Tennis Elbow
Tennis elbow, or lateral epicondylitis, is a condition that causes pain and tenderness on the outer part of the elbow. It occurs when the tendons that attach the forearm muscles to the elbow become overloaded, often due to repetitive gripping or wrist movements. Although commonly associated with racquet sports, it can affect anyone performing repetitive arm and wrist activities. Most cases improve with rest, physiotherapy, and activity modification.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
What is Tennis Elbow?
The outer part of the elbow is where several tendons attach the forearm muscles to the bone. These tendons help control movements of the wrist and fingers, such as gripping, lifting, and twisting. Normally, these tendons handle repeated movements without issue.
Tennis elbow, or lateral epicondylitis, occurs when the tendons on the outer elbow become irritated or inflamed. This usually develops after repetitive wrist and forearm movements, causing pain and tenderness at the tendon attachment. Despite the name, it is not limited to tennis players - any activity involving repeated gripping or lifting can lead to this condition.
Understanding Tennis Elbow
Tennis elbow typically develops gradually, and the main features include:
- Pain or tenderness on the outer part of the elbow, which may radiate down the forearm.
- Discomfort when gripping, lifting, or twisting objects, such as turning a door handle or holding a cup.
- Stiffness or soreness in the elbow, especially in the morning or after activity.
- Weakness in the forearm and hand, making it harder to perform daily tasks.
Symptoms can vary from mild discomfort to more persistent pain that affects day-to-day activities, but most cases improve with appropriate management.
Causes and Risk Factors
Tennis elbow, also called lateral epicondylitis, occurs when the tendons that attach the forearm muscles to the outside of the elbow become overloaded or irritated. This is usually due to repetitive movements of the wrist and arm. Common factors that increase the risk include:
| Repetitive or forceful movements | Frequent gripping, lifting, twisting, or wrist extension in sports (tennis, squash) or activities like painting, typing, or using hand tools. |
| Technique or equipment | Poor technique, improper ergonomics, or unsuitable sports/work equipment can increase tendon strain. |
| Previous injuries | Past elbow or forearm injuries can make tendons more vulnerable. |
| Muscle weakness or imbalance | Weak forearm or shoulder muscles can increase stress on the elbow tendons during activity. |
| Age | Most common in people aged 35-55, when tendons are more prone to overuse injuries. |
Diagnosing Tennis Elbow
Tennis elbow is usually diagnosed through a clinical assessment. A clinician will review your symptoms and medical history, including how and when the pain started and any activities that aggravate it.
During the examination, they will check for tenderness over the outer elbow, assess the range of motion of the wrist and arm, and test the strength of the forearm muscles. Pain during these movements often helps confirm the diagnosis.
Imaging tests may sometimes be used to support the diagnosis or guide treatment:
| Ultrasound | Useful to check for tendon thickening, small tears, or inflammation. Often the first-line imaging as it is quick and non-invasive. |
| MRI | Can provide a more detailed view of the tendon and surrounding structures. Used if symptoms are severe, persistent, or if other conditions need to be ruled out. |
Treatment Options
Most cases of tennis elbow improve with non-surgical measures. Initial management focuses on reducing pain, promoting healing, and restoring function:
| Activity modification | Avoid or reduce activities that aggravate the pain, while maintaining gentle movement to prevent stiffness. |
| Pain relief & anti-inflammatories | Over-the-counter pain medications such as paracetamol or NSAIDs can help manage discomfort. Ice or cold packs may also provide temporary relief. |
| Physiotherapy | Targeted exercises strengthen the forearm muscles and improve tendon resilience. Stretching and ergonomic advice can prevent recurrence. |
| Supportive devices | Braces or straps worn over the forearm can reduce strain on the affected tendon during activities. |
| Injection therapies | Steroid injections or, in some cases, platelet-rich plasma (PRP) injections may be considered if pain persists despite conservative measures. |
Surgery is rarely needed and usually only considered for persistent cases that do not respond to non-surgical treatment over several months.
How can Lanthorn help?
Ultrasound Elbow - £300
This non-invasive scan allows us to look directly at the tendons in your elbow. It can confirm tendon changes associated with tennis elbow, look for any other structural problems, and guide any targeted injections for more precise treatment.
Tennis Elbow Steroid Injection - £450
Ultrasound-guided steroid injections can help reduce inflammation and relieve pain in cases where symptoms persist despite rest, physiotherapy, or medication. These injections are carefully placed to maximise benefit while minimising risk.
PRP Injections - From £750
PRP involves using your own blood’s growth factors to support healing in damaged tendons. This may be considered when conventional treatments haven’t provided sufficient relief.
