Tennis elbow symptoms usually begin gradually. The main symptom is pain, which may begin with a dull aching or soreness on the outer part of the elbow that goes away within 24 hours after an activity. As time goes on, it may take longer for the pain to go away. The condition may further progress to pain with any movement, even during everyday activities, such as lifting a jug of milk. Pain may spread to the hand, other parts of the arm, shoulder, or neck (referred pain).

Tennis elbow pain:

• Usually occurs in the dominant arm (your right arm if you are right-handed, left arm if you are left-handed).
• Affects the outside of the elbow (the side away from your body). Pain increases when that area is pressed or when you are grasping or twisting objects.
• May increase in the evening and make sleep difficult. The elbow might be stiff in the morning.
• Eventually may occur with mild activity, such as picking up a coffee cup; turning a jar lid, doorknob, or key; or shaking hands. Simply starting your car could hurt. You may even have pain when you aren't using your elbow.

Other parts of the arm, shoulder, and neck may also become sore or painful as the body tries to make up for the loss of elbow movement and strength.

Swelling rarely occurs with tennis elbow. If your elbow is swollen, you may have another type of condition, such as arthritis.

Radial tunnel syndrome is an unusual type of nerve entrapment that is sometimes confused with or can develop at the same time as tennis elbow.