Tennis elbow at work: causes, recovery and prevention

What is tennis elbow?

Tennis elbow, medically lateral epicondylitis or lateral elbow tendinopathy, is pain on the outside of the elbow where the tendons that lift the wrist and fingers attach to the bone. It hurts to grip, lift, twist or carry, and the pain can spread down the forearm.

Despite the name, most cases have nothing to do with tennis. Danish medical guidance puts the prevalence at about 1 to 3% of adults, mostly between 35 and 60. Among slaughterhouse workers, 9% had it on clinical examination (sundhed.dk).

Which work tasks cause it?

The Danish occupational medicine guidance names repeated, forceful use of the hands and arms as the most important work-related risk factor. In practice:

• Forceful gripping, such as tools, knives and heavy objects
• Lifting 20 kg or more at least 10 times a day
• Repetitive forearm movements for more than two hours a day
• Twisting the wrist and forearm while gripping, which the NHS also links to mouse and computer work

The exact thresholds are uncertain, but the pattern is consistent: force combined with repetition. Tennis elbow can be recognised as a work-related condition in Denmark.

How long does it take to recover?

Usually months rather than weeks. Danish medical guidance says symptoms mostly go away within 8 to 13 months, but can last for years. In a trial in The Lancet, 83% of patients who simply waited had recovered or improved a lot after one year, and 91% of those who had physiotherapy.

Which treatments work?

• Load management. Reduce the gripping and twisting that provoke the pain without stopping all activity.
• Exercise, particularly strengthening of the wrist extensors, which reduces pain and improves strength.
• Physiotherapy if it has not improved after about six weeks (NHS).

What to be careful with:

• Steroid injections give quick relief, but after a year they lead to worse results and more relapses. In a JAMA trial, 54% relapsed after injection against 12% with placebo.
• Braces and straps may ease symptoms for some people, but a Cochrane review found too little evidence to say whether they work.

Advice from Danish occupational medicine: adjust the work early and avoid long sick leave.

How can employers prevent tennis elbow?

1. Find the gripping and twisting tasks. Look for repeated, forceful work with the hands, especially for more than two hours a day.
2. Reduce the force. Use lighter tools with better handles, keep knives sharp and use power tools or aids for the heaviest grips.
3. Vary the work. Rotate tasks so no one grips forcefully for hours.
4. Act on early pain. Adjust tasks before the pain becomes chronic.

Precure began with this condition. Our MLI® Elbow sensor measures the load on the forearm muscles during ordinary work, and our Individual program helps employees with elbow pain find and change what triggers it. Read about MSDs in general.

This guide is general information. See a doctor or physiotherapist about your own pain, especially after an injury or if the elbow is swollen, hot or very painful.

Sources

1. Lateral og medial epikondylitis, arbejdsbetinget, sundhed.dk, Lægehåndbogen, 2025
2. Epikondylit, sundhed.dk, Lægehåndbogen, 2025
3. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial, Smidt et al., The Lancet, 2002
4. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia, Coombes et al., JAMA, 2013
5. Orthotic devices for tennis elbow, Cochrane Database of Systematic Reviews, 2001
6. Tennis elbow, NHS, 2024

Written by a physiotherapist. General information, not a diagnosis: see a doctor or physiotherapist about your own pain.