Tennis elbow (lateral epicondylalgia)
Tennis elbow — also called lateral epicondylalgia — is pain on the outside of the elbow due to reduced load tolerance in the wrist extensor tendon (commonly extensor carpi radialis brevis). It’s not limited to tennis: it’s common with gripping, lifting, tools, gym work and repetitive hand use. Most cases improve with the right loading plan and activity modification.
Typical symptoms
- Pain on the outside of the elbow, worse with gripping or lifting a kettle
- Pain with wrist extension (e.g., typing/mouse use can aggravate)
- Reduced grip strength and forearm fatigue
- Symptoms often build gradually over weeks
What helps (first‑line)
- Education + load management: reduce high‑irritability tasks temporarily while keeping the arm active
- Isometrics and progressive loading: graded wrist extensor strengthening
- Grip retraining: reduce over‑gripping and improve technique for work/gym/sport
- Manual therapy: can help short‑term pain to allow exercise progression
Assessment
We’ll assess the elbow, wrist and shoulder/neck contribution, identify your key aggravating loads, and build a step‑by‑step plan. Ultrasound is not always required for tennis elbow, but can be useful when symptoms are persistent or if there is diagnostic uncertainty.
Recovery timeline
Most people improve over 6–12 weeks with a consistent loading programme. More persistent cases can take longer, especially if work demands keep provoking the tendon. The aim is to build tolerance so you can return to full function without flare‑ups.
When to seek medical advice urgently
- Significant swelling, redness, fever or trauma
- Numbness/tingling into the hand or progressive weakness
- Locking/catching or severe movement restriction
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