Tennis Elbow: What it is, Causes, Symptoms, Treatment, & More

What is Tennis Elbow?

Tennis elbow, which is also referred to as lateral epicondylitis, is caused by the over-use of the outer part of the elbow and may result in irritation or damage. Tennis elbow is not an ailment exclusive to tennis players as there are numerous other people who use their wrists, hands, and forearms in repetitive work activities and may end up with tennis elbow.

This condition mainly affects the extensor tendons of the forearm, in particular the tendon called Extensor Carpi Radialis Brevis (ECRB). These tendons become subjected to repeated stress, resulting in inflammation and pain involving the area around the outside of the elbow, causing them to become weak.

How Common is Tennis Elbow?

Tennis elbow is a quite common injury, in which the tendons around the elbow joint get inflamed. Recent clinical studies show that about 40-50% of tennis players develop symptoms of tennis elbow during their careers.

But the majority of cases are actually due to repetitive work activities, such as typing, lifting, painting, carpentry, and using tools. It typically occurs in adults aged 35-50 and is one of the most common causes of elbow pain worldwide.

What are the Symptoms of Tennis Elbow?

Tennis elbow symptoms usually develop gradually and may worsen if left untreated. The following symptoms are commonly seen in tennis elbow:

• Pain on the outer side of the elbow.

• Weak grip strength.

• Redness and swelling at the site of the injury.

• Pain while shaking hands.

• Tenderness around the elbow.

• Pain in the shoulder when lifting the arm.

• Rigidity in elbows, particularly in the morning.

• Pain that spreads to the forearm and wrist.

What Causes Tennis Elbow?

Continuous repetitive movements can cause tiny tears in the tendons, leading to pain, inflammation, and weakness around the elbow joint. The following are the causes of Tennis Elbow:

• Repetitive Hand and Wrist Movements: Repeated movements such as gripping, typing, lifting, or twisting the wrist can strain the forearm tendons and increase the risk of tennis elbow.

• Sports Activities: Playing racket sports like tennis, badminton, or squash with improper technique or excessive practice can damage the elbow tendons over time.

• Occupational Overuse: Jobs involving repetitive arm movements, such as painting, plumbing, carpentry, cooking, tailoring, and computer work, can increase stress on the elbow muscles and tendons.

• Poor Lifting Technique: Lifting heavy objects incorrectly or putting sudden pressure on the forearm muscles may cause tendon injury and elbow pain.

• Weak Forearm Muscles: Weak muscles around the wrist and forearm may fail to support repetitive movements properly, increasing tendon strain.

• Improper Sports Equipment: Using heavy rackets, incorrect grip size, or tightly strung rackets can increase pressure on the elbow tendons during sports activities.

• Lack of Rest and Recovery: Continuous repetitive work without proper breaks or recovery time can lead to overuse injuries and tendon damage.

• Age-Related Tendon Degeneration: People between 35 and 50 years of age are more likely to develop tennis elbow because tendons gradually lose flexibility and strength with age.

• Poor Ergonomics: Incorrect posture while typing, using tools, or performing repetitive tasks may increase stress on the elbow and forearm muscles.

Risk Factors for Tennis Elbow

Several factors can increase the risk of developing tennis elbow:

• Repetitive hand movements

• Poor posture during work

• Smoking

• Weak forearm muscles

• Improper sports techniques

• Occupations involving repetitive arm activity

What are the Complications of Tennis Elbow?

If tennis elbow is left untreated for a long period of time, it can affect daily activities and lead to several complications involving the muscles, tendons, and arm function. The following are the most common complications of tennis elbow:

• Chronic Elbow Pain: Continuous tendon irritation and damage may cause long-term elbow pain that can interfere with routine activities and physical work.

• Weak Grip Strength: Tennis elbow can weaken the forearm muscles, making it difficult to hold, grip, or lift objects properly.

• Reduced Arm Function: Severe pain and stiffness around the elbow may limit arm movement and reduce the ability to perform normal hand and wrist activities.

• Tendon Degeneration: Repeated strain without proper treatment may gradually damage the tendon tissues and lead to chronic tendon degeneration.

• Difficulty Performing Daily Activities: Simple tasks such as opening jars, shaking hands, writing, typing, carrying bags, or turning door handles may become painful and difficult.

• Persistent Inflammation: Long-term irritation of the elbow tendons may cause ongoing inflammation and discomfort around the joint.

• Sleep Disturbance: Some people may experience increased elbow pain at night, making it difficult to sleep comfortably.

• Reduced Sports Performance: Athletes and sports players may experience weakness, pain, and reduced arm strength that can affect their sports activities and performance.

• Muscle Weakness: If tennis elbow is not treated, the forearm and wrist muscles can slowly become weaker because people tend to use their arm less, and the pain continues.

• Increased Risk of Recurrence: If you do not recover fully or take steps to prevent it, tennis elbow symptoms can keep coming back even after they seem to get better for a while.

When Should I See My Healthcare Provider?

You should see a doctor for tennis elbow if your symptoms last a long time, get worse, or make it hard to move your arm or do daily tasks. Getting help early can prevent lasting tendon damage and help you recover faster.

• Elbow Pain Lasting More Than a Few Weeks: If your elbow pain lasts for more than a few weeks and does not get better, it could mean you have ongoing tendon damage or chronic tennis elbow. In this case, you should see a doctor.

• Difficulty Gripping Objects: Weak grip strength or pain while holding objects such as bottles, bags, cups, or tools may suggest worsening strain on the forearm tendons.

• Severe Pain During Wrist Movement: Pain that increases while twisting the wrist, lifting objects, shaking hands, or performing repetitive activities should be examined by a doctor.

• Weakness in the Arm or Hand: Persistent weakness in the forearm, wrist, or hand can interfere with daily activities and may indicate tendon or muscle involvement.

• Swelling or Stiffness in the Elbow: Swelling, tenderness, or stiffness around the elbow joint may occur due to inflammation and should not be ignored if symptoms continue.

• Pain that Does Not Improve With Rest: If elbow pain continues despite rest, ice therapy, medicines, or avoiding repetitive activities, proper medical treatment may be necessary.

• Difficulty Performing Daily Activities: Simple tasks such as writing, typing, cooking, lifting objects, or opening jars may become painful, indicating worsening tennis elbow symptoms.

• Pain Spreading to the Forearm or Wrist: Pain that spreads from your elbow down to your forearm or wrist can be a sign that the muscles and tendons are under more strain.

• Increased Pain During Sports or Work: If your pain gets worse during sports, exercise, or repetitive work, it is important to have it checked by a doctor to avoid further injury.

• Reduced Arm Movement: In more severe cases of tennis elbow, you might find it hard to bend, straighten, or move your arm comfortably.

• Night Pain or Sleep Disturbance: If you have ongoing elbow pain at night that makes it hard to sleep, it could be a sign of inflammation or long-term tendon irritation.

How is Tennis Elbow Diagnosed?

Doctors diagnose tennis elbow by performing a physical examination and using imaging tests:

How is Tennis Elbow Managed?

Treating tennis elbow usually means easing pain, helping the tendon heal, regaining arm strength, and avoiding more strain on the elbow. Most people get better with simple treatments and changes to their daily habits.

• Rest and Activity Changes: Cutting back on activities that put stress on your elbow can help prevent more irritation. It’s best to avoid things like gripping, lifting, or moving your wrist over and over until the pain gets better.

• Ice Therapy: Putting an ice pack on the outside of your elbow for 15 to 20 minutes a few times a day can help lower pain, swelling, and inflammation in the tendon.

• Pain Relief Medicines: Your doctor might suggest taking medicines like ibuprofen or naproxen to help with pain and swelling from tennis elbow.

• Support Strap: Using a tennis elbow brace or counterforce strap helps reduce pressure on the affected tendon and supports the forearm muscles.

• Physiotherapy: Working with a physiotherapist can help you recover by making your arm more flexible, building up your forearm muscles, and easing stress on your elbow tendons with special exercises.

• Stretching and Strengthening Exercises: Doing certain wrist and forearm exercises can make your muscles stronger, help your tendons heal, and improve how your arm works. These exercises also lower the chance of the pain coming back.

• Ergonomic Changes: Maintaining good posture, arranging your workspace properly, and using proper sports techniques can ease strain on your elbow and help you recover over time.

• Corticosteroid Injections: For more serious cases, doctors might use corticosteroid injections for a short time to lower pain and swelling if other treatments have not worked.

• Platelet-Rich Plasma (PRP) Therapy: PRP therapy involves injecting concentrated platelets from the patient’s blood into the damaged tendon to support tissue healing in chronic tennis elbow cases.

• Shockwave Therapy: Extracorporeal shockwave therapy may help stimulate healing and reduce chronic tendon pain in some patients who do not respond to standard treatment.

• Surgery: Surgery is usually considered only in severe or long-standing cases where symptoms do not improve after several months of non-surgical treatment. The damaged tendon tissue may be repaired or removed surgically.

• Lifestyle and Recovery Support: Getting enough rest, eating well, staying hydrated, and not smoking can help your tendons heal and may speed up your recovery.

Tennis Elbow During Pregnancy

Tennis elbow during pregnancy can develop due to repeated arm movements, hormonal changes, fluid retention, and increased strain on the joints and tendons. Although the condition is not directly related to pregnancy, some women may experience elbow pain and weakness because pregnancy hormones can loosen ligaments and increase stress on muscles and tendons.

Pregnant women with tennis elbow are usually advised to:

• Avoid repetitive lifting, gripping, or wrist movements that worsen elbow pain.

• Make sure to rest and avoid overworking your forearm muscles.

• Put an ice pack on your forearm for 15 to 20 minutes to help with pain and swelling.

• Wear an elbow brace or support strap if your doctor suggests it.

• Perform gentle stretching and physiotherapy exercises under professional guidance.

• Keep good posture while working or doing chores at home.

• Avoid self-medication without medical advice during pregnancy.

What is the Prognosis for Tennis Elbow?

The prognosis for tennis elbow depends on the severity of the tendon damage, activity modification, proper treatment and early diagnosis. Most people recover from tennis elbow and are able to return to their normal activities after a course of treatment, rest, physiotherapy and regular exercise, which can take from a few weeks to several months. Recovery is generally good if the affected area is freed from strain and properly treated.

But after-treatment, repeated movements, faulty work posture, smoking or overlooking symptoms can lead to chronic pain, the degeneration of tendons and even to the tennis elbow coming back again.

Is Tennis Elbow Curable?

Yes, most cases of tennis elbow can be cured if the condition is treated early and properly. Many people get better with simple treatments like rest, physiotherapy, ice, exercises, braces, and pain killer medicines.

Severe or chronic tennis elbow may take longer to recover, but symptoms can usually be controlled effectively with proper medical care and rehabilitation.

How Can I Prevent Tennis Elbow?

The following steps can help reduce the risk of tennis elbow:

• Avoid repetitive strain on the wrist and forearm muscles.

• Use proper posture and ergonomics during work and sports activities.

• Take regular breaks during repetitive tasks or computer work.

• Perform stretching and strengthening exercises for forearm muscles.

• Use proper sports equipment and correct racket grip size.

• Warm up properly before sports or physical activities.

• Avoid lifting heavy objects with improper technique.

• Maintain good flexibility and muscle strength in the arm and wrist.

• Quit smoking to improve tendon healing and blood circulation.

• Seek early treatment if elbow pain or weakness develops.

Does Health Insurance Cover Tennis Elbow?

Yes, health insurance generally covers treatment for tennis elbow if it is considered medically necessary. These insurance plans may help reduce the financial burden of doctor consultations, diagnostic tests, physiotherapy sessions, medicines, injections, and surgery if required.

If tennis elbow is diagnosed after buying the policy, it is usually covered once the 30-day waiting period has elapsed (unless caused by an accident). If you already had tennis elbow when you purchased the policy, it may be considered a pre-existing disease (PED), and coverage will begin only after the applicable PED waiting period, which generally ranges from 2 to 4 years, depending on the insurer.

Note: Always check your policy document for exclusions, physiotherapy limits, sub-limits, and waiting periods before making a claim.

How Much Health Insurance Coverage is Needed for Tennis Elbow Treatment?

The ideal health insurance coverage for tennis elbow depends on the severity of the condition and the treatment required.

For mild cases that only need doctor consultations, medicines, braces, and physiotherapy, a sum insured of around ₹5 lakh is generally sufficient. However, if the condition requires prolonged physiotherapy, PRP therapy, steroid injections, or surgery, treatment costs can increase significantly.

To ensure adequate financial protection against orthopaedic treatments, rehabilitation, and unexpected medical expenses, many experts recommend opting for a health insurance cover of ₹5 lakh to ₹10 lakh.