If you are anything like us, you may have been inspired by recent play at Wimbledon to pick your racquet up again. If you now have a nagging ache on the outside of your elbow that flares up every time you lift the kettle, turn a key or shake someone’s hand, there’s a good chance you’re dealing with tennis elbow. If you don’t play tennis, that name has probably already confused you. You wouldn’t be the first.
Most people with tennis elbow have never picked up a racquet. At our clinics in Brighton Queens Road and Kemptown, we see it far more often in people who spend their days at a keyboard, up a ladder, behind a hairdressing chair or working out in a gym than we do in tennis players. This guide explains what’s actually happening in the elbow, what tends to help, what to watch out for and when it’s worth getting properly assessed.
It’s worth saying at the outset: not every ache on the outside of the elbow is tennis elbow and not every case needs the same approach. The most useful thing anyone can do, whether that’s a GP, a physiotherapist or a chiropractor, is work out what’s going on before recommending a course of action.
What Is Tennis Elbow and Why the Name Is Misleading
Tennis elbow, medically known as lateral epicondylitis or lateral elbow tendinopathy, affects the tendon that attaches the muscles controlling your wrist and fingers to a bony bump on the outside of the elbow. Every time you grip, twist or extend your wrist, that tendon takes the load.
This is usually due a tendon that has struggled to keep up with repeated or unfamiliar loading, rather than a straightforwardly inflammatory injury. That’s a useful thing to know, because it shapes what tends to help: most tendons in this state respond better to sensibly managed activity and gradual reloading than to strict rest.
As for the tennis link, racquet sports can trigger it, but tennis players make up a small proportion of cases. Tennis elbow is one of the most common causes of persistent elbow pain, and it can affect almost anyone whose daily activities involve repeated gripping or wrist movement.
Who Tends to Get It?
Tennis elbow develops from repetitive or unaccustomed gripping, twisting and wrist extension, wherever that load comes from. Common triggers we come across include:
Computer and desk work: prolonged mouse use and repetitive, low-level clicking
Trades: screwdrivers, drills and hand tools, often combined with lifting
Hairdressing: repetitive scissor work and holding hairdryers for long periods
Gardening and DIY: secateurs, hedge trimmers, sanding and painting, which is why we tend to see a small rise in elbow complaints once the gardens and allotments around Brighton and Hove get their summer attention
Sport: not just tennis, but golf, climbing, rowing, paddleboarding and gym-based lifting, particularly when grip-heavy exercises increase quickly
Everyday life: carrying shopping, lifting children or simply an unfamiliar few weeks of physical activity
It’s most common in adults in their 40s and 50s, though it can happen at any age, and affects men and women in similar numbers.
Symptoms: Is It Tennis Elbow?
Typical signs include:
- Pain and tenderness on the outside of the elbow, sometimes spreading into the forearm
- Pain that’s worse with gripping, twisting or lifting, such as turning a key or lifting a kettle
- A noticeably weaker grip on the affected side
- Difficulty with tasks like opening jars or carrying bags
- Morning stiffness or stiffness after rest
- Symptoms that build up gradually, rather than appearing suddenly after one specific injury
Simple Self-Help Steps That May Help
For everyday, gradually developing elbow pain without any of the red flags below, some simple measures are often a sensible starting point:
- Modify rather than avoid aggravating activities. Reducing the intensity, frequency or technique of a repetitive task is usually more useful than stopping altogether
- Take regular breaks from repetitive gripping, twisting or clicking tasks
- Avoid heavy lifting with a straight arm and palm facing down where possible
- Gentle movement and light use of the arm within a comfortable range, rather than complete rest
- Use a tennis elbow support
- Over-the-counter pain relief, used as directed and short-term, may help some people manage discomfort while things settle
These steps help many people, but they’re a starting point rather than a guarantee and they work best alongside an understanding of what’s actually causing the pain.
Red Flags: When to Take It Easy and When to Seek Urgent Medical Advice
Most elbow pain of this kind is not dangerous, but it’s worth knowing the signs that suggest something other than straightforward tennis elbow or that need more urgent attention:
- Pain following a fall, blow or injury, especially with visible swelling, deformity or an inability to move the elbow, which could indicate a fracture and should be assessed at an urgent care centre or A&E
- A hot, red, swollen elbow, particularly with fever or feeling generally unwell, which can suggest infection and needs same-day medical attention
- Numbness, tingling or weakness spreading down the arm or into the hand, which may point to a nerve-related issue rather than tennis elbow and is worth having assessed
- Pain that is severe, constant and unrelated to movement or position, particularly at night, which is uncommon in tennis elbow and worth discussing with your GP
- Symptoms that aren’t improving, or are getting worse, despite a few weeks of sensible self-management
None of this is intended to worry you unnecessarily. The vast majority of elbow pain of this type is straightforward and responds well to appropriate care. It’s simply worth knowing what would prompt a different course of action.
When an Assessment At Sundial Is Sensible
It’s reasonable to get elbow pain properly assessed if:
- Symptoms haven’t started easing after a couple of weeks of sensible self-management
- Grip strength or daily tasks are genuinely affected
- You’re not sure whether it’s tennis elbow, golfer’s elbow, referred pain from the neck or shoulder, or something else entirely
- You want a clear, individual plan rather than a generic exercise sheet
A proper assessment matters because several conditions can look similar on the surface but need different approaches, including golfer’s elbow (the same problem on the inside of the elbow), referred pain from the neck or shoulder, radial tunnel syndrome (a nerve-related condition that can mimic tennis elbow) and elbow arthritis, which is more likely in older adults or where there’s swelling or restricted movement through the joint’s full range. Imaging such as ultrasound or MRI isn’t usually needed to diagnose tennis elbow itself and tends to be reserved for cases where the diagnosis is unclear or symptoms persist despite proper treatment.
How Sundial Clinics May Help
We’re a multidisciplinary clinic, which means the right first step depends on what’s actually going on, not on which discipline happens to have an opening that week. Depending on your assessment, that might involve:
- A thorough assessment. This is always the starting point: understanding your history, how the pain behaves and ruling out the conditions that can mimic tennis elbow, including checking your neck and shoulder for referred pain.
- Clear explanation. You should leave with an understanding of what’s actually going on, roughly what to expect and why a particular approach is being suggested.
- Hands-on care where appropriate. This might include joint mobilisation or soft tissue work from one of our chiropractors or manual therapy from a physiotherapist, generally used alongside an exercise programme rather than as a standalone fix. Sports massage therapy can also have a role in easing tightness in the surrounding forearm muscles for some people.
- Guided exercise rehabilitation. For most people, a properly structured, gradually progressed loading programme for the wrist and forearm is the most useful long-term tool, tailored to how irritable your tendon currently is.
- Referral on when it’s the right call. If your assessment suggests something outside straightforward tennis elbow, if red flags are present, or if progress stalls despite appropriate treatment, we’ll say so and help you access the right next step, whether that’s your GP, an orthopaedic specialist or further imaging. We would rather be clear about the limits of what manual therapy or exercise rehabilitation can address than keep treating something that needs a different kind of input.
Our clinical lead, Matt Cunningham, holds Associate Membership with the Pain Faculty of the Royal College of Chiropractors, which is particularly useful for the smaller number of cases where elbow pain becomes persistent or doesn’t follow the expected pattern and a deeper understanding of pain mechanisms helps guide what happens next.
Injections and Dry Needling
Corticosteroid injections are sometimes offered for tennis elbow and can ease pain in the short term. However, current UK specialist guidance is generally cautious about their routine use, since the evidence on longer-term outcomes is mixed, with some studies linking them to higher rates of symptoms returning compared with an exercise-based approach. This is a decision best made with a GP or specialist who can weigh it up against your individual circumstances. At Sundial, Dr Dan Hammond is available by appointment to discuss whether an injection is suitable in your particular case and, if appropriate, can offer the procedure here.
Some people also find dry needling helpful, where fine needles are used to target tight or irritated muscle tissue in the forearm to help ease pain and support recovery. This can be offered alongside other conservative treatment. At Sundial, Matt Cunningham can help with needling as part of a wider rehabilitation plan.
Surgery for tennis elbow is rarely needed and is generally only considered after a genuine trial of conservative treatment, typically six months or more, hasn’t resolved persistent symptoms.
How Long Does Recovery Take?
Recovery varies considerably depending on how long symptoms have been present before treatment starts and how consistently a loading programme is followed. Many people notice meaningful improvement within six to twelve weeks of starting appropriate care, though full recovery can take longer for symptoms that have been present for months. This is one of several reasons why earlier assessment tends to be worthwhile.
Preventing Tennis Elbow
- Warm up the forearm and wrist before repetitive gripping activities, whether that’s a round of golf, a day of DIY or a return to the gym after time off
- Take regular breaks from repetitive tasks, especially screen and mouse work
- Build grip and forearm strength gradually rather than suddenly increasing load
- Review your desk setup if computer work is a trigger, particularly mouse position and wrist angle
- Use well-fitted, appropriately sized tools and equipment for repetitive manual tasks
Frequently Asked Questions
Can tennis elbow affect both arms? Yes, although it’s more common in the dominant arm. If both sides are affected, it’s worth considering whether a shared activity, such as a work task or hobby, is loading both arms similarly.
Is tennis elbow worse at night? Some people notice more stiffness or aching at night or first thing in the morning, though significant night pain isn’t typical of tennis elbow. If pain is genuinely disturbing your sleep, it’s worth having it assessed to rule out other causes.
Can I still exercise with tennis elbow? Generally yes, though specific activities and loads may need adjusting rather than stopped altogether. A clinician can help you work out what to modify while keeping the rest of your routine going.
Why does my grip feel so weak? The muscles controlling grip and finger extension attach directly to the affected tendon, so pain and tendon changes there commonly translate into a genuinely weaker grip, not just discomfort.
Do I need a scan to diagnose tennis elbow? Usually not. Tennis elbow is typically diagnosed through history and physical examination. Scans are generally reserved for cases where the diagnosis is unclear or symptoms haven’t responded to appropriate treatment.
When should I see a chiropractor or physiotherapist for tennis elbow? If symptoms haven’t started improving within a couple of weeks of sensible self-management, or are significantly affecting grip, work or daily tasks, it’s a reasonable time to get a proper assessment. This helps confirm the diagnosis, rule out anything that mimics tennis elbow, and set out a clear plan, whichever professional is best placed to deliver it.
Getting Assessed
If elbow pain is becoming a daily frustration, the most useful next step is a proper assessment to understand what’s actually causing it. From there, we can talk through what’s likely to help, what to expect, and whether that’s something we can support you with directly or whether you’d be better served elsewhere. There’s no pressure to commit to a course of treatment before that conversation has happened.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.
References
1. Karanasios S, Korakakis V, Whiteley R, et al. (2021) Br J Sports Med, 55:477–485
2. Singh HP, Watts AC, Bateman M, et al. (2023) BESS patient care pathway: Tennis elbow,
3. Asghari E, Zarifian A, Shariyate MJ, Kachooei AR. (2022) Perceived Pain Severity and Disability After the Recurrence of Tennis Elbow Following a Local Corticosteroid Injection