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What Is the Best Treatment for Tennis Elbow?

Tennis elbow is caused by overuse of the forearm muscles

A young woman holds her elbow in pain.

Tennis elbow is caused by overuse of the forearm muscles

You don’t have to play tennis to develop a common condition known as tennis elbow. Caused by repetitive overuse of the forearm muscles, tennis elbow happens when the tendons that join the forearm muscles on the outer side of the elbow become inflamed or develop tiny tears, leading to pain and tenderness. It’s a painful and sometimes debilitating problem, but several tennis elbow treatments can help relieve pain.

What causes tennis elbow?

To understand tennis elbow, it helps to understand your elbow anatomy. Three bones make up your elbow joint: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). Muscles, ligaments and tendons hold the elbow joint together. The bony bump on the outside of the elbow is called the lateral epicondyle.


“The clinical term for tennis elbow is lateral epicondylitis, and it involves the muscles and tendons that help stabilize your wrist when you straighten your elbow,” says Michael Hadley, MD, a family medicine physician with expertise in sports medicine at Scripps Coastal Medical Center Encinitas. “People who play racquet sports, such as tennis or pickleball, repeatedly use these muscles when they swing at the ball, but tennis elbow can also result from any repetitive activity that strains the forearm or uses repetitive extension of the wrist or hand.”


Tennis elbow can result from other activities, such as using hand tools, gardening, sewing, painting, construction work. In some cases, the cause is unknown. The condition is most common between the ages of 30 and 50, but it can affect anyone.


Tennis elbow symptoms usually begin with mild pain or burning on the outer part of your elbow that slowly worsens over time. Your grip strength may be weaker, and you may have pain at night.

How can you treat tennis elbow?

Treatments for tennis elbow depend on the severity of your symptoms and how long you have had them. If your pain is mild and has started recently, you may be able to treat it at home by discontinuing the activities that contribute to your pain and resting your arm.


“For most patients, the most important and effective treatment is to wear a brace to help rest the affected muscles and tendons,” says Dr. Hadley. “Braces designed specifically for tennis elbow are available in many sporting goods shops or online. The brace may need to be worn consistently for several weeks to allow proper healing.”


In addition, non-steroidal anti-inflammatory drugs (NSAIDS), such ibuprofen, available over the counter, may help reduce pain and swelling.


If you still have pain after several weeks of home treatment, make an appointment with your doctor. Usually, a physical examination will be enough to diagnose tennis elbow, but they may order X-rays or imaging exams to rule out fractures or other potential problems.


You doctor may recommend one or more of the following treatments for tennis elbow.

Physical therapy

A physical therapist can show you specific exercises to help with flexibility, strength and range of motion, as well as use therapies, such as ultrasound or massage, to help the injured muscles and tendons heal.


Your therapist also may evaluate how you use your arm and wrist and suggest modifications to help prevent further irritation, such as using your shoulder and upper arm muscles more to reduce strain on your elbow.

Steroid injections

Your doctor may suggest a cortisone shot in the painful area of your elbow to reduce inflammation. Steroid injections can be very effective in relieving tennis elbow pain, but if you resume the irritating activity without modifying how your move your arm and wrist, the condition may return.

Extracorporeal shock wave therapy

Shock wave therapy sends sound waves to the elbow to stimulate the body’s natural healing processes.

Platelet-rich plasma

Platelet-rich plasma (PRP) uses your body’s own platelets to help injured tissue heal. The platelets are removed from your blood and injected into the affected area.

Surgery

Approximately 80% to 95% of patients find relief from tennis elbow pain without surgery, but if you do need surgery, your doctor will refer you to an orthopedic surgeon. Many elbow surgeries can be performed as outpatient procedures, meaning you can go home the same day.

How can you prevent tennis elbow?

Making a few modifications to how you use your arm and wrist can help prevent tennis elbow:


  • Try simple exercises to stretch and strengthen your wrist and forearm muscles.
  • If you play racquet sports, ask a coach to make sure you are using the right size racquet. Have them evaluate your form and identify areas where you can change how you move to minimize strain on your arm and wrist.
  • Take frequent breaks from repetitive motions.
  • Try to minimize bending your wrist at work and during activities. 
  • Use tools with large, padded grips and avoid gripping so hard that you put a lot of tension in your hand and wrist.


“Sometimes, just making a small change to how you use your wrist or position your arm can make a major difference,” says Dr. Hadley. “It’s worth it to invest in a session with a physical therapist or athletic coach to help prevent elbow problems from affecting your work or play.”