Greater Washington
Arthritis, Rheumatology and Osteoporosis Center

Tennis Elbow 

Tennis elbow is a painful condition that occurs when tendons in your elbow are overloaded, usually by repetitive motions of the wrist and arm. The pain of tennis elbow occurs primarily where the tendons of your forearm muscles attach to a bony bump on the outside of the elbow. Pain can also spread into forearm and wrist. 


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Tennis Elbow

:Symptoms and causes

The pain associated with tennis elbow may radiate from the outside of your elbow into your forearm and wrist. Pain and weakness may make it difficult to grip an object, turn a doorknob or hold a coffee cup.

Tennis elbow is an overuse and muscle strain injury. The cause is repeated contraction of the forearm muscles that is used to straighten and raise your hand and wrist which may result in a series of tiny tears in the tendons that attach the forearm muscles to the bony prominence at the outside of the elbow.

Factors that may increase the risk of tennis elbow include: Age, which it's most common in adults between the ages of 30 and 50; Occupation, that involve repetitive motions of the wrist and arm such as plumbers, carpenters, butchers and painters. Certain sports. Participating in racket sports increases your risk of tennis elbow, especially if you employ poor stroke technique.


The diagnosis of tennis elbow is made based on history and physical exam. During the physical exam, examiner may apply pressure to the affected area or ask patient to move the elbow, wrist and fingers in various ways. In many cases, it could provide enough information for your doctor to make a diagnosis of tennis elbow. But if physician suspects that something else may be causing your symptoms, X-rays or other types of imaging tests may be ordered.


Tennis elbow often gets better on its own. But if over-the-counter pain medications and other self-care measures aren't helping, your doctor may suggest physical therapy. Severe cases of tennis elbow may require surgery.

If your symptoms are related to tennis, your doctor may suggest that experts evaluate your tennis technique or the movements involved with your job tasks to determine the best steps to reduce stress on your injured tissue.

A physical therapist can teach you exercise to gradually stretch and strengthen your muscles, especially the muscles of your forearm. Eccentric exercises, which involve lowering your wrist very slowly after raising it, are particularly helpful. A forearm strap or brace may reduce stress on the injured tissue. Injections. Your doctor might suggest injecting platelet-rich plasma, Botox or some form of irritant (prolotherapy) into the painful tendon. Dry needling — in which a needle pierces the damaged tendon in many places — can also be helpful.

Surgery: if your symptoms haven't improved after six to 12 months of extensive non-operative treatment, you may be a candidate for surgery to remove damaged tissue. These types of procedures can be performed through a large incision or through several small incisions. Rehabilitation exercises are crucial to recovery.