Tennis elbow (lateral epicondylitis) is a painful condition resulting from the inflammation or micro-tearing of the tendons that join the forearm muscles to the outside of the elbow. This overuse injury is caused by repetitive motions of the arm and wrist, especially gripping and twisting actions, which overload the forearm’s extensor muscles. The resulting discomfort can significantly limit daily activities, but immediate home management steps can help mitigate the pain and promote healing. This guide offers actionable steps to safely manage the pain and begin recovery.
Initial Steps for Immediate Relief
The first priority in managing acute tennis elbow pain is to halt the cycle of irritation using the Rest, Ice, and over-the-counter (OTC) medication approach. Rest means completely stopping the aggravating activity, such as gardening, typing, or lifting, to prevent further strain on the injured tendon. Continued use of the wrist extensor muscles perpetuates microscopic damage to the tendon fibers.
Applying ice to the painful area on the outside of the elbow helps reduce localized inflammation and provides temporary pain relief. Apply a cold pack or ice wrapped in a thin towel for a maximum of 15 to 20 minutes, repeated several times daily, especially after any activity that caused a flare-up. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be taken for temporary pain and swelling control. These medications offer only short-term symptom relief and do not address the underlying tendon issue.
Proper Bracing and Activity Adjustments
External support, specifically a counterforce brace, can mechanically reduce the strain placed on the tendon insertion point during functional activities. This brace is a strap worn around the forearm, positioned one to two inches below the elbow joint. The device works by compressing the forearm muscles, redirecting the force away from the damaged tendon insertion point.
Correct placement involves ensuring the brace’s padded section sits directly over the most prominent part of the forearm muscle belly (the extensor wad), not directly on the bony point of the elbow. The strap should be snug enough to provide compression but must not be so tight that it causes numbness, tingling, or discoloration, which indicates possible nerve or circulation compression. Wear the brace primarily during activities that involve gripping or lifting to reduce the load on the injured tissue.
Beyond bracing, modifying how you use your arm throughout the day is highly effective in managing symptoms. Practical adjustments include using two hands to lift heavier objects, like a coffee mug or a grocery bag, to distribute the load and reduce stress on the wrist extensors. When performing twisting motions, such as turning a doorknob or opening a jar, focus on turning the entire arm and body rather than relying solely on the wrist. Adopting a neutral wrist position when using a computer mouse or keyboard also helps prevent undue tension in the forearm muscles.
Active Recovery: Stretching and Strengthening
Once the acute pain has lessened, transitioning into active recovery through therapeutic exercise is necessary for long-term tendon healing and strength restoration. The initial phase focuses on gentle stretching to improve flexibility in the wrist extensor and flexor muscles.
Wrist Extensor Stretch
To perform a wrist extensor stretch, extend the arm straight out with the palm facing down. Gently use the opposite hand to pull the fingers downward toward the body until a light stretch is felt along the top of the forearm.
Wrist Flexor Stretch
The wrist flexor stretch involves extending the arm straight with the palm facing up. Pull the fingers downward toward the body to stretch the underside of the forearm.
Hold each stretch for 15 to 30 seconds and repeat several times daily. Avoid any movement that reproduces the sharp elbow pain. Stretching should be performed gently, focusing on a lengthening sensation rather than a painful pull.
The next stage involves specific strengthening exercises, with eccentric training being particularly beneficial for tendon repair. Eccentric exercises involve slowly lengthening a muscle while it is under tension, which stimulates collagen production and strengthens the tendon structure.
Eccentric Wrist Extension
A common exercise is the eccentric wrist extension. Support the forearm on a table with the wrist hanging over the edge, palm down, and hold a light weight, such as a one-pound dumbbell. Use the unaffected hand to lift the weight into the fully extended position. Then, slowly lower the weight back down using only the injured arm’s muscles over a count of three to five seconds. The goal is to perform three sets of 10 to 15 repetitions, gradually increasing the number of sets before considering a slight increase in weight.
Isometric exercises, which involve holding a muscle contraction without movement, can also be introduced early on by gripping an object like a rolled towel for 10 seconds to build tolerance to load.
When to Seek Professional Guidance
While many instances of tennis elbow respond well to consistent home care, specific indicators warrant professional medical evaluation. If the pain persists without noticeable improvement after four to six weeks of diligent rest, icing, and activity modification, consult a healthcare provider. A professional assessment is also warranted if the pain becomes debilitating, is constant throughout the day, or consistently disrupts sleep.
Warning signs suggesting a more serious issue include numbness, tingling, or a burning sensation that radiates down the forearm and into the fingers, which could indicate nerve involvement. A doctor or physical therapist can confirm the diagnosis, rule out other conditions, and provide access to targeted therapies, such as prescription anti-inflammatories or a guided physical therapy program. Seek professional help if there is visible swelling, a noticeable deformity around the elbow joint, or if the pain is accompanied by fever or general weakness.