Tennis Elbow: what it is and how we help

Tennis elbow at a glance

Tennis elbow, or lateral elbow tendinopathy, is pain on the outer side of the elbow caused by overloading the tendon that attaches the wrist and finger extensor muscles to the bone. Despite the name, most people who get it do not play tennis: it is usually caused by repetitive gripping, typing, lifting or DIY. Most cases improve within a year, and progressive loading exercise speeds recovery.

Symptoms of tennis elbow

• Pain and tenderness on the bony outer part of the elbow
• Pain gripping, lifting a kettle, turning a door handle or shaking hands
• Pain spreading down the forearm
• Weaker grip and morning stiffness

What causes tennis elbow?

Repeated wrist extension and gripping load the tendon faster than it can adapt. Common triggers include a sudden increase in computer work, racket sports, gardening, painting, manual trades and lifting young children. It is most common between 35 and 55.

How is tennis elbow treated?

The first steps are reducing aggravating activities, not complete rest, and starting a progressive strengthening programme. Steroid injections can give short-term relief but are linked to worse outcomes at one year for many people, so they are used cautiously.

How we help with tennis elbow in Chiswick

• Physiotherapy: load management and a graded tendon strengthening programme, including isometric and slow-loading exercise.
• Acupuncture: reviews suggest short-term pain relief, useful while strength builds.
• Red light therapy: THOR laser, which has trial evidence for lateral elbow pain when combined with exercise.
• Manual therapy: soft tissue work for the forearm and mobilisation of the elbow and neck.

What does the evidence say?

Exercise that gradually loads the tendon has the most consistent evidence. Low-level laser therapy has shown benefit in some trials when combined with exercise. Braces can reduce pain during activity for some people.

How long does tennis elbow last?

Most people recover within a year, although symptoms commonly last between six months and two years if the tendon keeps being overloaded. Recovery is usually faster when you reduce the aggravating tasks early and start strengthening, rather than waiting for the pain to disappear on its own. Tendons adapt slowly, so expect steady improvement over weeks rather than days. Pain that is getting worse after three months of good management is a reason for reassessment.

How to treat tennis elbow at home

A simple loading plan helps most people. Start with isometric holds: rest your forearm on a table, palm down, and push the back of your hand up against your other hand for 30 to 45 seconds, five times, once or twice a day. As pain settles, progress to slowly lowering a light weight or water bottle with the wrist, over three to four seconds. Mild discomfort during exercise is acceptable if it settles by the next morning. Our tennis elbow exercises guide shows each stage.

Tennis elbow or something else?

Pain on the inner side of the elbow is more likely to be golfer's elbow. Pain that spreads down the arm with tingling may come from the neck or a trapped nerve, and pain with swelling or locking can point to a problem inside the joint. A quick assessment separates these, because each needs a different plan.

What to expect at Omnia

Your physiotherapist asks about your work, hobbies and the tasks that hurt, then tests grip strength and checks the elbow, wrist and neck. You leave with a starting exercise and practical changes for your desk or tools. Acupuncture or THOR laser can be added to settle pain while the tendon strengthens. Most people need a handful of sessions spread over several weeks, with the exercise programme doing most of the work.

What you can do at home

• Reduce, rather than stop, the activities that provoke pain
• Grip with the palm facing up when lifting where possible
• Adjust your mouse and keyboard so the wrist stays neutral
• Follow our tennis elbow exercises guide

See our guides to how to treat tennis elbow and tennis elbow exercises.

Tennis elbow is treated at Omnia Lifestyle, 8 to 9 Bedford Corner, Chiswick W4, two minutes from Turnham Green. Book online or call 020 4515 0000.