Tennis Elbow Symptoms and Causes

Tennis elbow announces itself as pain or burning on the outer part of the elbow, paired with a grip that feels weak. The AAOS describes symptoms that develop gradually rather than after one event, and that flare in forearm activities: holding a racquet, turning a wrench, shaking hands. The formal name is lateral epicondylitis.

The one tendon that carries the blame

Under the outer bony bump of the elbow — the lateral epicondyle — the extensor carpi radialis brevis, or ECRB, attaches to bone. That tendon stabilizes the wrist when the elbow is straight, which means every hard grip loads it. What the AAOS finds there is not classic inflammation but degeneration: the tendon wears down and, in some cases, develops microtears.

What you feel, and exactly where

• Burning or pain over the outer elbow, in a spot you can point to with one finger
• Tenderness on that bony bump, sore before you even move the arm
• Weak grip strength, so a coffee mug or a full kettle slips
• A gradual onset, weeks of mild soreness before the day it becomes a problem
• Pain running down the forearm in more intense cases

The movements that set it off

Anything that grips or twists. Shaking someone’s hand. Turning a doorknob or a screwdriver. Lifting a grocery bag with the palm down. Holding a phone out to read it. The pattern is diagnostic in itself: the elbow is not painful to bend or straighten, it is painful to use the hand with. Wrist-driven jobs produce the same overload lower down the arm — see wrist tendonitis symptoms for that version.

Most cases never touched a racquet

The name is a historical accident. The AAOS places most patients between 30 and 50 and points to occupational risk: painters, plumbers, carpenters, cooks, butchers and auto workers, whose forearms repeat the same gripping motion for hours. If you got it at a desk, a keyboard and a mouse held at the wrong height do the same job more quietly.

What the outer elbow is not

Pain that comes with numbness or tingling into the ring and little fingers is a nerve pattern, not a tendon one, and needs a different workup. Pain deep inside the joint that also limits how far the elbow straightens points at the joint rather than the tendon; the swollen, squishy bump right on the point of the elbow belongs to elbow bursitis symptoms instead.

When to have it seen

Book an appointment if the pain has lasted more than a few days, if it makes handshakes or carrying objects genuinely difficult, or if relative rest for the arm changes nothing. Most treatment is unglamorous — activity modification, a brace, physical therapy — and it works for the large majority. For the picture in other joints, start from tendonitis symptoms.

This content is informational and does not replace a medical consultation, diagnosis, or treatment.