Tennis Elbow: The Causes and Treatments

Tennis elbow

You’ve probably heard of tennis elbow, but you don’t have to play tennis to suffer from it. It can cause moderate to severe pain and restricted movement of the elbow in non-athletes too. [1]

Being aware of the common symptoms of tennis elbow could help you diagnose this condition and seek proper treatment. Let’s learn more about tennis elbow and the symptoms it causes. 

What is tennis elbow? 

Tennis elbow, just as the name suggests, affects the elbow joint can develop in any athlete, particularly in tennis players. This condition can affect anyone who overloads the tendons in their elbow. It can affect men and women of all ages. [2]

It also referred to as lateral epicondylitis in medical terms, occurs due to the inflammation of the tissues in the elbow joint usually due to repetitive stress or overuse.

It is marked with intense pain specifically at the outer side of the lateral part of the elbow joint. [3]

Let’s look at the common causes, symptoms, and risk factors of this condition.

What are the causes of tennis elbow?

The elbow joint is supported by muscles, which help move the elbow, wrists and fingers. The tendons in the elbow connect the muscles to the bones and support the movement of the muscles in the forearm. [4]

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It occurs due to repeated injury to the joint tissues including muscles, and tendons in the elbow joint.

The muscles and tendons in the forearm and arm that are attached to the bones become inflamed as a result of overuse or strenuous activities. This can trigger inflammation leading to the development of tennis elbow. [5]

Tendons and muscles are involved in tennis elbow

It usually affects a muscle in the forearm called the ECRB (extensor carpi radialis brevis). This muscle helps to raise and extend the wrist. This also explains why most patients with tennis elbow experience pain on moving the wrists. [6]

Repetitive stress and strenuous activities involving the elbow joint can weaken the ECRB muscle increasing the risk of tennis elbow.

It can also affect other muscles and tendons that are used to straighten or extend your wrist. Excessive use causes a strain on the tendon fibers resulting in inflammation and tiny tears.

These changes usually develop near the lateral epicondyle, the bony bump on the outer side of the elbow. 

Any movement of the elbow, wrist, or forearm puts further strain on these tissues causing pain at the lateral epicondyle. [7]

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It is important to differentiate between tennis elbow and golfer’s elbow. While it causes pain along the outer or latter side of the elbow joint, golfer’s elbow causes pain on the inner side of the joint. 

Who can get tennis elbow?

Overuse of the elbow joint or excessive strain on the muscles and tendons in the forearm can cause tennis elbow. This why it is more common in tennis players.

The ECRB muscle is overused during tennis as the player has to extend his elbow and wrist causing inflammation of the muscles and tendons. [8]

The other risk factors of tennis elbow are discussed beneath: 

  • It is estimated to affect nearly 1 in 3 people at any given time.
  • The condition is more common in adults between 40 and 60 years of age.
  • It is possible to get a tennis elbow if you are using your forearm for certain activities you are not used to, for example, painting and gardening may increase the risk of tennis elbow. 
  • It may occur after an acute injury such as after knocking or banging your elbow.

It may occur due to any activity that places stress and strain on the elbow joint, such as [9]

  • Playing any other racquet sports like badminton or squash
  • Playing the violin
  • Using a hammer, screwdriver, or computer frequently. 
  • Activities that involve repetitive fine movements of the hands and wrists such as typing and using scissors 
  • Swimming
  • Turning a key forcibly
  • Using shears for gardening
  • Throwing sports like the javelin and discus 
  • Manual work like bricklaying or plumbing 
  • Using a roller or paintbrush while decorating

What are the common symptoms of tennis elbow?

It is characterized by tenderness and pain on the outer side of the elbow. Patients may also experience pain in the forearm and the back of the hand. [10]

The intensity of the pain can range from mild discomfort that occurs only while using the affected elbow to severe pain felt even when the elbow is at rest.

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The pain becomes worse while using the arm or elbow, especially twisting movements. Wrist movement like extending or gripping can make the pain worse.

Activities that can worsen the pain in the elbow include:

  • Lifting and bending the arm
  • Straightening the wrist 
  • Gripping small objects like a pen
  • Twisting your forearm while turning a doorknob and opening a jar
  • Extending your arm to open a shelf at a height

An episode of this condition usually lasts for 6 months to 2 years. If managed properly, a majority of people recover fully within a year. However, if left untreated, the joint damage may become worse causing severe restriction of movements. 


It may not be easy to prevent tennis elbow, although avoiding too much strain on the muscles and tendons might help to some extent.

However, taking good care of the affected joint by minimizing strenuous activities and the application of heat or cold may help to speed up recovery.



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