Do I Really Have Tennis Elbow, Or Is It…?

Tennis elbow, or lateral epicondylitis, is a painful condition that affects the bony bump on the outside of your elbow where the tendons of the forearm muscles attach to the bone. You may also experience pain and weakness in your wrist and forearm, particularly when performing movements like gripping, shaking hands or turning a doorknob.

What causes tennis elbow?

Tennis elbow is a type of repetitive strain injury due to overusing the muscles in your forearm. These are the muscles you employ every time you straighten or raise your hand a wrist. If they are overused by making certain repetitive movements, tiny tears can develop in the tendon. Due to poor blood flow in the area, a vicious cycle of attempted healing and repeated tearing can occur.

Although tennis players may be at risk, particularly if they have poor technique, other types of movements can also lead to tennis elbow, for example, using a computer mouse, painting, using plumbing tools or cutting up meat.

Treatments for tennis elbow

For mild cases of tennis elbow, the most effective treatment is normally a temporary modification of activities, icing and pain killing medication. In some cases, however, you might need surgical or non-surgical intervention.

At Thames Shoulder and Elbow we offer a procedure called dry needling which increases blood flow to the area and stimulates the body’s own natural healing processes. Steroid injections are no longer recommended as they delay tendon healing and, although they can provide short term relief, the condition tends to recur with greater severity in the future. More recently PRP (platelet rich plasma) injections have been tried. This is where a part of the patient’s own blood is injected around the tendon, but this was not found to be any more effective than dry needling.

Other conditions with similar symptoms

It’s important to be aware that other conditions affecting the elbow can have similar symptoms, therefore you should avoid jumping to the conclusion that elbow pain is due to tennis elbow. Although it is usually possible for a specialist diagnose these conditions early, very often they have not been considered until treatments for tennis elbow have not worked.

At Thames Shoulder and Elbow, we routinely treat:

  1. Radial tunnel syndrome

This is another cause of pain and weakness around the elbow joint, as well as in the top of the forearm and hand. It is due to pressure on the radial nerve, which passes through a narrow area below your elbow called the radial tunnel. If the radial nerve becomes irritated – usually due to a variation in the anatomy around the elbow – it may get pinched inside the radial tunnel causing radial tunnel syndrome. The condition is hard to diagnose on tests and often requires a test injection of local anaesthetic to check that symptoms are relieved. Surgery is usually required to widen the radial tunnel and prevent the nerve from getting trapped.

  1. Elbow cartilage defects

man weight lifting

Sometimes the cartilage which covers the ends of the bone in your elbow joint and allows them to move smoothly against each other, can become damaged.

This is most commonly due to a degenerative condition like osteoarthritis but it may also be the result of certain types of injury such as osteochondritis dissecans (OCD) which can be the result of repetitive overuse of the arm (for example by weightlifting or throwing) or as the result of a traumatic injury such as a fall.

Damage to the cartilage can cause swelling, loss of movement and a grinding sensation or clicking or locking in the elbow when you try to bend or straighten it. Treatment may range from bracing the elbow joint through to arthroscopic debridement surgery or cartilage replacement.

  1. Golfer’s elbow

While tennis elbow is pain on the outside of the elbow, golfer’s elbow – medial epicondylitis – is pain on the inside, which may also spread to your forearm and wrist. Like tennis elbow it is due to overusing the muscles in the arm and wrist. It is particularly common in certain types of sports that involve hitting or throwing a ball as well as in certain jobs that involve making forceful or repetitive movements. Dry-needling can also be effective in treating golfer’s elbow.

  1. Ligament tear

Ligaments are the strong bands of tissue that connect one bone to another. Tears to the lateral ulnar collateral ligament (LUCL) of the elbow can usually occur as the result of making repeated overhead movements such as javelin throwing, or from a traumatic injury including falling onto your outstretched arm which can cause the LUCL to rupture or be torn away from the humerus. This results in instability of the elbow joint with certain movements such as pushing off from a chair.  Surgery is usually required. If it is diagnosed soon after injury the ligament can often be repaired directly, but later on a ligament reconstruction with a donor or synthetic tendon is required.

These are just a few of the more common reasons why you might be experiencing elbow pain, all of which have different causes. It is important not to self-diagnose but to seek out proper medical help and an accurate diagnosis if you have pain so that you receive correct type of treatment.

Orthopaedic Consultant & Surgeon | London

Thames Shoulder & Elbow are able to provide advice and support to anyone experiencing symptoms affecting the upper limbs (shoulder, upper arm, elbow, forearm and wrist).

Telephone: 020 376 15987


Our Locations

Hospital of St John and St Elizabeth, St John’s Wood – Directions
BMI The Syon Clinic, Brentford – Directions
HCA Chiswick Health Centre, Chiswick – Directions
West Middlesex University Hospital, Chelsea and Westminster Foundation Trust, Isleworth – Directions