Tennis elbow, clinically known as lateral epicondylitis, is a painful condition characterized by damage or irritation to the tendons on the outside of the elbow joint. This injury often results from repetitive strain and overuse of the forearm muscles, not exclusively from playing tennis. The pain can radiate down the forearm and is frequently exacerbated at night, making restorative sleep difficult. Finding strategies to minimize overnight discomfort is necessary because poor sleep can intensify pain perception and hinder the body’s natural healing process. This article provides practical, actionable steps for adjusting sleeping habits, utilizing supports, and managing pain proactively to achieve better rest with tennis elbow.
Optimizing Sleeping Positions
The primary goal of overnight positioning is to eliminate any direct pressure on the affected elbow and maintain a neutral alignment of the joint. Sleeping directly on the injured arm is strictly counterproductive, as the pressure can compress already irritated tendons and restrict blood flow. Avoiding this position is the single most effective way to prevent waking up with sharp, increased pain.
The back (supine) sleeping position is the most advantageous for managing lateral epicondylitis because it allows the arm to remain in a neutral and supported posture. When lying on the back, the affected arm should be rested comfortably beside the body or across the torso. Ensure the elbow is slightly bent rather than locked straight, as a slight bend helps reduce tension on the forearm muscles and their tendon attachments.
If sleeping on the side opposite the injured arm is preferred, careful positioning is still required to prevent strain. The affected arm should be supported in front of the body on a pillow, keeping the wrist from curling or twisting. Using a body pillow or placing a firm pillow behind the back can help prevent the body from unconsciously rolling over onto the painful side. Avoid placing the arm above the head, as this position stretches the tendons and can worsen inflammation overnight.
Utilizing Supports and Braces
External supports can be employed during sleep to maintain the elbow and wrist in a protective, neutral position, preventing unconscious movements that aggravate the condition. Nighttime bracing differs from the counterforce straps worn during the day for activity, which primarily aim to redistribute force. Instead, the focus overnight is on gentle immobilization and tendon rest.
A simple wrist brace or soft splint is often recommended to be worn at night because the tendons involved in tennis elbow also cross the wrist joint. Keeping the wrist in a neutral position prevents the forearm muscles from tightening, which reduces strain on the inflamed lateral epicondyle. Some individuals also find relief using a compressive elbow sleeve, which provides constant, gentle support without the rigidity of a splint.
Pillows serve as tools for stabilization and elevation, working in conjunction with any bracing used. When lying on the back, placing a small pillow beneath the forearm provides additional support and ensures the elbow remains slightly elevated, which may help reduce swelling and discomfort. For side sleepers, a larger pillow can be hugged to support the affected arm, preventing it from drooping down or twisting the forearm and wrist.
Pre-Sleep Pain Management Strategies
Proactive management steps taken just before bed can significantly reduce the pain signals that interfere with the ability to fall asleep and stay asleep. Applying cold therapy, specifically icing the outer elbow, is an effective way to decrease localized inflammation and pain sensation. Icing should be done for about 10 to 15 minutes, ideally 30 minutes before getting into bed, rather than immediately before, to avoid excessive numbness under the covers.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can be timed to offer pain relief throughout the sleep cycle. To maximize effectiveness during the middle of the night when pain often peaks, these medications should be taken about 30 to 60 minutes before the intended bedtime.
Incorporating gentle relaxation techniques can help lower the body’s overall muscle tension, which often exacerbates tendon pain. Simple methods like deep, slow breathing or guided meditation can engage the parasympathetic nervous system, promoting a state of calm before sleep. Reducing systemic tension proactively decreases the likelihood that the forearm muscles will remain taut, which could otherwise pull on the irritated tendons throughout the night.