Elbow tendonitis, commonly known as tennis elbow (outer pain) or golfer’s elbow (inner pain), is a painful condition caused by the inflammation or degeneration of the tendons connecting the forearm muscles to the elbow joint. It typically arises from the repetitive stress and overuse of these muscles, leading to microtears over time. This condition can significantly interfere with daily activities like gripping, lifting, and typing. Addressing the discomfort requires a step-by-step approach, moving from immediate pain relief to long-term strengthening and prevention.
Immediate Relief and Acute Pain Management
The initial response to an elbow tendonitis flare-up should focus on minimizing strain and reducing acute pain and inflammation. The single most important action is to stop or significantly modify the activity that caused the pain, allowing the overworked tendons a chance to rest and begin healing. This may involve modifying repetitive movements or switching to your non-dominant hand for certain tasks.
Applying ice to the painful area is an effective way to manage discomfort and swelling in the early stages of the injury. Use a cold pack wrapped in a thin towel for 15 to 20 minutes, three to four times daily. While resting, a counterforce brace may also be beneficial, as it relieves tension on the affected tendon by compressing the forearm muscle just below the elbow.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can temporarily help reduce both pain and inflammation. For individuals with sensitive stomachs, topical NSAID creams or gels can be applied directly to the elbow area, delivering medication with fewer systemic side effects. However, these medications are intended for temporary use to manage acute symptoms, not as a long-term solution for healing the underlying tendon issue.
Targeted Rehabilitation Exercises
Once acute pain subsides, the focus must shift to a rehabilitation program involving active stretching and strengthening to restore tendon health and build resilience. This phase is crucial for long-term recovery, combining flexibility work to lengthen tight muscles and strengthening exercises to build load tolerance. Stretching the forearm muscles helps maintain mobility and prevents stiffness.
To perform a wrist extensor stretch (for tennis elbow), straighten your arm with your palm facing down, then use the other hand to gently pull your fingers toward your body. For a wrist flexor stretch (for golfer’s elbow), extend your arm with your palm facing up and gently pull your fingers back toward your body. Hold each stretch for 15 to 30 seconds and repeat several times daily, ensuring the stretch is felt but never painful.
For strengthening, eccentric exercises are particularly effective because they involve slowly lengthening the muscle while under tension. Use a light weight, such as a one-pound dumbbell, with the forearm supported on a table and the wrist hanging over the edge. For tennis elbow (palm down), use the unaffected hand to lift the weight, then slowly lower it using the affected wrist over three seconds. For golfer’s elbow (palm up), the affected wrist slowly lowers the weight with the same controlled, three-second movement. Begin without weight, focusing on 10 to 15 repetitions for three sets, and only progress to adding weight once 30 repetitions can be completed without increasing pain.
Professional Medical Interventions
While many cases of elbow tendonitis improve with rest and home exercises, professional medical intervention is necessary if the pain persists for more than a few weeks or if performing daily tasks remains difficult. A physician can confirm the diagnosis and rule out other potential causes before recommending a specialized treatment plan.
A common recommendation is formal physical therapy, where a therapist provides targeted manual therapy and an individualized program that may include isometric, concentric, and eccentric exercises. A doctor may also suggest a corticosteroid injection, which provides rapid, short-term relief by reducing inflammation. However, repeated injections can potentially weaken the tendon tissue over time, making them a limited option.
An alternative, regenerative approach is Platelet-Rich Plasma (PRP) therapy, which involves injecting a concentrated solution of the patient’s own platelets and growth factors into the injured tendon. PRP aims to stimulate the body’s natural healing process and has shown promise in promoting long-term recovery, often being a preferred option over steroids for chronic cases. Surgery is rarely needed, typically reserved for severe symptoms that have not improved after six to twelve months of consistent conservative treatments.
Preventing Future Recurrence
After recovering, implementing long-term lifestyle and technique adjustments is the best strategy to prevent recurrence. A thorough assessment of your work or sports environment, known as ergonomics, is a fundamental step. This includes adjusting the height of your desk or chair to maintain a neutral wrist position and ensuring your primary tools or equipment are properly sized.
For athletes, focusing on proper technique, grip, and form during repetitive movements significantly reduces strain on the forearm tendons. Using appropriate tools, such as rackets with a larger grip size or ergonomic handles, can minimize the force required for gripping. Always perform light stretching and warm-up movements before engaging in any activity that requires strenuous or repetitive use of the forearm muscles.