia Doctors: Tennis elbow: https://www.columbiadoctors.org/specialties/orthopedics/our-services/shoulder-and-elbow/conditions-we-treat/tennis-elbow
- PubMed: Management of lateral epicondylitis (systematic review): https://pubmed.ncbi.nlm.nih.gov/31543413/
This article is for general education and does not replace a consultation. If you have symptoms, please see a qualified doctor.