Tennis elbow, medically known as lateral epicondylitis, is a common condition that causes pain around the outside of the elbow. While the name suggests a link to racquet sports, the majority of people who develop this issue do not play tennis at all. It is an overuse injury that affects the tendons connecting the forearm muscles to the outside of the elbow joint. Many patients wonder, “What are the symptoms of tennis elbow?” Recognizing the signs early on can support prompt diagnosis and treatment.

Key Takeaways

• In tennis elbow, pain and tenderness are most often felt on the bony bump on the outside of the elbow, known as the lateral epicondyle.
• Patients often experience a noticeable decrease in grip strength, making simple tasks like shaking hands or turning a doorknob difficult.
• Symptoms may worsen during activities that involve gripping, lifting, or extending the wrist against resistance.

Common Symptoms of Tennis Elbow

For many patients, the symptoms begin subtly, perhaps as a slight soreness after a day of intense activity. Over time, however, the discomfort tends to become more persistent and noticeable. In the following subsections, we’ll explore some of the common symptoms of tennis elbow.

Localized Pain and Tenderness

The hallmark sign of tennis elbow is pain located directly over the lateral epicondyle. This is the prominent bony knob on the outside of your elbow. You may find that this area is extremely tender to the touch. Even light pressure, such as resting your arm on a table, can provoke significant discomfort.

Pain That Radiates

The pain often does not stay confined to the elbow joint itself. Many individuals report that the aching or burning sensation travels down the forearm. This radiating pain can extend all the way to the wrist and even the back of the hand.

Functional Limitations and Weakness

Patients frequently notice a reduction in their grip strength as the body attempts to limit the use of the inflamed tendons. This weakness can turn routine activities such as carrying a grocery bag, twisting a doorknob, or shaking someone’s hand into painful struggles.

Symptoms at Rest and at Night

While the pain of tennis elbow is typically activity-related, in some cases, it is felt even when the arm is completely still. Some patients report an aching or throbbing sensation at rest. Furthermore, pain at night is not uncommon. Lying on the affected arm or simply moving it during sleep may cause you to wake up with discomfort.

Stiffness and Morning Symptoms

You may also notice a feeling of stiffness in the elbow joint, particularly first thing in the morning. This stiffness usually improves as you begin to move the arm, but it can be a persistent early symptom.

Understanding the Underlying Condition: Lateral Epicondylitis

The most commonly affected tendon involved in tennis elbow is the extensor carpi radialis brevis (ECRB) tendon. This tendon originates at the lateral epicondyle. Repetitive microtrauma, or tiny tears, in the ECRB tendon can lead to degenerative changes in the tendon tissue. Instead of healthy, organized collagen fibers, the tendon tissue may become disorganized and weak. This degenerative process makes the tendon highly sensitive to stress and prone to pain with even minimal activity.

Beyond the Court: Who Gets Tennis Elbow?

While the condition is named after a sport, only a small number of cases are actually related to tennis. The true cause is any activity that involves repetitive or forceful use of the forearm muscles. This repetitive strain can occur in a wide variety of occupations and hobbies.

Occupational Risk Factors

Many professions require the kind of repetitive wrist and hand motions that can lead to lateral epicondylitis.

• Plumbers and Pipefitters: Repetitive wrench use and twisting motions.
• Painters: Constant gripping of brushes and rollers, combined with wrist extension.
• Carpenters and Mechanics: Frequent use of hand tools and forceful gripping.
• Cooks and Butchers: Repetitive chopping, stirring, and handling heavy utensils.
• Office Workers: Prolonged, improper use of a computer mouse and keyboard, especially with a poor ergonomic setup, can contribute to the strain.

Sports and Hobbies

For athletes, poor technique or ill-fitting equipment are often culprits. In tennis, for example, using a racquet with too large a grip size or hitting the ball with improper form can place excessive stress on the ECRB tendon. Other sports like golf, bowling, and throwing sports can also be associated with this condition. Hobbies such as gardening, knitting, or playing certain musical instruments may also involve the necessary repetitive motions to trigger symptoms.

Age and Other Factors

As we age, the blood supply to our tendons naturally decreases, which may slow down the body’s ability to repair micro-tears. Smoking is also considered a potential risk factor that could impair the healing process.

When to Seek Professional Guidance

If you find yourself asking, “What are the symptoms of tennis elbow?”, early diagnosis and treatment can support recovery. It may be time to consider consulting an experienced elbow specialist if:

• The pain on the outside of your elbow persists for more than a few weeks.
• The pain is severe enough to interrupt your sleep or prevent you from performing routine daily tasks.
• You notice a significant and persistent loss of grip strength.
• Simple over-the-counter pain relievers and rest do not seem to provide any lasting relief.

A specialist can perform a thorough physical examination and may use imaging tests, such as X-rays or an MRI, to rule out other potential causes of elbow pain and support the diagnosis. The goal is to confirm the diagnosis and develop a personalized treatment plan.

Navigating Treatment Options

Many tennis elbow cases respond well to non-surgical treatments. The primary focus of initial treatment is to reduce pain and allow the damaged tendon tissue to begin healing.

Conservative Management

Initial treatment strategies focus on modifying activity and managing pain.

• Rest and Activity Modification: This involves identifying and avoiding the specific activities that aggravate your symptoms. This does not necessarily mean complete immobilization, but rather a temporary reduction in the intensity and frequency of the offending movements.
• Ice Application: Applying ice to the painful area for 15 to 20 minutes several times a day may help manage acute pain and swelling.
• Bracing: In some cases, a counterforce brace or strap worn just below the elbow may help reduce the tension on the ECRB tendon, providing temporary relief during activity.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen may help manage pain.

Physical and Occupational Therapy

Physical therapy is typically a cornerstone of treatment. A therapist can guide you through specific exercises designed to strengthen the forearm muscles and stretch the affected tendons. A program may include gentle stretches to improve flexibility and reduce muscle tension, along with strengthening exercises.

PRP Therapy

Platelet-rich plasma (PRP) therapy is a regenerative option that involves drawing a small amount of your own blood, processing it to concentrate the platelets, and then injecting the concentrated solution into the site of the tendon injury. Platelets contain growth factors that may help stimulate the body’s natural healing response.

Surgical Treatment

Surgery may be recommended for patients whose symptoms are severe and have not improved after non-surgical treatment. Many procedures can be done through a minimally invasive arthroscopic technique, using a camera and small incisions. Recovery from surgery generally involves a period of immobilization followed by a physical therapy program to restore strength and range of motion.

Summary

By knowing the common symptoms of tennis elbow, including localized pain, radiating discomfort, and functional weakness, you empower yourself to seek appropriate care when needed. Many treatment options are available depending on the severity of the condition.

Frequently Asked Questions

Is tennis elbow only caused by playing tennis?

No, that is a common misconception. While the condition is named after the sport, it is an overuse injury caused by any repetitive activity that strains the forearm muscles and tendons. This can include many occupational tasks like painting, plumbing, or using a screwdriver frequently.

Can I continue to exercise or work if I have tennis elbow?

Yes, but patients are generally advised to avoid activities that cause pain. Continuing to perform the movements that aggravate the tendon may prevent healing. A physical therapist can help you modify your exercise and work routines to maintain activity without further injuring the tendon.

What is the difference between tennis elbow and golfer’s elbow?

Tennis elbow (lateral epicondylitis) causes pain on the outside of the elbow. Golfer’s elbow (medial epicondylitis) is a similar condition that causes pain on the inside of the elbow. They affect different sets of forearm tendons.