Tennis Elbow

Is elbow pain making even the simplest everyday activities uncomfortable?

Perhaps you've noticed a sharp pain when picking up the kettle, opening a jar or gripping something firmly. Even shaking someone's hand or carrying the shopping can suddenly become surprisingly painful.

And if you enjoy tennis, golf, gardening or other physical activities, that persistent discomfort around the outside of your elbow can be particularly frustrating.

If you've been diagnosed with tennis elbow, you'll know how much it can interfere with your work, recreational activities and normal routine.

The good news is that most cases improve without surgery. However, recovery can take time, particularly when the affected tendon continues to be irritated by everyday movements.

Understanding what's causing the pain, which activities may be aggravating it and what treatment options are available can help you take a more informed approach to recovery.

What Is Tennis Elbow?

Despite its name, you certainly don't need to play tennis to develop tennis elbow.

In fact, many people who experience the condition have never picked up a tennis racquet.

Tennis elbow, medically known as lateral epicondylitis, affects the tendons that attach the forearm muscles to the bony prominence on the outside of your elbow, known as the lateral epicondyle.

These muscles and tendons help control movements of your wrist and fingers, particularly when gripping objects or lifting your wrist upwards.

One tendon commonly involved is the extensor carpi radialis brevis (ECRB), which plays an important role in stabilising your wrist during gripping and lifting activities.

When this tendon is repeatedly overloaded or subjected to more physical stress than it can comfortably tolerate, pain and changes within the tendon can develop.

However, there's an important distinction worth understanding.

Although the medical term lateral epicondylitis suggests inflammation, persistent tennis elbow isn't always an inflammatory condition.

Healthcare professionals increasingly refer to it as lateral elbow tendinopathy, recognising that ongoing symptoms often involve changes in tendon structure and its ability to tolerate physical loading.

This matters because simply reducing inflammation may not be enough. Restoring strength and gradually improving the tendon's tolerance to everyday activities can be just as important. [1]

What Are the Common Symptoms of Tennis Elbow?

Tennis elbow often starts as a mild discomfort around the outside of the elbow.

You might initially notice it only after playing sport or completing a particularly demanding physical task.

But as the condition progresses, movements that previously caused no discomfort can become increasingly painful.

Common symptoms include:

• Pain on the outside of the elbow: Tenderness or aching around the bony prominence on the outer side of the elbow.

• Pain when gripping objects: Discomfort when shaking hands, holding a racquet, carrying shopping bags or lifting everyday household items.

• Weak grip strength: Difficulty gripping objects firmly, sometimes making even light items feel surprisingly difficult to hold.

• Pain when twisting your forearm: Activities such as opening jars, turning doorknobs or using a screwdriver may become uncomfortable.

• Pain extending into the forearm: An aching or burning sensation that may travel from the outer elbow into the forearm.

• Discomfort when straightening the arm: Some people experience pain when extending the elbow or wrist, particularly while holding something.

• Night-time elbow pain: Persistent symptoms may make it uncomfortable to find a suitable sleeping position.

One particularly frustrating feature is that the elbow may feel relatively comfortable at rest, only for pain to return as soon as you grip or lift something.

And because gripping is involved in so many everyday movements, avoiding the activities that aggravate the condition isn't always straightforward.

What Causes Tennis Elbow?

Tennis elbow is generally considered an overuse or overload injury.

This means it can develop when the demands placed on the forearm tendons exceed their ability to tolerate or recover from repeated physical stress.

Although sports can certainly contribute, many cases develop through ordinary work and household activities.

Repetitive Gripping and Twisting

Using screwdrivers, gardening tools, paintbrushes or other handheld equipment can place repeated stress on the forearm muscles and tendons.

Sports and Recreational Activities

Tennis, squash, badminton, golf and weightlifting all involve gripping and repetitive arm movements.

Poor technique, unsuitable equipment or a sudden increase in activity can place additional strain on the tendons.

Manual Work and Household Tasks

Jobs involving repetitive gripping, lifting or wrist movements may increase the risk of developing tennis elbow.

Even activities such as gardening, cleaning or carrying heavy objects can contribute when performed frequently or for prolonged periods.

Computer and Office Work

Prolonged mouse use or repetitive hand and wrist movements may aggravate symptoms, particularly when combined with sustained gripping or awkward wrist positions.

Age-Related Tendon Changes

As we get older, tendons can undergo structural changes that affect their ability to tolerate physical stress.

Tennis elbow is particularly common among middle-aged adults, although it can occur at almost any age.

Sudden Increases in Activity

Sometimes the problem develops after taking on an unfamiliar task.

Perhaps you've spent the weekend painting the house, returned to tennis after a long break or started a new exercise routine.

The tendon may simply not have been accustomed to the additional workload.

Often, several factors contribute rather than one identifiable cause. [2]

Why can Tennis Elbow be so Difficult to Get Rid Of?

One of the biggest challenges with tennis elbow is that you use the affected tendons far more often than you might realise.

Think about how many times you grip something during an ordinary day.

You pick up your phone, make a cup of tea, turn a door handle, prepare dinner, carry shopping bags or use your computer.

Even though many of these activities don't involve much elbow movement, the forearm muscles still have to work to stabilise your wrist and maintain your grip.

And that means the painful tendon may continue being loaded throughout the day.

Another frustrating aspect is that symptoms don't always appear immediately.

You might complete an activity without too much discomfort, only to experience increased soreness later that evening or the following morning.

This doesn't necessarily mean you've caused additional tendon damage, but it may indicate that the activity placed more stress on the tendon than it could comfortably tolerate.

The challenge is finding the right balance: reducing activities that repeatedly aggravate the tendon while maintaining enough appropriate movement and strengthening to support recovery.

Simply avoiding all movement for weeks or months is not generally the best long-term solution.

Tennis Elbow vs Golfer's Elbow – What's the Difference?

Although tennis elbow and golfer's elbow share some similarities, they affect different tendon attachments around the elbow.

Tennis elbow (lateral epicondylitis) causes pain around the outside of the elbow, where the wrist extensor tendons attach.

Golfer's elbow (medial epicondylitis) affects the tendons attaching to the inside of the elbow, which are involved in gripping and bending the wrist.

Both conditions can develop through repetitive strain or excessive loading, and neither is limited to people who play the sport reflected in its name.

The location of the discomfort provides an important clue, but a professional examination may be needed to distinguish between the two conditions.

How Is Tennis Elbow Diagnosed?

If pain around your elbow is persistent or interfering with your normal activities, it's worth having the condition properly assessed.

A healthcare professional will generally begin by discussing your symptoms, work activities, recreational interests and any recent changes in physical activity.

They may then examine your elbow, wrist and forearm to identify movements that reproduce the pain.

Common assessments include:

• Checking for tenderness over the outer elbow.

• Assessing pain when extending the wrist or fingers against resistance.

• Measuring grip strength.

• Evaluating elbow and wrist movement.

• Checking for symptoms that could indicate a nerve or joint problem.

In many cases, tennis elbow can be diagnosed through a physical examination without requiring imaging.

However, an ultrasound, MRI scan or X-ray may be recommended if the diagnosis remains uncertain or another condition is suspected.

This is particularly important because not all pain around the outer elbow is caused by tennis elbow. Nerve irritation, arthritis and other injuries can sometimes produce similar symptoms. [3]

What Are the Best Treatment Options for Tennis Elbow?

If you've been living with persistent elbow pain, your first priority is understandably to find some relief.

But an effective treatment approach should also consider why the tendon became irritated and how to reduce the likelihood of symptoms returning.

Treatment generally focuses on managing pain, reducing excessive tendon loading and gradually restoring strength and function.

Depending on your circumstances, several approaches may be considered.

1. Activity Modification and Relative Rest

Giving your elbow a break from activities that repeatedly aggravate the pain is often a sensible first step.

However, this doesn't necessarily mean completely resting the arm or avoiding all movement.

Instead, consider how you might temporarily reduce the demands placed on the affected tendon.

For example:

• Avoid repeatedly lifting heavy objects with the affected arm.

• Reduce activities involving forceful gripping or twisting.

• Break gardening or manual tasks into shorter sessions.

• Modify your sporting activities while symptoms settle.

• Use both hands when lifting heavier household items.

The aim is to reduce unnecessary strain without allowing prolonged inactivity to contribute to weakness and stiffness.

2. Heat Therapy

If your elbow and forearm feel stiff or uncomfortable, gentle heat may provide some welcome relief.

Applying a warm compress or heat pack to the affected area for approximately 15–20 minutes may help relax tight forearm muscles and improve comfort.

Heat can be particularly useful when symptoms are accompanied by ongoing muscle tension or stiffness.

However, heat may not be suitable immediately following an acute injury or when significant swelling is present. Cold therapy is another option that some people find more comfortable during a painful flare-up.

Whichever approach you choose, always protect the skin from extreme temperatures. [4]

3. Tennis Elbow Braces and Support Straps

You may have seen people wearing a small strap around their upper forearm.

These are commonly known as tennis elbow braces or counterforce straps.

They're designed to alter how force is transmitted through the forearm muscles during gripping and lifting activities.

Some people find that wearing a suitable strap helps make certain activities more comfortable.

However, braces don't necessarily address the underlying tendon problem, and evidence for their longer-term effectiveness remains limited.

A physiotherapist or healthcare professional can advise whether a brace may be appropriate for your particular symptoms.

4. Physiotherapy and Rehabilitation

Physiotherapy can play an important role in managing tennis elbow, particularly when symptoms have persisted or normal activities have become difficult.

However, the type and intensity of exercise matter.

When your elbow is particularly painful, repeatedly forcing it through heavy gripping exercises or strenuous wrist movements may aggravate the affected tendon.

That doesn't mean all exercise should be avoided.

A physiotherapist may initially recommend gentle movement and carefully controlled exercises that place manageable demands on the tendon.

As symptoms improve, a progressive rehabilitation program can help:

• Restore comfortable elbow and wrist movement.

• Strengthen the wrist extensor and forearm muscles.

• Improve grip strength.

• Increase the tendon's tolerance to physical loading.

• Rebuild strength lost through reduced activity.

• Prepare the arm for a gradual return to work, sport and recreational activities.

One important point is that strengthening exercises don't necessarily need to wait until every trace of discomfort has disappeared.

Appropriately graded rehabilitation is supported by current clinical guidance and can help improve short-term pain and function in people with lateral elbow tendinopathy. [3]

5. Pain Relief and Anti-Inflammatory Medication

Depending on the severity of your symptoms, a healthcare professional may recommend suitable pain-relieving medication.

Non-steroidal anti-inflammatory drugs (NSAIDs), including certain topical anti-inflammatory gels, may provide short-term relief.

However, not everyone can safely use these medications, particularly people with certain medical conditions or those taking medicines that may interact with them.

It's also important to remember that persistent tennis elbow isn't necessarily driven by ongoing inflammation.

Reducing pain may make everyday activities more comfortable, but it doesn't automatically mean the tendon has regained its normal strength or tolerance for physical activity.

6. Corticosteroid Injections

Corticosteroid injections have historically been used to provide relief from persistent tennis elbow pain.

Although they may offer short-term improvement for some people, research has raised concerns about their longer-term effectiveness.

In fact, the British Elbow & Shoulder Society's clinical guidance recommends against corticosteroid injections for lateral elbow tendinopathy, citing evidence of poorer outcomes at later follow-up compared with placebo.

If an injection has been suggested, it's important to discuss the potential benefits, limitations and risks with your healthcare professional. [3]

7. Other Treatments for Persistent Tennis Elbow

If your symptoms continue despite appropriate activity modification and rehabilitation, further assessment may be recommended.

Other interventions sometimes discussed include platelet-rich plasma (PRP) injections, additional specialist treatments and, in selected circumstances, surgery.

However, the evidence supporting several of these approaches remains uncertain, and surgery is not usually required for uncomplicated tennis elbow.

The most appropriate approach depends on your diagnosis, the duration of your symptoms and your response to conservative treatment.

8. Drug-Free Home Treatment Options

Not everyone wants to rely solely on medication to manage elbow discomfort.

Some people may be unable to take particular medications because of existing health conditions, while others simply prefer to explore drug-free alternatives.

Depending on the underlying cause of the symptoms, non-invasive home treatment options may be considered alongside appropriate activity modification and rehabilitation.

The important thing is to understand what each approach is designed to address, rather than expecting one treatment to resolve every possible cause of elbow pain.

Managing Tennis Elbow Symptoms with OSMO Patch

When elbow pain begins interfering with your work, sleep or favourite activities, finding a practical way to manage the discomfort becomes an understandable priority.

For people experiencing localised swelling and associated pain around the elbow, the OSMO Patch offers a drug-free, non-invasive home treatment option designed to help reduce swelling and associated discomfort.

It's a simple approach that fits around your normal routine.

The patch is applied to the affected area before going to bed and works while you sleep.

OSMO Patch may be considered alongside appropriate rest, activity modification and rehabilitation.

However, tennis elbow often involves tendon changes rather than significant swelling, and the patch isn't intended to repair damaged tendons or replace the strengthening and rehabilitation needed to restore normal tendon function.

(ALWAYS FOLLOW THE DIRECTIONS FOR USE. Not suitable for individuals with seafood or shellfish allergies)

Discover How OSMO Patch Works

Watch the Video to learn exactly how the OSMO Patch works and discover how it may be used together with proper rest to support the relief of inflammation and the associated pain in conditions such as tennis elbow.

How Long Does Tennis Elbow Take to Heal?

If you've been struggling with tennis elbow for several weeks or months, one of the questions you're probably asking is, "When will my elbow finally feel normal again?"

Unfortunately, there's no exact timetable.

Recovery depends on how long you've had symptoms, the severity of the tendon problem and whether you're able to reduce the activities that continue to aggravate it.

Some people begin noticing improvement within several weeks, while others may experience symptoms lasting six to twelve months or occasionally longer.

The encouraging news is that most cases improve without surgery.

But there's an important distinction between feeling less pain and regaining normal strength.

Your elbow may become more comfortable before the affected tendon and forearm muscles have regained the capacity needed for heavier lifting, repetitive gripping or strenuous sporting activities.

Returning too quickly to activities that previously caused pain can sometimes trigger another flare-up.

A gradual return to normal activities, supported by appropriate rehabilitation, generally provides a more sustainable approach to recovery. [2]

Practical Tips for Managing Tennis Elbow Day to Day

While your elbow is recovering, a few simple adjustments may help reduce unnecessary strain and make everyday activities more comfortable.

Change How You Lift Objects

Rather than lifting a heavy kettle, frying pan or shopping bag with one hand, consider using both hands or reducing the weight.

Keeping objects closer to your body may also help reduce strain on your arm.

Avoid Gripping More Firmly Than Necessary

Many everyday tasks involve gripping harder than we realise.

Where possible, use a relaxed grip and avoid repeatedly squeezing or holding objects tightly for prolonged periods.

Break Up Repetitive Tasks

If your work involves using tools, typing or handling objects, consider introducing regular breaks and varying your activities.

The same principle applies to gardening, cleaning and other household tasks.

Review Your Workstation

If computer work aggravates your symptoms, consider the position of your keyboard and mouse.

Keeping your wrist in a comfortable, neutral position and avoiding prolonged awkward postures may help reduce unnecessary strain.

Be Sensible About Returning to Sport

If tennis, golf or another recreational activity contributed to your symptoms, don't be too quick to return at your previous intensity.

Gradually rebuilding your tolerance and reviewing your technique or equipment may help reduce the likelihood of recurring problems.

Don't Let One Bad Day Discourage You

Recovery isn't always perfectly consistent.

You may experience a few comfortable days followed by increased soreness after an unusually demanding activity.

An occasional flare-up doesn't necessarily mean you've undone all your progress. What matters is how your symptoms and functional ability improve over time.

Frequently Asked Questions About Tennis Elbow

Can You Get Tennis Elbow Without Playing Tennis?

Absolutely. Despite its name, tennis elbow commonly affects people who have never played tennis.

Repetitive gripping, twisting, lifting and other forearm activities can all contribute to the condition.

Does Tennis Elbow Cause Pain Down the Forearm?

Yes. Although the pain usually begins around the outside of the elbow, it can extend into the forearm.

However, pain accompanied by numbness, tingling or unusual changes in sensation may indicate another condition that requires medical assessment.

Should I Rest or Exercise with Tennis Elbow?

A combination of relative rest and appropriately graded exercise is generally recommended.

Activities that significantly aggravate symptoms should be modified, but prolonged complete rest may contribute to weakness and reduced tendon capacity.

A physiotherapist can help develop an exercise program suited to your recovery.

Is Heat Good for Tennis Elbow?

Heat may help ease forearm muscle tension and stiffness, particularly when symptoms are ongoing.

However, heat may be unsuitable immediately following an acute injury or when significant swelling is present.

Does a Tennis Elbow Brace Help?

Some people find that a tennis elbow strap makes gripping and lifting activities more comfortable.

However, braces do not necessarily resolve the underlying tendon problem, and their longer-term effectiveness is uncertain.

Can Tennis Elbow Heal Without Surgery?

Yes. Most people with tennis elbow improve without surgery.

Conservative management generally involves modifying aggravating activities, managing pain and gradually restoring forearm strength.

Can Tennis Elbow Come Back?

Yes. Symptoms may recur when the affected tendon is repeatedly exposed to more physical stress than it can comfortably tolerate.

Maintaining forearm strength, gradually increasing activity levels and modifying aggravating movements can help reduce the risk of recurrence.

Is Tennis Elbow Caused by Inflammation?

Not always.

Although inflammation may be present in some cases, persistent tennis elbow is often associated with changes in tendon structure and its ability to tolerate physical loading.

This is why ongoing treatment may require more than simply reducing inflammation.

When Should You Seek Medical Attention?

If your elbow pain isn't improving, continues to worsen or is significantly affecting your ability to work or perform everyday activities, arrange an assessment with a qualified healthcare professional.

Seek prompt medical attention if you experience severe pain following an injury, significant swelling or deformity, or difficulty moving your elbow.

Redness, warmth accompanied by fever, new numbness, unusual weakness or changes in the colour of your hand or fingers also warrant medical assessment.

Medical References

The following medical resources provide additional information about tennis elbow, associated tendon problems and recognised treatment approaches.

[1] American Academy of Orthopaedic Surgeons (AAOS): Tennis Elbow (Lateral Epicondylitis). Read the AAOS medical resource

[2] Healthdirect Australia: Tennis Elbow – Symptoms, Causes and Treatment. Read Healthdirect Australia's guidance

[3] Singh HP, Watts AC, et al. (2023): BESS Patient Care Pathway: Tennis Elbow. Shoulder & Elbow. 2023;15(4):348–359. Read the published clinical guideline

[4] National Health Service (NHS): Tennis Elbow – Symptoms, Self-Care and Treatment. Read the NHS guidance