Tennis Elbow: Symptoms, Causes, and How Long It Lasts

It started with a twinge when you picked up your coffee mug. Now it shows up when you shake hands, carry groceries, or turn a screwdriver. You've never played tennis in your life. That's typical, and it's why tennis elbow surprises so many people.

What is tennis elbow?

Tennis elbow (lateral epicondylitis) is pain where the forearm tendons attach to the bony bump on the outside of your elbow. Those tendons connect the muscles that lift your wrist and straighten your fingers. When they're overworked, tiny areas of damage build up faster than the tendon can repair them.

According to Mayo Clinic², repeatedly tensing these forearm muscles can break down tendon fibers near the outer elbow. Cleveland Clinic¹ calls tennis elbow one of the most common causes of elbow pain. It also notes that more than 9 in 10 people who get it don't get it from tennis.

Tennis elbow is one of several causes covered in our guide to elbow pain. Pain on the inside of the elbow is a different problem. Learn how to tell golfer's elbow and tennis elbow apart.

What are the symptoms of tennis elbow?

The main symptom is pain on the outer elbow that gets worse when you grip or twist. According to Cleveland Clinic¹, the pain is often sharp or burning. It can spread into the forearm and wrist, especially at night.

Common symptoms include:

• Pain or burning on the outside of the elbow^1,2
• Pain that spreads down the forearm toward the wrist²
• A weaker grip¹
• Trouble shaking hands, turning a doorknob, or holding a coffee cup²
• Elbow stiffness, or difficulty fully straightening your arm^1,3
• Pain that ranges from mild discomfort to constant pain that affects sleep³

Symptoms usually build over weeks rather than starting with one injury. Many people notice them first at work, when gripping a tool or a mouse for hours.

What causes tennis elbow?

Repeated gripping, twisting, and lifting are the main causes. According to Mayo Clinic², common triggers include:

• Racket sports, especially a backhand with poor form
• Plumbing tools, painting, and driving screws
• Cutting meat or other foods
• Heavy computer mouse use

Mayo Clinic² notes the exact cause isn't fully understood. Sometimes no clear trigger is found at all.

Who is more likely to get it

• Adults ages 30 to 60. This is when tennis elbow is most common².
• People in hand-heavy jobs. Plumbers, painters, carpenters, butchers, and cooks all repeat the same arm motions². See our care for physical jobs.
• People who lift a lot. Cleveland Clinic¹ says regularly lifting more than 45 pounds raises the risk.
• Racket and paddle players. Poor form, poorly fitted gear, and playing more than two hours a day add risk². Paddle players can read about pickleball elbow.
• Smokers and people with obesity. Both are linked to higher risk^1,2.

Desk workers aren't spared. Read about elbow pain from typing and mouse use.

How long does tennis elbow last?

Recovery usually takes about six months, though it ranges from a few months to more than a year. According to Cleveland Clinic¹, some people need up to 18 months. Cleveland Clinic also notes that people almost always make a full recovery.

NHS guidance³ says tennis elbow often improves after resting the arm for a few weeks, but it can sometimes last over a year. A 2022 physical therapy guideline adds that symptoms often linger and can come back⁴.

Timing depends on how long you've had it, how much tendon damage there is, and what you do with your arm each day¹. Using the elbow hard before the tendon heals can raise the risk of a tear¹. So can pushing through pain. Building back up step by step tends to work better than stopping and starting.

What helps tennis elbow?

Easing the strain and strengthening the forearm are the core of care. Research supports exercise more than any single hands-on technique.

Change what's straining it

NHS guidance³ suggests avoiding or reducing the activities that make symptoms worse. A wrapped cold or hot pack for up to 20 minutes may ease pain³. Look at your grip, your tools, and your technique. Small changes in how you hold a tool or a paddle can reduce the load.

Strengthen the forearm

A 2022 physical therapy guideline recommends strengthening exercises for the muscles that lift the wrist⁴. It supports pairing them with other care, including hands-on care⁴. Exercises usually start light and build gradually. See tennis elbow exercises you can do at home.

Hands-on care

The same guideline found gentle joint movement of the elbow may ease pain in the short term⁴. Longer-term evidence is limited. It also says treatment aimed at the neck, upper back, or wrist may help short-term when those areas are stiff⁴. That's why your doctor checks above and below the elbow.

Braces and straps

A forearm strap may give some relief while you do a task that flares your pain⁴. Evidence for longer-term benefit is mixed⁴. Learn more about whether tennis elbow braces and straps work.

What about steroid shots?

Steroid shots may ease pain for a short time, but the longer view is less encouraging. In a 2013 trial, people who got a steroid shot did worse at one year than those who got a placebo shot⁵. Their pain also came back more often, 54% compared with 12%⁵. In that same trial, a physical therapy program helped early but made no clear difference at one year⁵. Talk with your medical doctor about your options.

When should you get tennis elbow checked?

See a provider if elbow pain doesn't ease with rest and home care. Mayo Clinic² recommends a visit when self-care steps don't help. NHS guidance³ suggests getting checked if pain lasts after two weeks of self-care.

Tingling in your ring and little fingers points to a different problem. Read about cubital tunnel syndrome.

Find out what's behind your elbow pain

Elbow pain gets in the way of small, constant things. Lifting a pan, shaking a hand, starting a shift. You've tried resting it, but the pain comes back as soon as you pick up the tools again.

We're here to help you find out what's going on. Chiropractic Company has cared for Greater Milwaukee since 1982, with 400,000+ patients, 1,400+ five-star Google reviews, and 20+ neighborhood clinics. Your doctor checks your elbow, wrist, shoulder, and neck, with X-rays if your exam calls for them. Your doctor may use gentle joint movement for the elbow, alongside forearm strengthening and tips for your grip and tools. Your care is designed around your work, your sport, your medical history, and your goals. You choose your care, and you see the same doctor as it continues.

Care is natural and drug-free. Treatment begins at your second visit, or the same day in acute cases if your doctor decides it's appropriate. Some plans add physical therapy at our Menomonee Falls, Waukesha, and West Allis North clinics. Active? See our care for athletes, or learn more about elbow pain care.

We're in-network with most insurance companies and accept Medicare and workers' compensation. Eligible new patients can start with the $29 new-patient special, which includes a consultation, an exam, and X-rays if needed. *See offer terms.

Visit one of our 20+ neighborhood clinics across Greater Milwaukee: Milwaukee East, Milwaukee North, Milwaukee Third Ward, Shorewood, Glendale, Mequon, Cedarburg, Grafton, Germantown, Brookfield, Menomonee Falls, Waukesha, Oconomowoc, New Berlin, West Allis, West Allis North, Greenfield, Hales Corners, Franklin, Muskego, and Cudahy.

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