Muscle, joint & pain

Tennis Elbow or Golfer's Elbow

Save

The two conditions share a mechanism — a forearm tendon irritated by repeated gripping and wrist motion — but sit on opposite sides of the elbow and respond to slightly different loading exercises. Telling them apart starts with one question: which bony bump on the elbow hurts when you press it, the one on the thumb side or the one on the pinky side?

Last updated: July 2026

Talk to a clinician

Gale can help you find a clinician in your state and request a visit.

Find care →

Which Side of the Elbow Hurts?

The fastest way to tell them apart is to press directly on the two bony bumps at the elbow, called the epicondyles. Pain at the outer bump — the one nearer the thumb when the palm faces forward — is lateral epicondylitis, commonly called tennis elbow. Pain at the inner bump, nearer the pinky, is medial epicondylitis, or golfer's elbow. Tennis elbow is markedly more common than golfer's elbow in general population studies of elbow pain, which is part of why it gets more attention, but the inner-elbow version is not rare. Both tend to radiate a short distance down the forearm from the tender point rather than staying pinpointed at the bump alone.

What's Actually Happening in the Tendon

Tennis elbow involves the tendons of the wrist and finger extensor muscles, which attach at the outer epicondyle and pull the wrist backward and the fingers open. Golfer's elbow involves the wrist flexor and forearm pronator tendons, which attach at the inner epicondyle and pull the wrist forward and rotate the palm down. In both cases, repeated gripping and wrist motion — a firm handshake grip repeated hundreds of times a day, a keyboard and mouse held with a cocked wrist, a racket swing, a hammer, a screwdriver — outpaces the tendon's ability to repair itself, producing microscopic degeneration rather than true inflammation despite the "-itis" in the name. Neither condition needs the sport in its name to develop: most tennis elbow does not come from tennis, and most golfer's elbow does not come from golf. Painters, plumbers, carpenters, and anyone doing repetitive hand-intensive work develop both at similar or higher rates than the sports that lent them their names.

The Movements That Provoke Each One

A simple test at home, though not a substitute for an exam, is which motion reproduces the pain. Tennis elbow flares with actions that extend the wrist against resistance or grip with the wrist bent back — lifting a coffee cup or gallon of milk with a straight arm, turning a doorknob, shaking hands firmly, a backhand tennis stroke. Golfer's elbow flares with actions that flex the wrist or rotate the forearm against resistance — a golf swing at impact, throwing a baseball, using a screwdriver, carrying a suitcase with the wrist curled inward. Because the extensor tendons at play in tennis elbow are used constantly in daily gripping tasks, it tends to be noticed sooner and more often than golfer's elbow, whose flexor tendons are used more selectively.

Why the Corticosteroid Shot Is Not the Quick Fix It Looks Like

A corticosteroid injection can feel like an obvious first move for a painful tendon, and it does often reduce pain within the first few weeks. A randomized trial in people with tennis elbow found the opposite result over a longer horizon: at one year, the group that received a corticosteroid injection had worse outcomes and a higher rate of recurrence than the group that received a placebo injection, and adding physiotherapy did not meaningfully change that pattern 1. an early corticosteroid shot for tennis elbow tends to trade short-term relief for a higher chance the pain comes back. The trial was conducted specifically in lateral epicondylalgia (tennis elbow); it has not been repeated at the same scale for golfer's elbow, but clinicians treating both conditions have generally become more cautious about steroid injections as an early-line treatment because of this finding, favoring a loading exercise program first.

How Care Is Usually Sequenced

Care for both conditions usually starts the same way: reducing the specific gripping or wrist motion that provokes pain — not all use of the arm — combined with a progressive loading exercise program under a physical therapist's guidance, since the tendon generally needs graded strengthening rather than rest to regain its tolerance for load. A forearm strap or brace, worn just below the elbow, can reduce the pull on the irritated tendon during provoking tasks and is a reasonable early addition for many people. Ergonomic changes matter for both: a keyboard and mouse setup that keeps the wrist neutral rather than cocked, a tool grip that is thick enough not to require a tight fist, or a racket grip size adjustment for players. Most cases of either condition improve over weeks to several months with this conservative sequence; a minority that do not respond after a genuine trial of loading rehab are referred for further evaluation, and surgery is reserved for a small fraction of cases that remain limiting after conservative care has been fully tried.

How Clinicians Track Progress Over Time

Because both conditions are managed with a gradual, weeks-to-months loading program rather than a one-time fix, tracking whether it's actually improving matters. Clinicians and researchers sometimes use a validated self-reported questionnaire covering symptoms and function across the arm, shoulder, and hand — the DASH — to measure how much a condition like tennis or golfer's elbow is limiting specific daily tasks, and to see whether that limitation is trending down over a course of therapy 2. A simpler version many physical therapists use in day-to-day practice is just asking which specific tasks are still provoking pain — turning a key, lifting a full pan, a tennis backhand — and rechecking that same short list at follow-up, since a task-based check-in is often more useful to a patient than an abstract pain score.

Telling Them Apart From Other Elbow and Wrist Problems

Pain, numbness, or tingling that runs into the ring and pinky fingers alongside inner-elbow pain can point toward irritation of the ulnar nerve, which runs directly behind the inner epicondyle — a different problem from golfer's elbow, though the two can coexist and be confused. A swollen, red, hot elbow, or fever, is not the picture of either overuse condition and points toward an infection or gout flare that needs prompt evaluation rather than a wait-and-see approach. Weakness gripping objects that developed gradually, without a specific injury, is consistent with either tennis or golfer's elbow, while a sudden inability to grip after an acute injury deserves a more urgent look.

Common questions

It's uncommon but possible, especially with heavy repetitive gripping work that loads both the flexor and extensor tendons. If both bony bumps are tender to press, that combination is worth mentioning to whoever evaluates you rather than assuming it's one or the other.

Usually not at first. Both conditions are typically diagnosed from the location of tenderness and the movements that provoke pain during a physical exam. Imaging is generally reserved for cases that don't improve with conservative care or where the exam suggests something else, like a fracture or nerve entrapment.

A counterforce strap worn just below the elbow, positioned over the forearm muscle belly rather than the joint itself, is a low-risk thing to try alongside reducing the provoking activity. It doesn't replace an evaluation if pain persists beyond a couple of weeks or is limiting daily tasks.

The names stuck from when the conditions were first described in tennis and golf populations, but occupational and everyday repetitive gripping — typing, tool use, lifting — causes the large majority of cases in the general population.

Most cases improve meaningfully within six weeks to a few months of reducing the provoking activity and following a structured loading program, though full resolution can take longer, and progress is often not a straight line week to week.

Related

Say it back

How would you explain this to someone you love?

Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.

Talk to a clinician

Gale can help you find a clinician in your state and request a visit.

Find care →

When to get it evaluated

  • —A swollen, red, hot elbow, especially with fever
  • —Numbness or tingling running into the ring and pinky fingers alongside inner-elbow pain
  • —Sudden inability to grip or bend the elbow after an acute injury, rather than a gradual onset
  • —Pain that is worsening or unchanged after several weeks of reduced activity

This article is educational and is not a substitute for an in-person evaluation by a clinician or physical therapist who can examine your elbow directly.

References

  1. 1.Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B (2013). Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia: A Randomized Controlled Trial. JAMA. PMID 23385272 ✓For lateral epicondylalgia (tennis elbow), corticosteroid injection produced worse 1-year outcomes and higher recurrence than placebo injection, with no significant added benefit from physiotherapy.
  2. 2.Hudak PL, Amadio PC, Bombardier C (Upper Extremity Collaborative Group) (1996). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and hand). American Journal of Industrial Medicine. doi:10.1002/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-LDescribes the DASH, a validated self-reported measure of symptoms and physical function across upper-extremity musculoskeletal disorders, used to explain how clinicians track progress in tennis and golfer's elbow.

2 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy

← Back to the health library