What Causes Tennis Elbow?

The most common cause of tennis elbow is excessive use of the forearm and wrist, for any movement or exercise that creates an excessive load on the extensor tendon of the wrist can result in minor tears and inflammation of the extensor tendon that originates from the lateral epicondyle of the elbow joint. Meanwhile, chronic inflammation can also lead to degeneration of the extensor tendon and exacerbates the inflammation.

Holding a hand in pain

Tennis elbow can also be caused by direct trauma to the lateral side of the elbow. When the muscle lacks flexibility and the wrist is flexed violently or the extensor tendon of the wrist is suddenly pulled and hit, the extensor tendon of the wrist can be strained and injured.

Symptoms of Tennis Elbow

Due to inflammation of the periosteum and muscles, the affected areas of patients suffering from tennis elbow usually feel hot, swollen, and painful. The painful symptoms of tennis elbow usually appear after overuse of the elbow and wrist. The initial symptoms are usually weakness of the wrist or elbow as well as pain and weakness while stretching the wrist or elbow. The painful symptoms occur spontaneously when playing ball games or exerting forces and can last for several days or even months. The location of the pain is usually on the lateral side of the elbow joint, together with local tender points. Sometimes the sensation of pain will radiate to the forearm muscles, wrists, and fingers. Since the patients will feel severe pain when they perform dorsiflexion or resists against external forces with their wrists, they are usually unable to twist towels, carry heavy objects, or play ball games.

Tennis elbow is a painful symptom caused by chronic wear and tear. If improperly treated, it will increase the pain and gradually limit the elbow's mobility while accelerating degeneration, in which the patients may even feel the pain while at rest. For severe patients, the inflamed soft tissues can exert pressure on the surrounding nerve or lead to peripheral muscle contraction.

How to Diagnose Tennis Elbow?
  • Tender points appeared on the lateral side of the elbow joint
  • Sensation of pain around the lateral side of the elbow when applying resistance to the wrist that has been bent upwards
  • Pulling and pain sensation when bending the wrist downward
  • The muscles of the forearm become stiff, accompanied by pain when gripping or twisting objects
visiting a doctor

Clinical judgement is usually needed to diagnose tennis elbow. If necessary, ultrasound or MRI scans can be used to show tendon degeneration and muscle tears of the extensor tendon of the wrist.

Treatments for Tennis Elbow
  • Rest: minimize activities or painful movements as far as possible.
  • Use elbow pads: besides using elbow pads that support the muscles of the forearm and reduce pain, intramuscular tapes can also be applied to relieve inflammation and pain.
  • Medication: apart from taking non-steroidal anti-inflammatory drugs, topical analgesic ointments or patches can also be applied to relieve pain. Patients with more severe tennis elbow may consider receiving local injections of anti-inflammatory steroids, which can help to quickly reduce the inflammation.
a Physiotherapist massaging patient
  • Physiotherapy: cold/heat therapy, electrotherapy, ultrasound, acupuncture, shock waves, etc., can be used to treat the affected area and relieve pain, improve circulation, and accelerate tissue recovery. Meanwhile, manual therapy can also increase joint mobility and reduce soft tissue adhesion. Click here to browse related fitness and pain relief products.
  • Exercise therapy: since the injured and inflamed tissues can easily recur without training, exercise training is very important. When the injury is severe, the patient can do light stretching exercises to increase local circulation, relax muscles, and reduce pain. After the pain is relieved, follow the instructions of the physiotherapist to perform suitable muscle strengthening exercises.
Prevention of Tennis Elbow
  • Correct the improper posture while performing daily tasks, do not repeat or overdo the same actions for a prolonged period of time. When appropriate, take sufficient rest before continuing the task.
  • Athletes who need to undergo training for a long time must always maintain the correct posture and strictly limit the training time. Do not train excessively.
  • If a trolley or suitcase is available, avoid picking up heavy objects with hands. When lifting heavy objects, pay attention to maintaining the correct wrist posture.
  • Employees who develop work-related tennis elbow should have their workloads reduced.
  • In order to avoid deterioration of the condition, individuals who experience discomfort in their elbows should consult a doctor or physiotherapist for professional advice as soon as possible. It is important to bear in mind that the longer the tennis elbow persists, the longer it will take to treat the condition.
Last Updated: Aug 2020
Please note that all medical health articles featured on our website have been reviewed by Quality Healthcare doctors. The articles are for general information only and are not medical opinions nor should the contents be used to replace the need for personal consultation with a qualified health professional on the reader’s medical condition.