Patient information from BMJ

Tennis elbow

Last published:Apr 25, 2022

Tennis elbow can be painful and can stop you using your arm normally. But there's a good chance your elbow will get better with time, and there are treatments that can help with the pain.

What is tennis elbow?

Tennis elbow causes pain on the outside of your arm, around the bony part of your elbow. It happens when you damage the tendons that connect your arm muscles to the bone of your elbow.

You can damage these tendons by doing anything that strains your elbow. Playing tennis is a common cause, which is why it's called tennis elbow.

But any activity that uses your forearm a lot (for example, using a screwdriver) can cause tennis elbow. The damage often happens slowly over time.

What are the symptoms?

You get pain when you move your elbow, especially when you hold something or twist your arm. You may not be able to grip as well as normal.

You're most likely to get tennis elbow in the arm you use most (your right arm if you're right handed). The pain may come and go.

You should see your doctor if your elbow isn't any better after a few weeks. If you have a fever, or if your elbow is red and swollen, see your doctor straight away.

What treatments work?

Rest the elbow as much as possible for about six weeks, and avoid doing repeated twisting movements. Talk to your doctor for advice if your work will make it hard to do this.

An ice pack may help. You may also want to use a forearm strap to brace the arm and support it.

Non-steroidal anti-inflammatory drugs (NSAIDs) may help with the pain. You can buy NSAIDs such as ibuprofen from a pharmacy, or your doctor may prescribe one. NSAIDs can have side effects, including an upset stomach.

If your pain does not improve using these treatments for six weeks, you may need physiotherapy, to teach you exercises to strengthen your arm.

Steroid injections have been tried for tennis elbow, but doctors usually don't recommend them.

Steroids (the full name is corticosteroids) and powerful anti-inflammatory drugs. Although they can reduce pain in the short term, it's possible that they make the condition worse in the long term. 

Surgery is sometimes used for people with severe tennis elbow that doesn't get better after many months.

Another possible treatment for tennis elbow that doesn't improve over time is extracorporeal shock wave therapy (ESWT). This involves using high-energy shock waves to relieve pain and help you to move more easily. But this is a fairly new treatment and there isn't much research yet on how well it works.

Another fairly new treatment involves injecting the area with blood products such as platelet-rich plasma to promote healing. But again, there isn't much research yet about how well it works.

You can ask your doctor about any of these treatments that you think might help you.

What will happen to me?

There's a good chance that your tennis elbow will get better over time. Most people get better with treatments including rest, ice, NSAID drugs, and a forearm strap. But some people need physiotherapy and a few need surgery.