How do clinicians diagnose tennis elbow?
Tennis elbow, or lateral epicondylalgia, is usually diagnosed through a simple conversation and physical exam. Most people notice pain on the outside of the elbow that worsens when gripping, lifting, or turning objects. Clinicians start by asking when and how the pain began, what activities make it worse, and how it affects work or sleep.
During your exam, the clinician will gently press on the outer elbow and test your wrist and finger strength. Pain with resisted wrist extension or middle-finger lifting is a key finding. You might also notice tenderness one to two centimeters below the bony bump on the outer elbow, or reduced pain-free grip strength when squeezing an object (like opening a jar).
Imaging such as X-ray, ultrasound, or MRI is rarely needed. These tests are only used if symptoms don’t improve after several months, or if your clinician suspects another problem like nerve irritation, arthritis, or a small ligament, cartilage or bone injury¹ ² ³.
If the pain is severe or feels different from typical tennis elbow, your clinician will check for other conditions that can mimic it, such as radial tunnel syndrome (nerve compression) or ligament injury.
Clinical insight
What are the treatment options for tennis elbow?
Treatment focuses on helping the tendon recover while keeping your arm moving. Care typically begins with simple, noninvasive steps and progresses only if symptoms persist. Common treatments include:
1. Education and activity changes
You’ll learn how to reduce strain on the tendon by adjusting how you lift, grip, or use your computer mouse. Short breaks, lighter loads, and neutral wrist positions make a big difference. Most people start to feel improvement within 6–12 weeks when they stay active but avoid aggravating movements¹ ².
2. Exercise-based rehabilitation
Exercise is the cornerstone of recovery. Physical therapy programs focus on gradually loading the wrist extensor muscles to rebuild tendon strength and tolerance.
- Isometric holds help to calm pain by exercising without moving the joint.
- Eccentric and concentric wrist exercises strengthen the tendon over time.
- Shoulder and upper back exercises improve arm mechanics and reduce overload on the elbow⁴ ⁶.
Research shows these exercise programs lead to meaningful improvements in pain and grip strength, especially when performed regularly over 8–12 weeks⁶ ⁷.
3. Medications
Topical or oral non-steroidal anti-inflammatory drugs (NSAIDs) can provide short-term pain relief for one to two weeks, though they do not speed up healing⁸. Always discuss potential side effects, especially if you have stomach, kidney, or heart concerns.
4. Bracing or supports
A counterforce strap or wrist brace can reduce pain during heavy tasks. These devices are best used temporarily, alongside your exercise program, not as a standalone fix⁴.
5. Injections
Corticosteroid injections may ease pain for a few weeks but tend to worsen outcomes later, with higher recurrence and delayed recovery. They’re no longer recommended as first-line care⁹.
Platelet-rich plasma (PRP) or autologous blood injections have mixed evidence; some people benefit after long-term symptoms, but overall results are uncertain and vary by preparation⁴.
6. Surgery
Surgery is a last resort for people who continue to have disabling pain after six to twelve months of structured rehabilitation. Only about 1–2% of people eventually need it² ¹⁰. Surgeons typically clean the damaged tendon and assess nearby structures, but studies show recovery rates are similar to continued non-surgical care¹⁰.
Sword's approach
Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.
Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.
- Care that adapts to your progress in real time
- Licensed experts guiding every step
- Simple, non-invasive, evidence-based programs
- Proven results for pain relief, movement, and satisfaction
Did you know?
Around two-thirds of herniated discs shrink on their own as the body reabsorbs the material, helping explain why most people recover without surgery11
How can I find pain relief for tennis elbow pain?
Small changes often make a big difference. Here are some practical strategies most people can try safely:
- Keep moving: Gentle arm use prevents stiffness and supports healing.
- Use lighter loads: Switch to lighter tools or smaller pans to reduce grip strain.
- Take micro-breaks: Rest briefly every 20–30 minutes if your job involves repetitive wrist movements.
- Warm up before activity: A few minutes of stretching and light gripping can prepare the tendon for work.
- Ease back gradually: Increase weight or intensity only when pain stays low.
Pain flares are common but not a sign of damage. This pain usually settles with breaks and with regular loading over time. If your symptoms persist beyond a few months or begin to worsen, check in with your clinician for tailored care.
