Tennis elbow may sound like a sports injury reserved for athletes, but it’s a surprisingly common condition that affects anyone who repeats the same arm and wrist movements—whether on the court, at a desk, or in a workshop. Also known as lateral epicondylitis, tennis elbow is caused by inflammation or microtears in the tendons that connect your forearm muscles to your elbow.
The result? Pain, weakness, and limited function in the arm. Dr. Michael Osterholt, Sports Medicine Physician and Washington State University Athletics Team Physician, discusses what causes tennis elbow, how to recognize the symptoms, and what treatment options can help you recover and get back to your daily routine.
What is tennis elbow?
Tennis elbow is an overuse injury affecting the tendons attached to the outside of the elbow, specifically at the lateral epicondyle and extensor muscle group. Patients often describe the pain as sharp and achy, which worsens with activities involving repetitive twisting, turning, or gripping. As the condition progresses, pain may occur with even minor movements, and grip strength often declines due to discomfort and inflammation.
“So, it's really that pain on the outside. And then decreased strength,” states Dr. Osterholt.
What triggers tennis elbow symptoms?
Common daily activities like turning a doorknob, opening a jar, or using tools such as a wrench can trigger significant pain in those with tennis elbow. These tasks involve twisting and gripping motions, which can aggravate the affected tendons and make everyday actions especially uncomfortable for individuals with this condition.
“I tend to see that it's a pain response to activities,” explains Dr. Osterholt. “The more severe it gets, the more pain it induces with even basic actions like people just moving their wrist to do something, without even lifting.”
Who is at risk for tennis elbow?
While tennis elbow is commonly associated with the sport, it often affects occasional or inexperienced players more than seasoned ones. Poor backhand technique—particularly overusing the wrist instead of proper body mechanics—places excess strain on the extensor muscles. As a result, people who suddenly play tennis without conditioning or training are more likely to develop the condition than regular players with refined technique.
And yet, people who don’t play tennis can also develop the condition. “We most commonly see it in people who do manual labor where they're performing repetitive motions day to day,” notes Dr. Osterholt. “We also see it in people who knit, artists who have paint brushes, really anyone where they're constantly repetitively engaging that wrist.”
How is tennis elbow diagnosed?
Tennis elbow is primarily diagnosed through a physical exam—with imaging like X-rays used to rule out other conditions, such as arthritis in the radial ulnar joint, which can mimic similar symptoms. During the exam, clinicians look for tenderness just below the lateral epicondyle, where pressing on the extensor mass often causes sharp, localized pain. In younger patients, doctors also check for possible fractures. Specific movement tests, such as wrist extension and flexion with the arm outstretched, can provoke pain and help confirm the diagnosis.
“I have the expertise of being able to utilize ultrasound,” shares Dr. Osterholt. “So, I put an ultrasound on that area and I can see disorganized tendon tissue. I can see increased blood flow or vascularity to the area. That tendon tends to be a lot thicker over time.”
Can tennis elbow be treated?
Treatment for tennis elbow depends on whether the condition is acute or chronic. For recent, inflammation-based cases, rest, avoiding repetitive lifting, applying ice multiple times a day, and using anti-inflammatory medications are typically effective. Most people see improvement with these measures. However, chronic cases—where tendon issues persist over time—are more complex and often require a different approach for long-term relief.
“That's when we get them into physical therapy. We work on scraping soft tissue, ultrasound. There are all kinds of different modalities we employ in order to help treat the condition conservatively,” assures Dr. Osterholt. “If those don't work, then we run down the line of injections. We do PRP, we also do prolotherapy in our clinic, which are injection options for chronic tendon disorders.”
The good news is that with timely and proactive treatment, most people with tennis elbow can fully recover and return to their usual activities. Tendon conditions like this often improve over time, especially when addressed early and managed appropriately.
“A lot of these disorders do get better with time. Our interventions are really trying to expedite the timeline and make your pain better, faster,” concludes Dr. Osterholt.
