What is tennis elbow?

Tennis elbow is typically caused by the repeated motions of the tendons that join the muscles in the forearm to the bones. If you don't treat tennis elbow, it can become worse and lead to chronic complications.
Tennis elbow is typically caused by the repeated motions of the tendons that join the muscles in the forearm to the bones. If you don't treat tennis elbow, it can become worse and lead to chronic complications.

Tennis elbow is an extremely painful condition that affects your elbow. This injury is typically caused by the repeated motions of the tendons that join the muscles in the forearm to the bones. The medical term for this condition is lateral epicondylitis, which you can get when you overwork these muscles. 

Tendons are strong cords of tissues that connect your muscles to your bones. Tennis elbow is typically caused by the tendon known as the “extensor carpi radialis brevis” and commonly occurs in both men and women between the ages of 30 and 50. This condition can generally be treated without surgery, but without proper treatment, it can become worse and lead to chronic complications.

A common misconception due to the name is that only those who play tennis get this injury. But research shows that tennis players make up only around 10% of tennis elbow cases, and those who play other sports can get it as well.

In short, you can get tennis elbow from any activity that involves repeated extension of the wrists, radial deviation (movement of the wrists from one side to another), and forearm supination (twisting movement of the forearm that causes the palm to come up).

What are the causes and symptoms of tennis elbow?

Repeating specific arm movements over a long time can cause muscle fatigue in your forearms. The muscle in your forearm is connected to the bone on the outside of your elbow by just one tendon — you can feel this bone on your elbow as a bump.

As the muscle gets tired, the tendon takes up most of the load of the movements. The persistent strain on the tendon may lead to inflammation and pain, although in some cases, an unforeseen injury could also lead to tennis elbow.

If you have tennis elbow, you may feel pain on the outside of your forearm and elbow. This pain usually increases with time and the repeated use of the elbow, especially when you do any movements that involve rotating your hand.

Other common symptoms of tennis elbow are:

  • Pain when you lift objects
  • Pain when you bend your arm
  • Pain when you grip a small object like a coffee cup or when you’re writing
  • A weak grip
  • In some cases, pain when you place your hand on a table with your palm facing down and try to lift your hand against any resisting force
  • With continued activity, pain extending up to your wrist even when it’s resting

Many of the symptoms of tennis elbow are similar to those of other medical conditions. You should check with your doctor for an accurate diagnosis.

How is tennis elbow diagnosed?

Your doctor or healthcare provider can generally diagnose tennis elbow with a physical examination. But in some cases, they may need some additional tests to rule out other conditions.

  • Your doctor may do an X-ray to check the bones in your elbow and determine if you have elbow arthritis.
  • A magnetic resonance imaging (MRI) scan can be done to check the severity of the damage to your tendons. It also helps determine if the pain in your arm is due to other conditions, like arthritis in your neck or discs in your spine.
  • An electromyogram (EMG) of your elbow may show if any nerve damage is causing pain in your arm.

How is tennis elbow treated?

One of the first things you should do if you have tennis elbow is minimize the movements of your arm, especially those that have led to the condition. Some of the other treatments for tennis elbow include:

  • Resting or discontinuing the activity that led to this condition
  • Taking anti-inflammatory medication
  • Strengthening the muscles around the elbow with regular exercises and stretches
  • Easing the inflammation using ice packs

If these treatments don’t help, your doctor may also suggest some other options, like:

  • Injecting steroids in the affected area to ease the pain or reduce the swelling
  • Putting your elbow in a brace to restrict movement and give your muscles a rest
  • Using a specialized ultrasound to break down the scar tissue and increase blood flow, which will help the healing process
  • In very rare cases, surgery

If you follow the treatment prescribed by your doctor and give your arm enough rest, it usually takes anywhere between 6 and 18 months for the symptoms to stop without surgery.

When should you see a doctor?

People who frequently do repetitive actions that put strain on their forearms, wrists, or hands are likely to get tennis elbow. If you regularly play any of the following sports, whether as a recreational activity or professionally, you may get affected by this condition:

  • Tennis
  • Golf
  • Fencing
  • Bowling
  • Baseball or softball
  • Squash
  • Racquetball

Certain professions also increase the likelihood of getting tennis elbow. These include:

  • Carpenters
  • Painters
  • Gardeners
  • Musicians
  • Plumbers
  • Auto mechanics
  • Chefs or butchers
  • Dentists

If you get any of the following symptoms, you should get in touch with your doctor:

  • Pain when you move or extend your arm
  • Pain when you hold even small objects, like pens or coffee cups
  • Excruciating pain in your hands that doesn't allow you to do your daily activities
  • A bump or swelling on your elbow

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Other points to keep in mind about tennis elbow

  • It’s good to listen to your body when you feel pain rather than pushing through it. Pain is your body’s way of letting you know that something isn’t right or that it needs attention. If you push through the pain, it could further harm your tendon and in some cases lead to a tear in the tendon.
  • If you play a sport regularly, make sure you use proper equipment. For example, if the strings in your tennis racquet are too loose or too tight, it may lead to added pressure on your arms. See what suits your specific body type and stick to it.
  • If your exercise regimen includes lifting heavy weights, make sure the muscles in your forearms and wrists are strong enough.
  • Make sure you stretch your body enough before doing any physical activity.
  • If you have pain in your elbow, wearing a brace helps by supporting your muscles and reducing the pain due to the symptoms.

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Medically Reviewed on 5/24/2022
References
SOURCES:

Buchanan, B.K., Varacallo, M. StatPearls, "Tennis Elbow," StatPearls Publishing, 2022.

Cleveland Clinic: "Tennis Elbow (Lateral Epicondylitis)."

Johns Hopkins Medicine: "Lateral Epicondylitis (Tennis Elbow)."