Can Tennis Elbow Get Worse if Not Treated?

Tennis elbow, also known as lateral epicondylitis, is a painful condition that affects tendons in part of your elbow. Untreated tennis elbow with symptoms can lead to further damage and possible tearing.

Tennis elbow, also known as lateral epicondylitis, is a painful condition that affects tendons in part of your elbow. It’s often associated with sports, particularly tennis, but it can occur as a result of a variety of activities that engage muscles in your wrist or arm.

When you overwork the tendons in your wrist and arm, you can develop tennis elbow. A single tendon connects the hard bump on the outside of your elbow to your forearm muscles – this is where you’ll feel pain. The irritation could also spread, though, into your wrist or forearm. Although many athletes develop lateral epicondylitis, they aren’t the only group that’s affected by this condition.

Your chances of getting tennis elbow increase if:

• You’re a certain age. Anyone can get tennis elbow regardless of their age, but the risk is greater if you’re between ages 30 and 50.
• You have certain jobs. If you are in an occupation that requires constant wrist and arm motions (like a plumber, painter, carpenter, cook, or butcher) you could get this condition.
• You play certain sports. Any sport that uses a racket will increase your chances of lateral epicondylitis, especially if you have an incorrect stroke technique.

Gender does not play a factor in developing tennis elbow. It’s believed that between 1%–3% of Americans develop tennis elbow at some point.

Signs of tennis elbow show up slowly. Usually, if you get tennis elbow, you’ll begin to experience mild pain that slowly gets worse over the next weeks and months. This happens because there isn’t usually a single instance that brings symptoms on, but rather, the same stressful action repeated over and over again. 

Common signs of tennis elbow include:

• Burning pain on the outside of your elbow
• Poor grip strength
• Pain during the night
• Pain when you twist, extend, or bend your arm
• Stiffness when you extend your arm
• Swelling and tenderness in your elbow

Your symptoms will get worse whenever you use your forearm, whether to hold a racket, shake hands, or turn a wrench. You can get tennis elbow in either or both arms, but it’s more likely to affect your dominant arm.

Tennis elbow is most often brought on by repeated arm movements that exhaust your forearm muscles. When your muscles become fatigued, your tendon starts doing more of the work. When the tendon becomes overworked, it becomes inflamed and painful. Tennis elbow is a form of tendinitis. If your condition goes untreated, it could turn into a degenerative condition called tendinosis and puts your tendon at risk of tearing.

On occasion, a sudden elbow or arm injury causes tennis elbow. Although it’s uncommon, you can develop this condition without any pattern of harmful movement.

If you think you have tennis elbow, you should visit your healthcare provider. They will perform a physical test to see if you have pain, stiffness, or swelling in your elbow joint and ask you if you engage in activities that worsen your pain. They might order one of the following tests to make a final diagnosis:

• An X-ray to make sure you don’t have a broken bone or arthritis
• An imaging test like an ultrasound, MRI, or CT scan to see if your tendons or muscles are damaged
• An EMG to look for compressed nerves

Tell your doctor if you have previously injured your elbow, you have rheumatoid arthritis, or you have a nerve disease.

The majority of people that develop tennis elbow are able to fully recover without surgery. The best things you can do to help your arm heal include:

• Getting a lot of rest. You should take a break from sports, intense work tasks, and any other activities that make your symptoms worse. This could take a few weeks.
• Taking medicine. Nonsteroidal anti-inflammatory drugs, like ibuprofen and naproxen, and acetaminophen can help reduce swelling and pain.
• Participating in physical therapy. Certain exercises can strengthen the muscles in your forearm. A physical therapist can further help you with ultrasounds, ice massages, and muscle-stimulating treatments that improve muscle healing.
• Using a brace. This can help reduce symptoms of this kind of tendinitis by allowing the tendons and muscles to rest.

If your symptoms persist, your healthcare provider might suggest surgery or other procedures. Your options may include:

• Surgery. If you’re still experiencing symptoms after 6–12 months of at-home treatment, you might need surgery to extract damaged tissue. 
• Ultrasound tenotomy. This procedure uses ultrasound technology as a doctor guides a certain kind of needle into the damaged part of your tendon. Ultrasonic energy causes the needle to vibrate so quickly that it liquefies the damaged tissue. This tissue is then sucked out.
• Injections. Botox or platelet-rich plasma can be injected to reduce pain in the tendon. Dry needling is another option.

Take these steps to help prevent tennis elbow:

• Pay attention to your body. If you feel pain, don’t push through it. This can lead to further damage and possible tearing.
• Use proper equipment. Certain kinds of rackets, like loose-strung or stiff ones, might decrease wear and tear on your forearm.
• Exercise regularly. Lifting weights can strengthen your wrist muscles and forearms.
• Before working or engaging in strenuous activity, stretch your arms and wrists.

If you develop tennis elbow, there’s a great chance that it will get better with patience and consistent at-home treatments. Don’t hesitate to reach out to your healthcare provider during the healing process, though, especially if you:

• Have difficulty holding things or moving your arm
• Develop a bump on your elbow or red, swollen joints
• Feel such intense pain that you have trouble sleeping or taking part in daily activities

Trust your primary healthcare provider, physical therapist, and surgeon (if applicable) to give you the care that you require.