Tennis Elbow (Lateral Epicondylitis): Symptoms, Causes & Treatment

Tennis elbow, medically called lateral epicondylitis, is a common condition causing pain on the outer side of the elbow. Despite its name, most of those affected are not tennis players, as it can affect anyone who makes repeated movements of the hand, wrist, and forearm. It results from strain and repeated small damage to the tendons connecting the forearm muscles (responsible for extending the wrist and fingers) to the bony prominence on the outer side of the elbow, so these tendons become irritated and cause pain.

The most prominent symptom of tennis elbow is pain and burning on the outer side of the elbow, which may extend to the forearm, and increases with activities requiring gripping things, twisting the wrist, or lifting weights, such as a firm handshake, opening a jar, holding a cup, or using tools. The patient notices weakness in the hand grip and difficulty with simple tasks. The chances of developing tennis elbow increase with jobs or hobbies requiring repeated forearm movements (such as carpentry, painting, prolonged office work, cooking, and racket sports), and it is more common in middle age.

The good news is that tennis elbow is a condition that improves most often with conservative treatment without needing surgery, although recovery may need weeks to months and requires patience. Treatment rests on several axes: relative rest and modifying pain-causing activities (not complete stopping), applying ice to relieve pain, anti-inflammatory painkillers when needed, and most importantly graded physical therapy exercises to strengthen and stretch the forearm muscles and tendons, considered the cornerstone of healing and preventing recurrence. Using a special elbow brace or strap may help reduce strain on the tendons. Resistant cases that do not improve after a long period may have the doctor resort to additional options, and surgery is very rare. It is important to correct wrong technique at work or in sports to prevent the problem from returning.

• Pain and burning on the outer side of the elbow that may extend to the forearm.
• Pain increasing with gripping things, twisting the wrist, or lifting weights.
• Weakness in the hand grip and difficulty with simple tasks.

• Strain and repeated small damage to the forearm muscle tendons at the elbow.
• Repeated movements of the hand, wrist, and forearm (not limited to tennis).
• Jobs and hobbies: carpentry, painting, office work, cooking, racket sports.

• Diagnosis is often clinical from the pain location and examination.
• No imaging is needed in most cases.
• X-ray or ultrasound when another cause is suspected or there is no improvement.

Conservative treatment (sufficient for most cases)

• Relative rest and modifying pain-causing activities (not complete stopping).
• Applying ice and anti-inflammatory painkillers when needed.
• Graded physical therapy exercises to strengthen and stretch the forearm muscles (the cornerstone).
• An elbow brace or strap to reduce strain on the tendons.

Resistant cases

• Additional options determined by the doctor, and surgery is very rare.

Recovery may need weeks to months. This content is educational and does not replace medical advice.

• Pain becoming chronic when treatment is neglected or strain continues.
• Persistent weakness in the hand grip.
• Impact on work and daily activities.

• Correcting wrong technique at work or in sports.
• Warming up and strengthening the forearm muscles and taking breaks from repeated movements.
• Using comfortable tools and avoiding sudden strain.