Elbow pain

There are 2 common conditions that affect the elbow Tennis Elbow and Golfer’s Elbow

Tennis elbow causes the outside of the elbow joint to feel painful and tender

Tennis Elbow or lateral Epicondylitis causes pain / tenderness on the outer aspects of the elbow and often affects people who play racquet sports and manual workers but it can affect anyone.

What causes Tennis Elbow

This is an overuse condition affecting the common extensor tendon which attaches the extensor muscles of the wrist to the outside of the elbow.  The movement generated by this muscle is when the palm of the hand is facing down and it contracts causing the muscles to pull the wrist up to 90 degrees.

Due to over use microscopic tears develop causing the tendon to degenerate resulting in the symptoms of Tennis elbow, when the condition becomes chronic or long lasting calcification can occur where the tendon attaches the bone (the tendon insertion). In rare cases larger tears can develop, but the vast majority of cases are not serious and can be self managed.

The Symptoms

Pain and tenderness on the outside of the elbow is most common and is triggered when lifting with palm facing downwards or action similar to wringing out a cloth or pouring a heavy kettle.  Often a precise tender spot can be pin pointed over the bone just in front tendon itself.

How is it Diagnosed

The symptoms are usually classic in their presentation so no special investigations are usually required, if there is uncertainty about the diagnosis an ultrasound or MRI may be required.

Can I prevent it?

  • If you are new to sport or activity seek expert advice, as poor or incorrect technique increases the risks of injury.
  • Build up any new activity slowly, it takes time for the body to adjust to new sports and activities
  • DIY is another common cause of tennis elbow especially if you are not used to doing it. Avoid repetitive actions or excessive lifting, break up large jobs into more manageable chunks
  • Before starting strenuous activity warm up (see our sports injury information)
  • Good posture and correctly set up workstations is important

How do I manage my Tennis elbow?

Most cases can be self-managed with modification of activities, simple exercises and pain killers if required, and a small number of cases may require a steroid injection or in very rare cases surgery may be considered.


  • If the elbow feels sore after physical activity apply an ice pack for 15 minutes every few hours
  • Massaging the elbow may help and try using topical non-steroidal anti-inflammatory gels available from pharmacists
  • Racquet sports, increase the size of the grip by adding more tape
  • Sports shops or online often stock specially designed braces for tennis elbow symptoms. They work by applying pressure to the tendons and muscles during activity and help reduce symptoms
  • Special exercises from your Physiotherapist called eccentric exercises can be beneficial to tennis elbow sufferers

Further Treatment

Anatomically guided Corticosteroid injections can be done for tennis elbow, this involves steroid being injected around the tendon and its insertion into the bone.  However with any invasive procedure there are risks and possible side effects for you to consider, these will be discussed with you in full by the Injection Therapist should an injection be considered necessary.

A small number of cases may require surgery; the surgery aims to release the strain on the tendon, removing degenerated tissue and promote healing.