Tennis elbow is pain on the outer side of the elbow caused by an irritated, overloaded tendon where the forearm muscles attach to the bone. Despite the name, most people who get it do not play tennis. It often improves on its own within a year, and exercise-based care can help you stay active while it settles.
Also known as lateral epicondylitis, lateral epicondylalgia, lateral elbow pain
Symptoms
- Pain on the bony bump on the outside of the elbow
- Pain that can spread down the back of the forearm
- Pain when gripping, lifting a kettle or shaking hands
- Weaker grip than usual
- Tenderness when you press on the outer elbow
- Stiffness or aching after rest, such as first thing in the morning
Causes and risk factors
- Repeated gripping, twisting or lifting, especially with force
- A sudden increase in activity, such as a weekend of DIY or gardening
- Work involving repetitive hand and wrist tasks
- Racket sports with a lot of backhand strokes
- Being aged 40 to 50
- Smoking, which is linked to a higher risk
What the evidence says helps
- Most people recover with time. In one large trial, around 9 in 10 people who simply waited and followed advice had improved by one year.12
- Exercise for the forearm muscles is one of the better-supported options. Reviews suggest it helps pain and grip more than passive treatments, although the benefit is modest.3
- Physiotherapy combining hands-on techniques and exercise gave faster early improvement than waiting in one trial, with similar results by one year.2
- Steroid injections can ease pain for a few weeks, but evidence shows people often relapse and do worse at six to twelve months than with no injection.24
- Anti-inflammatory gels may help short-term pain. Evidence for anti-inflammatory tablets is limited, and they can cause stomach side effects.5
- Shockwave therapy is sometimes offered for long-standing cases. NICE guidance says evidence on how well it works is uncertain.6
Things you can try at home
- Keep using your arm, but ease off the tasks that cause sharp pain for a while
- Try lifting with your palm facing up rather than down, and use both hands for heavy items
- Build up gripping and wrist exercises slowly, aiming for mild discomfort at most
- Break up repetitive tasks such as typing, decorating or gardening with short rests
- Check sports or work equipment, such as racket grip size or tool handles
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Your elbow is hot, red and swollen and you feel unwell or feverish: see a GP the same day or call NHS 111
- You cannot move or straighten the elbow after a fall, or it looks deformed: go to A&E
- Numbness, pins and needles or weakness in the hand that is getting worse: see your GP promptly
- Arm pain with chest pain, breathlessness or sweating: call 999
- Constant night pain, unexplained weight loss or a past history of cancer: see your GP
How Apollo can help
We start with a careful assessment to confirm the source of your outer elbow pain and rule out problems from the neck or nerves. We explain what is going on and agree a plan to manage load at work, home and sport. Your plan is built around a progressive strengthening programme, with hands-on care where appropriate, and we can measure grip strength to track your progress. If your symptoms do not settle or we find something that needs medical input, we will refer you on.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How long does tennis elbow last?
Flare-ups often settle within a few months, and most people have recovered within a year. Some cases last longer, especially if the arm keeps being overloaded. Managing your activity and following an exercise plan can help you stay active while it settles.
Should I rest my arm completely?
Complete rest is not usually needed. It helps to cut back on the tasks that cause sharp pain while keeping the arm moving. A gradual strengthening programme is generally more useful than stopping all activity.
Is a steroid injection a good idea for tennis elbow?
An injection may ease pain quickly, but research shows the benefit often wears off within weeks. People who have injections are more likely to relapse and can do worse in the longer term. It is worth discussing the pros and cons with your GP before deciding.
References
- Frydman A, Johnston RV, Smidt N, Green S, Buchbinder R (2018). Manual therapy and exercise for lateral elbow pain (protocol, background section). Cochrane Database of Systematic Reviews, CD013042. View source
- Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B (2006). Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 333(7575):939. View source
- Karanasios S, et al. (2021). Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small: a systematic review and meta-analysis of 2123 subjects in 30 trials. British Journal of Sports Medicine. View source
- Coombes B, et al. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet. View source
- Pattanittum P, Turner T, Green S, Buchbinder R (2013). Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow pain in adults. Cochrane Database of Systematic Reviews, CD003686. View source
- National Institute for Health and Care Excellence (2009). Extracorporeal shockwave therapy for refractory tennis elbow. Interventional procedures guidance IPG313 (now HealthTech guidance HTG201). View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
