Tennis elbow (lateral elbow pain)
Tennis elbow is usually a tendon-overload problem rather than a true inflammatory condition. It often affects gripping, lifting, typing, gym work, racquet sports and manual jobs. Symptoms can persist if the tendon is not reloaded progressively and patiently.
Common symptoms
- Pain on the outside of the elbow
- Pain with gripping, pouring, shaking hands or lifting a kettle
- Morning stiffness or ache after repetitive use
- Reduced grip strength and reduced confidence at work or sport
Why it happens
- Repetitive wrist-extension or gripping load
- Sudden increase in DIY, gym, racquet sport or manual work
- Poor load recovery or continuing to repeatedly irritate the tendon
- Occasionally linked with neck or radial nerve contribution
Assessment
- Clinical testing of tendon pain provocation and grip tolerance
- Assessment of wrist, shoulder and neck contribution
- Review of workload spikes and movement strategy
- Ultrasound can help assess tendon thickening, tears or neovascular changes if management decisions require it
Treatment options
- Relative load reduction without complete rest
- Progressive isometric, concentric and eccentric tendon loading
- Grip and forearm strengthening
- Shoulder/scapular support work where needed
- Brace or strap advice in selected cases
- Injection discussion only after careful review because short-term relief does not always equal best long-term outcome
When to get assessed
Assessment is useful if symptoms are persistent, recurring, limiting work or sport, or if you are unsure whether physiotherapy, imaging or injection is the most appropriate next step.
How ultrasound can help
Ultrasound is not automatically required for every patient. It is most useful when it will change management, improve diagnostic confidence or guide treatment safely.
Where injection fits
Injection is considered only where clinically appropriate after discussion of risks, benefits and alternatives. The aim is usually to reduce pain enough to progress rehabilitation, not to replace rehabilitation.