Tennis Elbow (Lateral epicondylitis)
Date issued: December 2022
Review date: December 2024
Ref: A-557/NB/ED/Tennis Elbow
PDF: Tennis Elbow final December 2022.pdf [pdf] 126KB
What is tennis elbow?
Tennis elbow is a pain on the outer side of the elbow which usually happens when you use the forearm, particularly on twisting movements such as turning a door handle.
What causes tennis elbow?
The site of the pain is where some tendons from the forearm muscles attach to the bone. The pain is due to inflammation of a tendon. This is probably caused by a small injury or overuse of the forearm muscles in repeated actions such as manual work (particularly with twisting movements such as screwdriving). Playing tennis or other racquet sports can also cause it.
What are the treatments for tennis elbow?
Not treating is an option. There is a good chance that symptoms will settle in time. It may take several weeks, or months, as tendons are 'slow healers'. However, treatment may improve symptoms more quickly.
Anti-inflammatory medication can be used with paracetamol or as an alternative. There are many types and brands. They relieve pain and reduce inflammation and swelling (often the cause of the pain). You can buy ibuprofen at pharmacies or supermarkets without a prescription. The dose varies depending on your age and other medical problems. Side-effects sometimes occur with anti-inflammatory painkillers. Ask your doctor or pharmacist for advice regarding them.
Steroid Injections are sometimes recommended. Steroids work by reducing inflammation.
Other treatment options
Paracetamol is useful to ease pain. It is best to take it regularly for a few days or so, rather than every now and then. An adult dose is two 500 mg tablets, four times a day. A doctor may prescribe additional painkillers such as codeine if the pain is more severe. If you are prescribed a combination of paracetamol and codeine (e.g., cocodamol or codydramol) then it is important not to take additional paracetamol as you will accidentally overdose
If pain is not controlled by simple painkillers, do not exceed the recommended dose but see your general practitioner to discuss the possibility of stronger painkillers.
In some cases, referral to a physiotherapist or to a specialist may be advised if symptoms persist. A small number of people require surgery to relieve symptoms.
Can tennis elbow be prevented?
You often cannot avoid a sudden overuse of the arm which can cause tennis elbow. However, if you increase the strength of your forearm muscles which bend the wrist backwards, it may help to prevent a further bout of tennis elbow in the future.
If you do a lot of DIY, invest in a ratchet or electric screwdriver.
Tools with larger handles are easier to grip, try wrapping a piece of foam round the handle of tools.