What is actually happening
The forearm muscles that extend your wrist and fingers share a tendon that attaches at the bony point on the outside of your elbow. When that tendon is asked to do more than it has been prepared for, it becomes irritated and painful to load. Researchers now call it a tendinopathy rather than simple inflammation, which is why anti-inflammatory approaches alone often disappoint.
The inside of the elbow can be affected in the same way. That is usually called golfer’s elbow.
Typical signs
- Pain on the outer elbow, sometimes spreading into the forearm.
- Pain when you shake hands, lift a kettle, turn a screwdriver or use a mouse.
- Tenderness when you press on the bony point at the outside of the elbow.
- Stiffness first thing in the morning.
Why it can take months
Tendons adapt slowly. Most people improve within several months, and some take a year or more, although the large majority recover. The most common reason for a longer course is stopping all use, which weakens the tendon further, followed by a rush back to normal loads that sets it off again.
What tends to help
- Reduce the aggravating load, but do not stop completely. Keep gripping and lifting at a level that does not leave you sore the next day.
- Progressive loading. Gentle, slow strengthening of the wrist and forearm muscles, increased week by week, is the best-supported treatment. This might start with holding the muscle still against resistance, then slow lifts and lowers with a light weight.
- Look at what caused it. Mouse position, grip size on tools or racket, and a sudden jump in training or work can all play a part.
- Hands-on work. Soft-tissue treatment to the forearm can ease tension and make exercises more comfortable. We use it alongside loading, not instead of it.
Counter-force straps and supports help some people carry on with everyday tasks while the tendon recovers.
What about injections?
Corticosteroid injections can reduce pain for a few weeks, but studies suggest people who have them tend to do worse after a year than those who rest and exercise. Talk to your GP about the options and the evidence.