If you experience a sharp pain that radiates from the elbow joint into the forearm when you swing a tennis racket, garden or turn a doorknob, you might have tennis elbow (lateral epicondylitis).  While this condition has long been associated with folks who play racket sports, doctors at New York’s Hospital for Special Surgery (HSS) say you don’t have to be a tennis player to develop it. 

Plumbers, painters, carpenters, chefs, butchers — essentially anyone whose daily life requires repetitive motion involving the wrist and arm — can get it. Racket sports increase the risk, but the vast majority of people with tennis elbow don’t regularly play them. It’s most common among adults ages 30 to 50. 

"Tennis elbow can interrupt ordinary life activity and keep people from doing the things they want to do, such as playing tennis,  working on the computer or even lifting a cup of coffee,” says Kevin Duffus, a NJ-licensed physical therapist and HSS Rehabilitation Network provider.

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What is tennis elbow?

Tennis elbow is an overuse and muscle strain injury.  Repetitive motion and stress — specifically, contraction of the forearm muscle used to raise and straighten the hand and wrist — cause tiny tears in tendons. As a result, these tendons, which sit along the muscle of the forearm, become inflamed. This in turn creates pressure and on the bony elbow bump on the outside of the arm, know as the lateral epicondyles. 

Tennis elbow pain generally radiates from the outside of the elbow into the forearm and sometimes to the wrist. Pain may gradually increase over time or with activities that require wrist extension. Common movements and other daily tasks, such as turning a screwdriver or shaking hands, may become difficult or painful. 

Most people with tennis elbow can point to the exact spot where they experience pain and identify which movements make the pain worse. 

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How is tennis elbow diagnosed?

Tennis elbow is easily diagnosed by a doctor. During a physical exam your doctor may assess your range of motion and your ability to perform simple movements. X-rays and other imaging tools, such as MRI, are not generally needed, although they might be used to rule out more serious conditions such as arthritis or bone fractures. 

Treatments

Most episodes of tennis elbow are resolved within a few months, and only 20 percent last more than a year.  The treatment you and your doctor choose will depend on your level of pain and how much the condition is affecting your daily life. Options include:

  • Wait-and-see. Rest the elbow by taking a break from your regular activity. 
  • Ice. Apply an ice or cold pack for 15 minutes three or four times daily. 
  • Anti-inflammatories. Over-the-counter anti-inflammatory medicines such as ibuprofen can be very effective for managing pain and inflammation. 
  • A forearm brace, strap or splint. Your doctor may suggest wearing a specially designed forearm brace, strap or splint to take stress off the tendons."This is one of those conditions that an over-the-counter brace from the pharmacy can really help," says Duffus.
  • Physical therapy and strength training. A physical therapist can prescribe a stretching and strengthening routine. If the tennis elbow is being triggered by how you swing, you’ll learn how to position your forearm to avoid injury in the future. 
  • Cortisone injections. If you don’t get relief from the above, an orthopedist can inject a shot of this powerful anti-inflammatory into the affected area. 
  • Surgery. Severe cases of tennis elbow that last for several months and drastically limit activity may require surgery. Surgery is often done on an outpatient basis and involves trimming the affected tendons. 

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Laurie Albanese is an award-winning memoirist and journalist, as well as an avid tennis player and traveller.