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Sore Arm? It Might Be Tennis Elbow

Medically Reviewed by Michael W. Smith, MD on February 23, 2020

What Is Tennis Elbow?

Tennis elbow is painful weakening of the tendons that join your forearm muscles to your bones. It happens when you work your elbow too much by repeating certain motions. You might hear your doctor call it lateral epicondylitis.

Despite the name, tennis causes only about 5% of cases. You can get it after doing any kind of repetitive movement, like painting or using hand tools. Tennis elbow is a common injury that usually needs only minor treatment, but it takes time and rest to heal.

Where Does Tennis Elbow Cause Pain?

The pain is focused on the outside of your arm, where your forearm meets your elbow.

It’s related to a muscle and tendons in your forearm. Tendons connect your muscles to your bones. When you repeat certain arm movements, the tendons at the elbow end of a certain muscle -- the extensor carpi radialis brevis (ECRB) muscle -- may get small tears.

The tears may put stress on the rest of your arm, making it painful to lift and grip things. If you don’t get treatment, the pain can last a long time.

What Are the Symptoms of Tennis Elbow?

The most common symptom of tennis elbow is an ache on the outside of your elbow. Over time -- from a few weeks to a few months -- the ache turns into a constant pain. The outside of your elbow may be too painful to touch. The pain might go into your forearm and wrist. You may feel pain when doing nothing at all or with anything from holding a pen to opening a jar.

You can have tennis elbow in one or both arms.

If you have symptoms after a week or so, or if they get worse, it’s time to call your doctor.

Also, call your doctor if you have any of these symptoms:

  • It's hard to move your arm.
  • There's a lump or bulge in it.
  • Pain or difficulty moving your arm keeps you from your everyday activities.
  • The area around your elbow is reddish or swollen.

What Are the Causes and Risk Factors of Tennis Elbow?

Tennis elbow affects up to 3% of people, mostly between the ages of 30 and 50.

Any activity that strains the muscles around your elbow over and over again can cause tennis elbow.

In tennis, hitting a backhand puts some stress on your forearm muscles, which clench when you hit the ball. If your technique is off or if you grip the racquet too tightly, it puts more stress on the tendons that connect your forearm muscles to your elbow. That can cause the tendons to get small tears.

You can get tennis elbow from playing other racquet sports, such as squash or racquetball. You can also get it from jobs or activities that involve repetitive arm motion, such as:

  • Cutting down trees with a chain saw
  • Painting
  • Carpentry
  • Playing some types of musical instruments
  • Kitchen work, such as cutting with a knife
  • Plumbing
  • Working on cars
  • Working on an assembly line

A direct blow to your elbow can also make the tendons swell.

How Is Tennis Elbow Diagnosed?

Your doctor will ask about your symptoms and medical history. They’ll check for pain in parts of your arm and ask you to do some simple motions such as straightening your wrist while they press on it.

Often, that’s enough to tell if you have tennis elbow. If your doctor thinks there may be something else going on, you may get tests such as:

  • Electromyography. This will help your doctor see whether you have a problem with the nerves in your elbow and how well and fast they send signals. It can also measure electrical activity in your muscles when they’re at rest and when you contract them.
  • MRI. This can find arthritis in your neck or problems in your back, such as a disk issue, that could cause pain in your elbow.
  • X-ray. This can check for arthritis in your elbow.

How Is Tennis Elbow Treated?

Your doctor will first tell you to stop playing sports or doing certain kinds of work so your arm can rest. They’ll probably recommend physical therapy and medications such as aspirin, ibuprofen, or naproxen.

Your doctor might also give you:

  • Corticosteroid medications. They’ll inject these into the area to help with swelling and pain.
  • A splint or brace. You’ll wear this on your arm to help your muscles and tendons rest.
  • Ultrasound. This treatment can break up scar tissue, increase blood flow, and promote healing.

Up to 95% of people who have tennis elbow get better without surgery. But you might need it if you still have pain after 6 to 12 months. Your doctor can remove damaged tissue through cuts in your arm.

How Can I Prevent Tennis Elbow?

Some small changes might help lower your risk of tennis elbow.

  • Keep your arms and wrists strong and flexible. Build strength with light weights. Warm up and stretch before any activity, especially one that involves making the same motions over and over.
  • Try not to make repetitive movements.
  • If you play a sport with a racquet, have an expert check your equipment to be sure it’s the right size and fit.
WebMD Medical Reference

Sources

SOURCES:

University of Rochester Medical Center: “Tennis Elbow.”

Cleveland Clinic: “Tennis Elbow (lateral epicondylitis).”

American Society for Surgery of the Hand: “Tennis Elbow -- Lateral Epicondylitis.”

American Academy of Orthopaedic Surgeons: “Tennis Elbow (Lateral Epicondylitis).”

SportsInjuryClinic.net: “Tennis Elbow.”

American Academy of Family Physicians: “Tennis Elbow.”

Proceedings of Baylor University Medical Center: “Tennis elbow.”

Mayo Clinic: “Electromyography (EMG).”

Orth Info: “Tennis Elbow (Lateral Epicondylitis).”

Harvard Health Publications, Harvard Medical School: “What to Do About Tennis Elbow.”

Mayo Clinic: “Tennis Elbow.”

Family Doctor.org: “Tennis Elbow.”

NHS: “Tennis Elbow.”

University of Rochester: “Tennis Elbow.”

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