Tennis Elbow

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

Take the Pain Quiz

Tennis elbow facts

  • Tennis elbow is tendinitis of the outer elbow.
  • Strain of an elbow tendon causes tennis elbow.
  • Risks of tennis elbow include activities that can strain the elbow.
  • Tennis elbow symptoms include dull pain and tenderness at the outer elbow often with a sensation of weakness and stiffness.
  • A physician uses a patient's history and physical examination to diagnose tennis elbow.
  • The standard treatment for tennis elbow involves measures to reduce the local inflammation.
  • The prognosis for tennis elbow is excellent.
  • It's possible to prevent tennis elbow by avoiding activities that strain the elbow.

What is tennis elbow?

Tennis elbow is inflammation of the tendon at the outer portion of the elbow, leading to pain. Classically, tennis elbow is a strain injury to this tendon from hitting a backhand shot at tennis. The medical term for tennis elbow is lateral epicondylitis because it involves inflammation at the insertion point of the tendon at the outer portion of the humerus bone at the elbow joint (the epicondyle). Most people with lateral epicondylitis actually acquire it from activities other than playing tennis.

In contrast, when the tendon that attaches at the inner portion of the elbow is inflamed, the condition is referred to as medial epicondylitis (or "golfer's elbow" because golfers commonly injure this area after striking the ground to take a deep divot).

What causes tennis elbow?

A strain injury to the tendon at the outer portion of the elbow causes tennis elbow. While this can occur by straining during a backhand tennis shot, it can also occur from many repetitive activities that can strain the elbow. These activities include using a screwdriver or work that includes similar motions, Frisbee disc throwing, and lifting objects by extending the wrist, etc.

Tennis Elbow Treatment and Prevention

Tennis elbow is usually easily diagnosed by a physical examination. Up to 90% of cases can be remedied by nonsurgical treatments, and symptoms usually diminish within four to six weeks with appropriate treatment.

Treatment goals include pain relief and prevention of symptom recurrence.

What are tennis elbow risk factors?

Risks of tennis elbow include any activity that can strain the elbow joint. Such activities include tennis, falling onto the extended upper extremity, using a screwdriver when unaccustomed, casting a fishing net, etc.

What are symptoms of tennis elbow?

Symptoms of tennis elbow include dull pain and tenderness at the outer elbow. There can be elbow stiffness and a sensation of weakness. Typically with tennis elbow, people retain the full range of motion of the elbow and there is no significant swelling or discoloration. Holding a beverage cup or shaking hands can bring on the pain.

How do physicians diagnose tennis elbow?

Physicians diagnose tennis elbow based on the history of outer elbow pain and tenderness often with recent repetitive-use injury. Tenderness at the outer elbow with normal range of motion of the elbow joint assures the diagnosis. Generally, no radiology testing is necessary. MRI scanning can illustrate inflammation of the outer elbow.

What is the treatment for tennis elbow?

Resting the elbow and employing measures to reduce the local inflammation are effective treatments for tennis elbow. Cold application several times daily and anti-inflammatory medications (such as ibuprofen [Advil] or naproxen [Aleve]) can be helpful. Physical therapy and rehabilitation exercises for the elbow that are guided by therapists can be helpful for persisting pain and inflammation. For tennis elbow that is resistant to these measures, local cortisone injection can be beneficial. Rarely, surgical repair of the injured tendon is considered.

What is the outlook (prognosis) for tennis elbow?

Tennis elbow most often has a complete recovery with conservative measures, particularly by resting the joint and avoiding reinjury.

Is it possible to prevent tennis elbow?

Avoiding strain injury of the elbow joint can prevent tennis elbow. Tennis players can benefit by proper instruction in hitting techniques. Tennis elbow straps can be used to minimize the risk of injury to the elbow tendons.

Exercises that strengthen the involved muscles can be helpful to avoid a reoccurrence once symptoms have disappeared.

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

Klippel, J.H., et al. Primer on the Rheumatic Diseases. New York: Springer, 2008.

Last Editorial Review: 3/14/2016

Reviewed on 3/14/2016
References
Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

Klippel, J.H., et al. Primer on the Rheumatic Diseases. New York: Springer, 2008.

Health Solutions From Our Sponsors