Last updated: October 2026
Tennis elbow is pain on the outside of the elbow from overloaded forearm tendons. Most people who get it don’t play tennis: gripping and wrist work such as DIY, housework or using a mouse is the usual cause. It can take 6 to 24 months to settle. Ease off the trigger, use ice or painkillers and build up simple exercises.
Below: how to tell it from golfer’s elbow, what to do today, an NHS exercise routine, the honest evidence on straps, injections, PRP and shockwave, how long it lasts and when to get help.
Need help now? Call 999 if arm pain comes on suddenly with pressure, heaviness or squeezing across your chest. Go to A&E or an urgent treatment centre if the pain is severe and you can hardly move your arm, you heard a snap or your elbow has changed shape after an injury, or your arm tingles or feels numb. See all the red flags.
Tennis elbow symptoms
The main symptom is pain on the outside of the elbow, from a mild ache to constant pain that disturbs sleep. The NHS and NHS Lothian list:
- pain on the outside of the elbow, often spreading down the forearm
- tenderness when you press on the outer elbow
- pain when gripping, lifting or twisting, such as turning a door handle, opening a jar or lifting the kettle
- a weak grip
- difficulty fully straightening the arm
It usually affects your dominant arm. The medical names are lateral epicondylitis or lateral elbow tendinopathy.
What causes tennis elbow (it’s rarely tennis)
NHS Lothian says most people who develop tennis elbow don’t play tennis. The tendons that lift the back of your hand get overloaded by repeated gripping and wrist movements. Common triggers the NHS lists include:
- Desk work: typing and using a mouse. Our posture and desk set-up guide can help.
- Manual jobs and DIY: using a screwdriver, painting, decorating and housework.
- Hobbies: racket sports, sewing and playing an instrument.
A classic pattern is a sudden burst of unaccustomed work, such as a weekend of painting. Sometimes there is no obvious cause.
Who gets it: it is most common between about 35 and 54. A Finnish study of 4,783 adults found about 1.3% had it at any one time, equally in men and women; smokers were more than three times as likely to have it. NHS inform adds obesity, high cholesterol and diabetes as factors that affect tendon health.
Tennis elbow vs golfer’s elbow and other causes
The side of the elbow that hurts is the biggest clue. The NHS advises against diagnosing yourself, so use this as a guide to what to do next.
| What you notice | Likely cause | What to do |
|---|---|---|
| Pain on the outside of the elbow, worse gripping, lifting or twisting | Tennis elbow (lateral epicondylitis) | Self-care and exercises below |
| Pain on the inside of the elbow, spreading down the forearm, worse gripping or twisting | Golfer’s elbow (medial epicondylitis), about a third as common | Same approach; NHS inform has a golfer’s elbow routine |
| Swelling, warmth and a dull ache, worse with pressure or movement | Bursitis | Rest and ice; see a GP if no better after 1 to 2 weeks |
| Pins and needles, or sharp, hot or burning pain, sometimes without neck pain | A problem in the neck | See our stiff neck guide and a GP or physio |
| Pain and stiffness spreading from the shoulder | A shoulder problem such as frozen shoulder | See our shoulder pain guide |
| Hot, red, swollen elbow with a high temperature or feeling shivery | Joint or bursa infection | Urgent: call 111 |
If several joints ache, see our guide to joint pain, or body aches if you ache all over.
What to do today
Using your arm won’t cause long-term damage, NHS Lothian says. The aim is to calm the tendon without stopping using the arm.
- Rest from the trigger, not from everything. Cut down or change whatever makes it worse. NHS inform suggests moving your elbow gently for 10 to 20 seconds every hour for the first 24 to 48 hours, then using it more.
- Change how you grip and lift. Lift with your palm facing up, grip with the least force you need, and use lighter or thicker-handled tools (a bandage wrapped round a hammer handle works). Try a different mouse and keep your work close to your body.
- Ice or heat: a cold or hot pack wrapped in a towel (frozen peas work) for up to 20 minutes every 2 to 3 hours. Skip it if you have poor circulation or reduced feeling. A hot water bottle is an easy heat option.
- Painkillers: the NHS suggests paracetamol or an anti-inflammatory gel. Ibuprofen gel is flammable, so don’t smoke or go near naked flames while it’s on your skin. Ask a pharmacist before taking ibuprofen tablets, which aren’t suitable for everyone.
- At night: rest the arm in a supported position, for example on a pillow. More tips are in best sleeping position.
- Work: NHS inform says you don’t need to be pain free to go back, and staying at or returning to work as soon as possible can help recovery. If work is the trigger, ask your employer about adjusting your tasks; our stress at work guide covers your rights.
Tennis elbow exercises: the NHS routine
These five come from NHS inform’s tennis elbow exercises. Do them sitting, with your forearm resting on a table and your wrist over the edge for exercises 3 to 5.
- Arm raise. Arms by your sides, bend one elbow to touch your shoulder, hold for a few seconds, then lower slowly.
- Wrist turn. Rest the back of your hand on the table, turn it so your thumb points up, then palm down, and slowly back.
- Fist clench. Make a gentle fist and lift your hand level with your forearm. Hold for a few seconds, then relax.
- Assisted wrist lift. Palm down, use your other hand to lift the wrist as far as it goes, then lower it slowly on its own.
- Weighted wrist lift. As exercise 4, holding a small weight such as a tin of beans. Help it up with the other hand and lower it slowly under control.
How much, and the pain rule: start with 2 or 3 repetitions at a time, spread through the day, adding 1 or 2 every few days. Then move to sets of 8 with a minute’s rest, 2 to 3 times a day, up to 2 sets of 15. Keep pain at 5 out of 10 or below. It may feel slightly worse at first, but it shouldn’t be worse overall the next morning. If it is, do fewer or go slower.
What the research says: exercises 4 and 5 are “eccentric”: the tendon works as the hand lowers slowly. Some physios start with isometrics (static holds, such as pressing the back of your hand up against your other hand); a 2020 review found these no better than moving exercises, though they can be a gentle first step. A 2024 Cochrane review of 23 trials found exercise and hands-on physio may slightly reduce pain by the end of treatment, but the effect is small. NHS Lothian says no single exercise beats another, and strong shoulders help take pressure off the elbow. If you lift weights, build back gradually (see muscle recovery).
Do tennis elbow straps and braces work?
A forearm strap (epicondylar clasp) sits just below the elbow to take some load off the tendon. The NHS says you can try one from a pharmacy, and NHS Lothian suggests wearing it only during activities that cause pain. The evidence is thin: a Cochrane review of five small trials couldn’t draw firm conclusions, and NHS inform says straps may help short term. Treat one as an experiment alongside the exercises, not instead of them.
Steroid injections: why the NHS is cautious
Steroid injections ease pain quickly, but for tennis elbow the gains tend to reverse. NHS inform says they don’t cure the condition and may harm the tendon. Three well-known trials explain why:
| Trial | Short term | At one year |
|---|---|---|
| Smidt, Lancet 2002 (185 people) | At 6 weeks, 92% of the injection group improved, against 32% who waited | 69% after injection, against 83% who waited and 91% after physio |
| Bisset, BMJ 2006 (198 people) | Injection best at 6 weeks | 47 of 65 early successes relapsed; physio did better long term |
| Coombes, JAMA 2013 (165 people) | Short-term relief | 83% recovered or much better after a steroid, against 96% after a placebo injection; recurrence 54% against 12% |
Ask your GP about the trade-off if one is offered.
PRP, shockwave and surgery
- PRP (platelet-rich plasma) or blood injections: a 2021 Cochrane review of 32 trials (2,337 people) found they probably make no meaningful difference to pain or function compared with a placebo injection, and concluded the costs and risks aren’t justified.
- Shockwave therapy: a Cochrane review of nine placebo-controlled trials (1,006 people) found little or no benefit. NICE says it raises no major safety concerns but evidence it works is inconsistent, so it should only be used with special arrangements. NHS Lothian doesn’t offer it.
- Surgery: the NHS says it may be an option if tennis elbow lasts beyond 6 to 12 months. A Cochrane review found too little good evidence to say whether it works, and NHS Lothian says success rates are not high.
How long does tennis elbow last?
Tendons heal slowly. NHS Lothian says tennis elbow can take 6 to 24 months to settle, but after a year about 8 in 10 people have improved significantly, with or without treatment. In the Lancet trial above, 83% of people who simply waited had improved at a year.
Milder cases can ease after a few weeks of resting the arm. In a US study of 576 patients, about 8.5% had it come back within 2 years, and about 1 in 10 still in pain at 6 months went on to have surgery. Long-lasting pain, neck pain and severe pain at the start are linked with slower recovery. If you feel no better after 6 weeks of exercises and self-care, get it checked.
Red flags: when to get urgent help
Call 999 if:
- arm pain comes on suddenly with pressure, heaviness or squeezing across your chest (this could be a heart attack)
Go to A&E or an urgent treatment centre if:
- the pain is severe and it’s hard to move your arm
- you injured your arm, heard a snap, or the elbow or arm has changed shape
- your arm tingles or feels numb
Call NHS 111 if:
- your elbow is swollen, red or hot and you have a very high temperature or feel hot and shivery
- you’ve had a significant fall or a direct blow to the elbow in the last 7 days
- arm pain gets worse when you exercise but eases when you rest
When to see a GP or physio
See a GP if your elbow still hurts after at least 2 weeks of rest and self-care, it’s hot, swollen or tender with no injury you can remember, or you have had cancer or a joint condition such as rheumatoid arthritis. A GP may prescribe anti-inflammatory tablets or refer you to physiotherapy.
Physio without a GP: the NHS suggests physiotherapy if things haven’t improved after 6 weeks of home treatment. In many areas you can refer yourself to NHS community musculoskeletal (MSK) services; find your local service on the NHS website. A physio can confirm the diagnosis and tailor exercises.
Other tendon problems, such as plantar fasciitis and pain around the knee or hip, respond to similar gradual loading.
Where our products fit (honestly)
No supplement or balm is a treatment for tennis elbow, and nothing replaces the exercises above and proper medical advice.
Our CBD Balm, Muscle and Joint Support is a massage balm made with broad spectrum CBD, peppermint, eucalyptus and juniper. It feels cooling and non-greasy, and some people like to massage it into the forearm as part of their exercise or wind-down routine. CBD isn’t a treatment for tennis elbow. Read more in our CBD balm guide.
Our Magnesium Glycinate Sleep Complex is an evening drink with magnesium bisglycinate and citrate, glycine and L-theanine, which some people make part of their evening wind-down. Magnesium contributes to normal muscle function. For more, see magnesium for muscle pain. For other supplements people ask about, see turmeric, collagen and glucosamine.
If you also take CBD by mouth, keep the FSA’s advice in mind. The FSA’s 10mg a day figure is precautionary advice rather than a legal limit, set while longer-term safety research continues. At Evopure we think it is a very cautious figure, and many adults use more. If you go above it, increase slowly, and check with your GP or pharmacist first if you take any medication.
Our products are for adults (18+) only. We don’t recommend our products during pregnancy or breastfeeding. If you take prescribed medicines, check with your pharmacist before adding a supplement.
If your fingers tingle or go numb rather than your elbow aching, read our guide to carpal tunnel syndrome.
FAQs
What is the fastest way to cure tennis elbow?
There is no quick cure. Cutting down the activity that triggers it, changing how you grip and lift, and building up forearm exercises gives the best long-term results. Steroid injections work fastest but often relapse.
How long does tennis elbow take to heal?
It can take 6 to 24 months to settle fully, but about 8 in 10 people are much better within a year. See a GP if it hasn’t improved after 2 weeks of self-care, or a physio after 6 weeks.
Should I rest my arm completely?
No. Rest from the activity that causes the pain, but keep moving the elbow gently. Using your arm won’t cause long-term damage.
Is tennis elbow on the inside or outside of the elbow?
The outside. Pain on the inside of the elbow is usually golfer’s elbow, which is managed in a similar way.
Can you get tennis elbow from using a computer?
Yes. Typing and using a mouse are common triggers. Try a different mouse, keep your work close to your body and take regular breaks.
Is heat or ice better for tennis elbow?
Either can help. Use whichever feels better, wrapped in a towel, for up to 20 minutes every 2 to 3 hours.
Sources
- NHS. Tennis elbow and Elbow and arm pain.
- NHS inform. Tennis elbow, Exercises for tennis elbow, Golfer’s elbow and Elbow problems.
- NHS Lothian. Tennis elbow: information for patients. Patient leaflet, 2026.
- NHS. Bursitis and Get NHS help for back and joint problems.
- NICE. Extracorporeal shockwave therapy for refractory tennis elbow (formerly IPG313). 2009.
- Shiri R, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol, 2006. PMID 16968862.
- Smidt N, et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet, 2002. PMID 11879861.
- Bisset L, et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ, 2006. PMID 17012266.
- Coombes BK, et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia. JAMA, 2013. PMID 23385272.
- Wallis JA, et al. Manual therapy and exercise for lateral elbow pain. Cochrane, 2024. PMID 38802121.
- Clifford C, et al. Effectiveness of isometric exercise in the management of tendinopathy. BMJ Open Sport Exerc Med, 2020. PMID 32818059.
- Struijs PA, et al. Orthotic devices for the treatment of tennis elbow. Cochrane, 2002. PMID 11869609.
- Karjalainen TV, et al. Autologous blood and platelet-rich plasma injection therapy for lateral elbow pain. Cochrane, 2021. PMID 34590307.
- Buchbinder R, et al. Shock wave therapy for lateral elbow pain. Cochrane, 2005. PMID 16235324.
- Buchbinder R, et al. Surgery for lateral elbow pain. Cochrane, 2011. PMID 21412883.
- Sanders TL, et al. The epidemiology and health care burden of tennis elbow: a population-based study. Am J Sports Med, 2015. PMID 25656546.
- Smidt N, et al. Lateral epicondylitis in general practice: course and prognostic indicators of outcome. J Rheumatol, 2006. PMID 16881095.
This guide is general information, not medical advice. If you’re worried about elbow pain, speak to a GP, pharmacist or physiotherapist. Evopure makes the CBD Balm, Muscle and Joint Support and the Magnesium Glycinate Sleep Complex.
