What is tennis elbow and is it a type of tendonitis or bursitis?Â
Tennis elbow is a clinical condition characterized by pain and inflammation on the outer part of the elbow, specifically where the tendons of your forearm muscles attach to the bony bump of the joint. In the United Kingdom, it is one of the most common musculoskeletal complaints, affecting individuals who perform repetitive gripping or lifting tasks. While the name suggests a sports injury, the majority of cases occur in people who have never played tennis, instead arising from occupational strain or household activities. Understanding whether this condition involves a tendon or a bursa is the first step in following the correct NHS-recommended recovery path.
What We’ll Discuss in This Article
- The clinical definition of tennis elbow (lateral epicondylitis).Â
- Why tennis elbow is classified as a type of tendonitis.Â
- The difference between elbow tendonitis and olecranon bursitis.Â
- Identifying the specific site of pain and inflammation.Â
- Common causes and risk factors in the UK workplace.Â
- Standard NHS and NICE management for elbow recovery.Â
Is tennis elbow tendonitis or bursitis?
Tennis elbow is a type of tendonitis, specifically affecting the tendons that connect the forearm muscles to the outside of the elbow bone. The clinical term for the condition is lateral epicondylitis. While bursitis can also occur in the elbow, it involves a different structure called the olecranon bursa, which is the fluid filled sac at the very tip of the elbow bone. Tennis elbow focuses entirely on the extensor tendons, which become irritated and develop microscopic tears due to repetitive stress. According to NHS information on tennis elbow, the condition is a result of overloading these specific tendon fibres.
The anatomy of the injury
The pain from tennis elbow occurs at the lateral epicondyle, which is the bony protrusion on the outside of your elbow. This is the anchor point for the muscles that allow you to extend your wrist and fingers. When you perform repetitive motions, such as using a screwdriver, typing, or hitting a backhand in tennis, these tendons are pulled tightly against the bone. If the activity is too frequent or forceful, the tendon begins to undergo a process of degeneration or inflammation. This leads to the characteristic tenderness and sharp pain felt whenever you try to grip an object or twist your forearm.
Distinguishing tennis elbow from bursitis
It is important to tell the difference between tennis elbow and elbow bursitis because they require different care. Tennis elbow (tendonitis) causes pain that is most acute when you use your hand or wrist, and there is usually no visible swelling. Elbow bursitis, on the other hand, typically causes a very obvious, squishy swelling at the back of the elbow that looks like a small balloon or an egg. While both involve inflammation in the same joint area, bursitis is an issue with the joint’s cushion, whereas tennis elbow is an issue with the joint’s movement system.
| Feature | Tennis Elbow (Tendonitis) | Elbow Bursitis |
| Location | Outer bony bump of the elbow | Tip of the elbow bone (back) |
| Visible Swelling | Rarely visible | Often very prominent and squishy |
| Pain Trigger | Gripping, lifting, or twisting | Direct pressure or leaning on elbow |
| Primary Tissue | Forearm extensor tendons | Olecranon bursa sac |
Common symptoms and identification
The most frequent symptom of tennis elbow is a persistent ache on the outside of the upper forearm, just below the elbow joint. You may find that the pain increases when you lift your arm, reach for an object, or perform simple tasks like turning a door handle or opening a jar. In the UK, clinicians often identify the condition by applying gentle pressure to the lateral epicondyle while asking the patient to lift their wrist against resistance. If this movement triggers a sharp pain at the bone, it is a strong indication of lateral epicondylitis.
[Image showing the point of tenderness for lateral epicondylitis on the outer elbow]
Who gets tennis elbow in the UK?
Despite its name, less than five percent of people with this condition actually develop it from playing tennis. In the UK, it is far more common in manual trades and office based roles. Plumbers, painters, decorators, and carpenters are at high risk due to the repetitive use of hand tools. Similarly, office workers who spend long hours typing or using a mouse with poor wrist posture can develop the condition over time. According to NICE clinical standards, the condition is most prevalent in adults aged between thirty and fifty, as the tendons naturally become less flexible with age.
Management and the road to recovery
The primary goal of managing tennis elbow is to allow the microscopic tears in the tendon to heal by reducing the mechanical load. The initial approach recommended by the NHS is the PRICE method (protection, rest, ice, compression, and elevation). Avoiding the activity that caused the pain is essential for preventing further tissue damage. Once the acute pain has settled, a physiotherapist can provide a program of strengthening exercises to improve the resilience of the forearm muscles. Using an epicondylar clasp or a tennis elbow brace can also help by redistributing the pressure away from the inflamed tendon attachment point during daily tasks.
Conclusion
Tennis elbow is a form of tendonitis that causes pain on the outer part of the elbow due to repetitive strain on the forearm tendons. It is distinct from bursitis, which involves the fluid filled sac at the tip of the elbow and usually causes more visible swelling. Most cases of tennis elbow are related to work or household tasks rather than sports and can be managed effectively with rest, ice, and gradual strengthening. If you experience severe, sudden, or worsening symptoms, call 999 immediately.
Why is it called tennis elbow if I don’t play tennis?Â
The name comes from the repetitive backhand motion in tennis that originally highlighted the condition, but any similar repetitive wrist movement can trigger it.Â
Can tennis elbow cause pain in my wrist?Â
Yes, because the affected tendons control the wrist, the pain can often radiate down the forearm and feel like it is coming from the wrist area. Â
How long does it take for tennis elbow to heal?Â
Most cases improve within six months to a year, though many people see significant relief within a few weeks of consistent rest and physiotherapy.Â
Should I wear a brace all the time?Â
You should usually only wear a tennis elbow brace during activities that irritate the joint to help take the pressure off the tendon. Â
Will I need a steroid injection for tennis elbow?Â
Steroid injections are sometimes used for short term pain relief, but they are generally not recommended as a long term solution in the UK.Â
Is it safe to keep working with tennis elbow?Â
You should try to modify your tasks to avoid movements that cause sharp pain, as continuing to overload the tendon can lead to a chronic problem. Â
Can I use ibuprofen gel for the pain?Â
Anti inflammatory gels can be effective for localized relief because the tendon is located relatively close to the skin surface.Â
Authority Snapshot
This article provides a clinical overview of lateral epicondylitis to help patients distinguish between different types of elbow inflammation. It has been written by the MyPatientAdvice Medical Writing/Research Team and reviewed by Dr. Rebecca Fernandez to ensure medical accuracy. The information presented is strictly aligned with the latest NHS and NICE protocols for the management of elbow and soft tissue injuries in the United Kingdom.
