Symptoms of Tennis Elbow

Tennis elbow typically develops gradually. Patients experience pain during movement at the lateral (outer) aspect of the elbow joint. This pain may radiate upward toward the upper arm or downward toward the forearm, often accompanied by a sensation of soreness, swelling, and discomfort, leading to reluctance to move the affected limb. Activities requiring grip strength—such as lifting a bucket, twisting open a bottle cap, or knitting—exacerbate the pain.

A localized tender point is commonly found over the lateral epicondyle of the humerus. Occasionally, tenderness may radiate distally toward the hand. The primary tender spot is located precisely over the lateral epicondyle of the humerus; however, this tenderness is usually confined to this area. In some cases, it may extend distally along the extensor tendons, where mild tenderness and pain upon movement may also be present.

Mild swelling may occur; in severe cases, bony hypertrophy (osteophyte formation) may be palpable. There is typically no local erythema or swelling, and elbow flexion and extension remain unaffected. However, forearm rotation elicits pain. When the affected limb is positioned with the elbow flexed and the forearm supinated, the extensor muscles relax, thereby relieving pain. In more severe cases, even simple movements such as finger extension, wrist dorsiflexion, or holding chopsticks can provoke pain. Conversely, pain tends to subside when the elbow is flexed and the wrist is externally rotated. A minority of patients report worsening pain during damp or rainy weather.