What is a tennis elbow?

A tennis elbow (epicondylitis humeri radialis) refers to a painful overuse of certain tendons in the elbow area. The pain originates from where the extensor tendons of the forearm muscles attach to the humerus (outside above the elbow). Incorrect - usually one-sided - loading and excessive stress on the forearm muscles through repetitive hand and arm movements can trigger an inflammatory reaction at the tendon insertion. Those affected experience the painful condition of a tennis elbow when slightly bending and twisting the wrist and elbow joint, as well as when clenching a fist, opening a bottle or even when pressure is applied to the elbow from outside. Particularly distressing: The pain can radiate from the elbow into the entire arm and fingers.

A first indication of a tennis elbow can be pain in the outer elbow area. Even though this discomfort can be considered a leading symptom, the inability to get a hold of something with the affected hand can also be an indicator of a tennis elbow.

It is important to determine which movements trigger the discomfort. For example, a stabbing pain can be noticeable when bending and stretching the arm and hand. Pain when rotating the forearm is also one of the characteristics of a tennis elbow.

Essentially, any movement that uses the affected forearm muscles, such as shaking hands, holding a cup or twisting open a bottle can be painful. A slight feeling of numbness or tingling in the area of the elbow or hand may also accompany the pain. Additional to load-dependent symptoms, pain at rest may occur in addition to the load-dependent symptoms.

Overview of potential tennis elbow symptoms:
• Pain on the outside of the elbow (also pressure pain)
• Stabbing pain, especially during twisting and bending movements
• Feeling of weakness in the wrist
• Feeling of not being able to grip properly
• Pain radiating into the entire arm (hand, forearm, upper arm)
• Signs of inflammation at the tendon insertion: redness, swelling, warmth
• Sensory disturbances in the entire arm area or parts of it
• Pain during physical activity, later accompanied by pain at res

Pain in the elbow or near the elbow can also have several other causes. These include, for example, rheumatic diseases, osteoarthritis, bursitis or nerve damage in the area of the elbow joint.  A fall on the elbow can also cause pain, e.g. due to a simple contusion or even a fracture of one of the bony structures involved in the elbow joint. 

The final diagnosis always belongs in the hands of the doctor.

That the eponymous sport "tennis" can cause tennis elbow is certainly true. However, a repetitive motion pattern also occurs in other sports such as golf, badminton and weight training. 

However, one-sided loading and overloading outside of sports can also cause a tennis elbow: Housework, gardening, computer work, manual labor - practically anyone can be affected. Even people who play an instrument like the violin or guitar can get a tennis elbow.

If you have pain in your elbow, you should first see your doctor. It is also possible to go directly to a specialist (the orthopedist is responsible here). 

The examination is first initiated by a discussion of the exact medical history and previous illnesses (anamnesis). A physical examination and uncomplicated tests then supplement the information obtained in the medical history. If the findings are inconclusive and other diseases are to be ruled out, further investigation is required. Here, imaging procedures such as X-ray, ultrasound or MRI provide information.

Conventional treatment is possible for a tennis elbow. Surgical treatment is only necessary in the rarest cases. 

Once the diagnosis has been made, the doctor decides which therapy is most suitable on a case-by-case basis. Sometimes, treatment costs are even covered by Medicare. At the beginning of therapy, it is most important to relieve the irritated tendon insertion and reduce the chronically increased tension caused by the pulling of the muscles. Therefore, activities that trigger pain must be strictly avoided. In addition, patients should regularly stretch their forearm muscles. This protocol is particularly important during the initial acute phase, which lasts about two weeks.

As soon as the patient no longer experiences severe pain, physiotherapy, stretching and strengthening exercises (i.e., exercises that stretch and strengthen the arm and wrist muscles) can be started. Other possible manual and physical therapies include, for example, deep-tissue massages of the affected muscles and heat or cold treatments (depending on the recovery stage). 

For acute and persistent symptoms, affected individuals can also wear special supports. These supports help to reduce muscle tension and traction at the enthesis by applying targeted pressure and changing the direction of the tendon pull. As a rule, these braces should be worn for several hours a day, especially during physical activity. Tape bandages and kinesiology tapes can also alleviate tennis elbow symptoms under certain circumstances. However, appropriate expertise or physiotherapeutic support is necessary for correct taping. 

In addition, doctors often use medicinal therapies such as injections to treat a tennis elbow. Likewise, locally or orally applied anti-inflammatory drugs, such as gels, ointments or pills, are often used. However, you should always discuss with your doctor what is appropriate in your case. Also, non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used to cure a tennis elbow.

Shock wave therapy is another commonly used form of treatment. Next to the more common therapy forms, there are other, less frequently used forms of therapy, such as therapy by ultrasound, X-ray, laser, or acupuncture.

Surgical tennis elbow therapy is at the end of the treatment sequence and is considered when long-term conservative therapy does not lead to lasting success. The doctor decides whether a surgery is necessary. Such surgeries are routine procedures with uncomplicated aftercare. Nowadays, the procedure is also minimally invasive: the tendon is treated with the help of tiny cameras and surgical instruments inserted into the region (arthroscopy).

A tennis elbow is considered curable if treated in time. But how long does it take for a tennis elbow to heal? That can vary from case to case. Some people get rid of the painful epicondylitis after just a few weeks. But many struggle with the symptoms for months, some even longer - the tennis elbow does not get better.

While physical rest is advisable during the acute phase of the disease, targeted exercise and muscle building are essential during the healing phase. 

As long as pain occurs under stress and during certain movements, consistent rest is key. Depending on the severity of the symptoms, you should take a few days off, always in consultation with your doctor, and then resume movements and exertion as soon as possible, adjusted to the pain. In this phase, relieving supports or an applied kinesiology tape can be helpful. 

If you notice an improvement, special stretching and strengthening exercises of the arm muscles can accelerate the healing process. Strengthening of the chest and shoulder blade muscles and posture training are also supportive.

Stretching the muscle groups of the forearm can increase its mobility and reduce muscular tension. To additionally decrease the muscle tone and improve the blood circulation - and thus the nutrient supply - the work with a fascia roller is also recommended.

If you suspect that you have a tennis elbow, then doctors (in this case general practitioners or orthopedists) can be important contacts. Physiotherapists can also give you good advice and recommendations on specific exercises.

If the symptoms persist over a longer period of time, then it can and may be quite uncomfortable during movements or the exercises recommended by the physiotherapist - the movement is nevertheless important and will be helpful for the further progression of the symptoms.

Epicondylitis in the early stages can usually be treated well. The elbow pain is then usually not yet permanent. In this phase of the disease, the pain is mainly triggered by pressure on the outside of the elbow. So is the strain on the muscles associated with the affected tendons.

It becomes problematic if you ignore the symptoms mentioned above and do not consult a medical professional. Then it can happen that the pain becomes stronger and stronger, radiates further and further into the surrounding musculature and occurs even in rest phases. This is how a tennis elbow can become chronic. Treatment is then usually more protracted.  Current studies and science clearly show that the prognosis in the case of a tennis elbow is very good and that exercise and load (despite any pain) are permitted and even important. A supportive measure such as a brace or supports can be beneficial and enable you to use your arm well in everyday life more quickly.

While you cannot completely avoid the risk of a tennis elbow, you can follow the general advice to reduce the risk or positively affect existing symptoms:

• When playing sports, make sure you perform your movements correctly.

• Discuss with your trainer how to train in a technically correct way, e.g. golf, tennis, strength training, to prevent overloads from developing.

• Take regular breaks with stretching and loosening exercises during strenuous and, above all, unfamiliar activities. This allows the muscles to relax in between. 

• If you already have pain, avoid the pain-inducing movement for a few days. This means reduce repetitive, one-sided arm movements and thus the overload of the elbow joint in everyday life, work and sports. Do tennis elbow symptoms make themselves felt repeatedly? Then do not hesitate to consult a doctor.

• If necessary, wear an epicondylitis brace or support (also called a tennis elbow support - available, for example, in pharmacies, medical supply stores or drugstores).

Notice:

Please note that the tips and advice given on this website have been compiled with great care but can in no way replace medical advice and treatment. If you have or suspect a health problem, see a doctor and follow medical advice regardless of what you have learned on this website. 

If there is a serious injury, it must be assessed and treated by a (specialist) doctor. If you are unsure about the cause of your pain, you should also consult a doctor.

If the symptoms are accompanied by redness, swelling, overheating of the joints, persistent or severe pain and/or neurological symptoms (e.g. numbness, tingling) or if the pain radiates to the legs, a doctor should be consulted immediately.

The information on this website is not intended as a basis for self-diagnosis, treatment and medication.

Please always read the instructions for use or package inserts of our products carefully and comply with them.  

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