Tennis elbow

Tennis elbow is a condition involving the tendons connecting your forearm muscles to your upper arm.


If you're experiencing pain or discomfort, our orthopaedic specialists can provide accurate diagnosis, expert advice and effective medical treatment for tennis elbow.

Man playing tennis 840449630.jpeg

At HCA UK we offer:

  • Experts in tennis elbow and other forms of tendonitis
  • Appointments with our shoulder and elbow consultants or our sport and exercise doctors confirmed within 24 hours
  • Private orthopaedic care rated 'good' or 'excellent' (as rated by by 97% of our orthopaedic patients)

What is tennis elbow?

Tennis elbow, clinically known as lateral epicondylitis, is a common overuse or strain injury causing pain on the outside of the elbow. It's often confused with golfer's elbow, which refers to medial epicondylitis (on the inside of the joint).

The pain from tennis elbow usually stems from inflammation of the tendons that connect your forearm muscles to a bone structure at the base of your upper arm bone (humerus).

Although it is possible for the condition to heal naturally, repeated strain without treatment can worsen symptoms over time. The most serious cases result in microscopic tears of the tendon as overuse pulls fibres away from the bone, needing much longer and more drastic measures to recover.

Despite its name, you can develop tennis elbow from any activity where repetitive movement of the forearm fatigues the muscles and overloads the tendons around the joint. This is why people who play racket sports are more susceptible, just as professionals who rely on hand tools or repeat the same motions are as well.

The effects of tennis elbow

Consultant orthopaedic Surgeon, Mr Omar Haddo describes how 'tennis elbow' can affect your movement and daily activity.
Couple holding hands 1135120094.jpeg

What are the symptoms of tennis elbow?

The symptoms of tennis elbow can vary depending on the severity of the condition and how long you've been dealing with the issue. Some people find the symptoms of tennis elbow get worse at night and often cause more pain over time. Avoiding treatment and continuing to strain the tendons around your elbow can result in further damage, more discomfort and a much longer recovery period. Some of the most common signs include:
  • Pain on the outside of the elbow, sometimes extending down into the forearm and wrist
  • Difficulty or discomfort twisting your forearm and wrist, such as when opening a jar or turning a door knob
  • Stiffness and pain when fully extending your arm
  • Weaker grip than usual
  • Swelling around the outside of the elbow, often making it tender to touch

What causes tennis elbow?

Tennis elbow isn't just a sports injury, as the name suggests. Lateral epicondylitis can develop in anyone repeatedly straining their forearm muscles or overloading them in sharp bursts.

Repetitive movements of your forearm can quickly fatigue its relatively small muscles. When this happens, the tendons connecting your muscles to the lateral epicondyle (the bony bump on the outside of your elbow) take more of the strain. If they become consistently overloaded, this can cause inflammation, pain and eventually tearing of the tendon.

Tendons are tough, cord-like tissues which move our limbs as the muscles they're connected to contract and relax. They're also important to absorb the various impacts and strains of movement. However, overloading tendons can strain the fibres and eventually tear them. Both medial and lateral epicondylitis are forms of tendonitis.

The tendon most likely responsible for tennis elbow symptoms is the one attached to the extensor carpi radialis brevis muscle, but any of the four muscles in the forearm could be affected by repetitive strain and lead to tendon damage.

Orthopaedics 1999866876.jpg

How is tennis elbow diagnosed?

Your consultant will first assess your medical history and discuss your symptoms with you. A physical examination, checking for swelling, stiffness and any pain around the elbow joint during movement, should provide much of the information needed to diagnose tennis elbow, if that is the issue.

In some cases, additional testing may be needed to rule out any nerve damage, arthritis or fractures causing the pain. This may include:

  • X-rays (to identify any broken bones or signs of arthritis)
  • Imaging tests, such as MRICT or ultrasound scans (to assess the severity of any tendon and muscle damage)
  • Electromyography (EMG) (to rule out a compressed or pinched nerve by monitoring electrical activity)

Tennis elbow treatments

Living with lateral epicondylitis can make it more difficult and painful to carry out everyday tasks. It may even impact your ability to work and relax, so finding the best relief for tennis elbow is crucial.

The condition can get better on its own with enough rest. However, treatments may help to speed up the recovery process or heal the damage if it's not doing so naturally.

Non-surgical tennis elbow treatment

A shoulder and elbow consultant will first suggest non-surgical treatments for tennis elbow. These are often effective in the earlier stages of the condition and less severe cases.

  • Avoid strenuous activities: It's best to take a break from the activities that caused your tennis elbow and any that continue to aggravate it. This will give tendons time to recover and prevent further damage. Hopefully, you'll be back out on the court or returning to work in no time.
  • Rest, ice, compression and elevation: The RICE method is used to treat a range of musculoskeletal conditions. These steps should help to reduce inflammation of the tendons and promote healing.
  • Over-the-counter medication: Painkillers such as paracetamol can help to relieve any pain and discomfort caused by tennis elbow and ibuprofen can reduce swelling to ease the pressure on your tendons and elbow joint. Ibuprofen may come in the form of tablets or topical creams and gels, depending on your preference.
  • Elbow supports and braces: A dedicated strapping, brace or splint, called an orthosis, can be effective in compressing the elbow and supporting the joint to reduce any further strain on the surrounding tendons.
  • Steroid or PRP injections: If treatments like the above haven't worked, some people are given injections of cortisone (steroids) or platelet rich plasma (PRP). Steroids reduce inflammation to promote healing, while PRP supports the body in repairing damaged tissue. These may need to be given with local anaesthetic.
  • Shockwave therapy: This type of treatment involves high-energy shockwaves being sent through the skin to target damaged tissue. It can be effective in relieving pain and stimulating healing.
Endometriosis Physiotherapy 1078576050.jpg

Tennis elbow physiotherapy

Physical therapy may be recommended by shoulder and elbow consultants as an effective treatment for chronic lateral epicondylitis. It's more common in cases where symptoms have persisted for a long time or the pain is more severe.

With the support of a physiotherapy specialist, you'll learn how to strengthen the muscles in your forearm to ease the burden on your tendons and gradually restore movement and flexibility around the elbow. This is typically achieved with a range of stretching and strength exercises.

Physiotherapy treatment for tennis elbow may also include manual techniques such as massage.

Surgical lateral epicondylitis treatment

If physiotherapy and other non-surgical treatments are unsuccessful in restoring pain-free movement to your joint, tennis elbow release may be recommended by your consultant.

The procedure can be done by elbow arthroscopy (a type of keyhole surgery) or open surgery to give the surgeon better access to the joint and surrounding tendons. Your consultant will discuss the type of anaesthetic you'll be placed under beforehand, with there being pros and cons to both local and general anaesthetic.

For elbow arthroscopy, you may only need local anaesthetic. This means you'll be awake during the surgery, but you won't feel any pain and you'll avoid the side-effects that can accompany general anaesthetic, such as nausea. 

Your surgeon will make small incisions on both sides of the elbow and insert a tiny surgical camera to allow them to assess the damage likely to be causing your pain and take the necessary steps, whether that be removing a bone spur or cutting and removing damaged muscles and tendons to promote healthy regrowth.

If open surgery is needed, a cut will be made on the outside of your elbow. Once the lateral epicondyle and the surrounding tendons have been exposed, the surgeon will assess the damage and make repairs or cut away any bone, tendon or muscle that is preventing healing.

Your consultant will discuss everything regarding the surgery in a pre-appointment meeting and can answer any questions you may have. Most tennis elbow release procedures are day cases, so no overnight stay required. However, arranging a pick up in advance to take you home after your surgery is advised.

Following your operation, you'll need several weeks to make a full recovery. Your consultant will outline any ongoing physiotherapy exercises to help restore your strength and movement.

Tennis elbow prevention

There are ways to prevent tennis elbow from developing or stop it reappearing after successful treatment, including:

  • Improve form and technique: Whichever activity or movement is causing tennis elbow, your form and technique play a significant role in your chances of developing an injury. For sports-related conditions, a coach can help improve your form when it comes to the likes of tennis or squash. For work-related injuries, consider how you carry out your job and what steps you can take to protect yourself from strain.
  • Strength and conditioning: Improved strength and endurance of your muscles ease the load put on tendons in times of fatigue. Consistent strength training and targeting of the forearm muscles should help prevent tennis elbow in the long term.
  • Warm-ups and stretching: Overloading can happen in an instant, so warming up and stretching before any physical activity involving your forearm and elbow can help prevent straining and painful symptoms from emerging.
  • Use the right equipment: Sports equipment, such as tennis rackets, should be the right size and type for your activity. The wrong size can strain certain parts of your arm and body in play, increasing the chances of tennis elbow.
Why choose HCA UK

Why choose HCA for tennis elbow treatment?

  • Lateral epicondylitis treatment experts: You'll benefit from specialist shoulder and elbow consultants who can provide the best medical treatment for tennis elbow.
  • Fast access to appointments: We will confirm initial consultations within 24 hours of your first contact with us.
  • Leading private hospital group: We have a higher proportion of excellent ratings from the Care Quality Commission (CQC) than any other private medical group in the UK.
  • Satisfied orthopaedic patients: Our 2022 patient survey revealed that 97% of patients rated HCA UK's orthopaedic care as good or excellent.
  • Official recognition: All our consultants are members of the British Orthopaedic Association (BOA) and adhere to its strict code of conduct.
How to book an appointment

How to book an appointment

For advice, diagnosis and treatment for your tennis elbow, it's quick and easy to book an appointment with one of our expert consultants.

 

Call us or fill in our online form with your details.

Shoulder imagery 1371774791.jpg

Our orthopaedic consultants

Use our consultant finder to select a tennis elbow specialist who can help you with lateral epicondylitis. You'll also be able to check their working locations, areas of expertise, accreditations and Doctify consultant rating.

The Princess Grace Hospital _ 0523_049

Book an appointment with a tennis elbow specialist

Tennis elbow can sideline you from sports, work and other activities for weeks and months without the right treatment. By getting in touch with one of our orthopaedic experts you will receive the best treatment options for your tennis elbow troubles. You can make an appointment with one of our experienced tennis elbow specialists by using the link below to choose your consultant and book into their diary directly. 

Our Tennis elbow locations

Institute of Sport Exercise and Health (ISEH)

Institute of Sport Exercise and Health (ISEH)

170 Tottenham Court Road W1T 7HA London
The Harley Street Clinic

The Harley Street Clinic

35 Weymouth Street W1G 8BJ London
The Portland Hospital

The Portland Hospital

205-209 Great Portland Street W1W 5AH London
The Princess Grace Hospital

The Princess Grace Hospital

42-52 Nottingham Place W1U 5NY London
The Lister Hospital

The Lister Hospital

Chelsea Bridge Road, SW1W 8RH London
The Shard Outpatients

The Shard Outpatients

The Shard, 32 St Thomas Street SE1 9BS London