Tennis Elbow: Symptoms, Treatment & Recovery

What is tennis elbow?

Tennis elbow is pain associated with the tendons on the outside of the elbow, often called lateral elbow tendinopathy or lateral epicondylitis. The affected tendons help the muscles of the forearm lift and control the wrist.

You do not have to play tennis to develop it. Repeated gripping, lifting and twisting during work, hobbies or sport can be relevant.

What symptoms might you notice?

• Pain or tenderness over the outer elbow.
• Discomfort when gripping, lifting or twisting.
• Pain extending into the forearm.
• Difficulty with tasks such as carrying shopping or lifting a cup.

Grip may feel weaker because it hurts to use the arm. Numbness, tingling or marked loss of strength should be assessed rather than automatically attributed to tennis elbow.

How is it assessed?

Your clinician asks about the onset, aggravating tasks, changes in activity and previous treatment. Examination considers the elbow, forearm and relevant neighbouring structures.

Not all outer elbow pain comes from the tendon. A scan may help answer a specific question, but ultrasound is not necessary for every straightforward case.

What can you change day to day?

Reduce or adapt tasks that repeatedly provoke symptoms while maintaining comfortable movement. Complete prolonged rest is rarely the long-term answer.

A support or forearm strap may ease symptoms for some people. It should be comfortable and should not create new pain or tingling.

A pharmacist or clinician can advise on suitable pain relief. A cold pack wrapped in a towel may provide temporary comfort; never apply ice directly to the skin.

How can physiotherapy help?

A tailored programme may include progressive forearm strengthening, movement work and practical changes to work or sport. The starting point and exercise load should reflect your symptoms.

Progress is usually gradual. Exercises that cause a substantial or sustained increase in pain should be reviewed rather than repeatedly forced.

See our physiotherapy information or ask the team about assessment for elbow symptoms.

Are steroid injections recommended for tennis elbow?

Steroid injections may offer short-term relief, but that does not necessarily translate into better recovery. NHS musculoskeletal guidance highlights concerns about recurrence and poorer longer-term outcomes, and many services do not routinely offer them for tennis elbow.

They should not be presented as the automatic next step when exercises have not helped. Review the diagnosis, rehabilitation and alternatives before considering an injection.

If an injection is discussed, ask about infection, bleeding, a pain flare, skin or fat changes and tendon-related risks, as well as the likely duration of benefit.

Does ultrasound guidance improve the outcome?

Ultrasound can help visualise structures and guide needle placement. However, the 2017 Gulabi trial cited in the original article found no clinically relevant advantage over landmark-guided steroid injection in its study group.

How long does recovery take?

Tendon symptoms can settle slowly, sometimes over months. Recovery varies with activity demands, symptom duration and other factors.

Monitor practical progress such as more comfortable lifting and better tolerance of daily tasks. If progress stalls, review the plan rather than simply increasing treatment intensity.

Persistent or complex problems may need a specialist opinion. Surgery is reserved for selected cases after appropriate assessment and discussion.

When should you seek help?

Arrange assessment if elbow pain keeps returning, limits work or everyday tasks, or is not improving with reasonable activity changes.

Seek urgent medical advice for a hot swollen elbow with fever, a significant injury, inability to move the arm or sudden marked weakness or loss of feeling. Do not assume these symptoms are routine tennis elbow.