What is tennis elbow?

Lateral epicondylitis of the elbow or “tennis elbow” is a condition that typically affects middle-aged adults. It is an overuse injury that involves inflammation and/or tiny tears of the wrist and finger muscle tendons located at the outer side of the elbow. These muscle tendons help to bend the wrist backwards (wrist extension), as well as open the fingers (finger extension). As such, individuals suffering from this condition often feel pain over the outer side of their elbows when lifting loads and gripping objects forcefully with their fingers.

This condition is common among tennis players, often caused by excessive force exerted by the wrist extensor muscles when hitting balls using a backhand shot, hence the term “tennis elbow”. However, athletes are not the only people who are at risk of developing tennis elbow. Many individuals with tennis elbow participate in work (e.g. cooks, office workers, butchers, plumbers, carpenters) or recreational activities (e.g. golf, racquet sports) that require repetitive and vigorous use of the forearm muscle or repetitive movements of the wrist and hand.

How do I know if I have tennis elbow?

Signs and symptoms of tennis elbow may include:

  • Pain or burning on the outer part of the elbow that may travel to the wrist (these sensations may be worse at night)
  • Pain when performing activities that require twisting or forceful exertion of the upper limb
  • Stiffness or pain when straightening the elbow
  • Weak and painful grip

How do you diagnose tennis elbow?

Your Doctor will obtain your health history and perform a physical examination. Your Doctor may also order medical diagnostic tests (e.g. X-rays, MRI scans, electromyography studies) to rule out other causes of your problem.

What is the treatment for tennis elbow?

It is important to seek early treatment for tennis elbow as non-surgical treatment success rates may decrease as severity of tennis elbow may worsen with time. Treatment options for tennis elbow include both non-surgical and surgical interventions.

Hand Therapy for tennis elbow

Tennis elbow cases that are mild to moderate in severity often respond well to non-surgical treatment, which largely involves resting of the upper limb to allow inflammation to subside naturally, as well as specific exercises for tennis elbow, targeted at preventing stiffness and improving strength. Your Doctor may refer you to our Hand Therapist, who will be able to provide the following services:

  • Advice and education pertaining to your condition
  • Wax therapy
  • Ultrasound therapy
  • Radial shockwave therapy
  • Advice on lifestyle and activity modifications so as to eliminate or minimise daily activities or wrist movements which may further aggravate the condition
  • If necessary, provide a customised splint to be worn over the affected wrist when you are using your hands to perform daily activities so as to provide support and encourage further rest of the wrist muscles
  • Soft tissue mobilisation and release
  • Appropriate exercises to improve elbow/wrist joint and muscle movements while avoiding aggravation of tennis elbow symptoms
  • Progressive strengthening exercises of the wrist after the inflammation subsides so as to prevent future recurrence
  • Pain relief management for tennis elbow 
  • Personalised home exercise program

Non-surgical treatment for tennis elbow

Your Doctor may suggest other non-surgical interventions such as anti-inflammatory medications, or corticosteroid injections over the site of inflammation which can also help reduce inflammation and pain over the elbow.

Surgical treatment for tennis elbow

If tennis elbow symptoms are severe or do not improve over time with non-surgical interventions, your Doctor may recommend arthroscopic or open surgery. Hand therapy is often required after surgery to help regain the movement, strength and function of the affected elbow and wrist.