Tennis Elbow vs Golfer's Elbow: How to Tell the Difference

The short answer: Tennis elbow causes pain on the outside of the elbow, and golfer's elbow causes pain on the inside. Both are overuse tendon problems with similar symptoms and a shared approach: calm the aggravating activity, then rebuild forearm strength gradually. A clinician can confirm which one you have and rule out other causes.

• Outside versus inside. Tennis elbow (lateral epicondylitis) hurts on the outer elbow [1]. Golfer's elbow (medial epicondylitis) hurts on the inner elbow [2].
• Both are overuse problems. The tendons that attach forearm muscles to the elbow bone become worn or partially torn from repetitive use [1][2]. Neither is limited to athletes [2][3].
• Both usually settle without surgery. OrthoInfo says roughly 80 to 95% of people with tennis elbow succeed with nonsurgical care [1], and golfer's elbow can usually be treated successfully without surgery [2].
• Exercise has the best support, but it is limited. A summary of a 30-trial meta-analysis favors exercise over passive treatments for longstanding tennis elbow, with about 70% of the trials at high risk of bias [6]. The review that examined both conditions found trials only for tennis elbow [7].
• Be careful with steroid injections. They help in the short term for tennis elbow but show no clear long-term benefit [8].
• Some causes mimic these. Neck problems and nerve compression can look like tennis elbow [1], and ulnar nerve irritation can accompany golfer's elbow [2].

Both are tendon problems at the elbow. The bony bumps on either side of the elbow are called epicondyles. Forearm muscles attach to them through tendons, and repeated strain can wear or partially tear those tendons [1][2].

• Tennis elbow involves the tendons on the outside of the elbow, most commonly the extensor carpi radialis brevis (ECRB) tendon, which helps lift the wrist [1].
• Golfer's elbow involves the forearm tendons on the inside of the elbow [2].

Despite the names, neither requires a racquet or a golf club. Our glossary entry on tendons explains the tissue involved.

A simple home clue. Put a finger on the bony bump on the outside of the elbow, then the inside. Tenderness over one of them, together with pain on the matching wrist movement above, points to that side. This is a rough guide only. It does not replace an exam.

Repetition, not one injury. Typical sources include:

• Tennis elbow: racquet sports, especially backhand strokes with poor form, plus plumbing tools, painting, driving screws, cutting food and heavy computer mouse use. Mayo Clinic also lists smoking, obesity and certain medications as risk factors [3]. Occupations at risk include painting, plumbing, carpentry and cooking [1]. Some cases have no clear cause [1].
• Golfer's elbow: repetitive gripping and wrist-bending movements. Golf is a common trigger, but tennis, overhead throwing, weightlifting and everyday household tasks can also cause it [2]. Poor swing technique or equipment may contribute [2].

Not every elbow ache is a tendon problem. OrthoInfo notes that neck problems, such as a herniated disk or arthritis, and nerve compression can mimic tennis elbow, and it advises telling your doctor about a prior elbow injury, rheumatoid arthritis or nerve disease [1]. For golfer's elbow, doctors commonly order X-rays to rule out fracture or arthritis, and may use nerve studies if compression is suspected [2]. Ultrasound or MRI is usually kept for symptoms that last or do not respond to treatment [2].

If your pain travels from the neck, or you have numbness or tingling, mention it. Our neck stretch and thoracic rotation pages cover the upper-body side, but they do not replace an assessment.

Mostly the same way. That is the "shared approach" in the calendar angle, and the sources support it.

Step 1: Calm it down.

• Rest from painful activities [1][2].
• Ice, about 20 minutes several times a day, and a short course of an over-the-counter anti-inflammatory if you tolerate it [2]. Mayo Clinic suggests ice for 15 to 20 minutes three or four times a day [4]. Consistent self-care for several weeks often relieves symptoms [4].
• Consider a brace. OrthoInfo lists bracing for tennis elbow [1] and a counterforce or wrist brace for golfer's elbow [2].

Step 2: Rebuild. See the next section.

Step 3: Review if it is not improving. Mayo Clinic says to see a provider if rest, ice and pain relievers do not ease elbow pain and tenderness [3], and, for golfer's elbow, if there is no improvement after several weeks of self-care [4].

Other options. OrthoInfo lists platelet-rich plasma injections, dry needling and shock wave therapy for golfer's elbow, and says their effectiveness compared with standard exercise is not yet clear [2]. Surgery is considered after at least several months of treatment for golfer's elbow [2] and after 6 to 12 months for tennis elbow [1].

What about steroid injections?

A review of corticosteroid injections for tennis elbow found a short-term benefit for pain, no difference from control later on for overall improvement or grip strength, and a negative effect at intermediate follow-up. The authors called the treatment difficult to recommend [8]. OrthoInfo says injections should be used very sparingly for tennis elbow because overuse may weaken the tendon attachment [1], and warns they may lengthen rehabilitation for golfer's elbow [2]. Please discuss this with your clinician; we do not recommend for or against injections for any individual.

Strengthening has the strongest support, but the research is thinner than most people assume.

• Tennis elbow. A Keele evidence summary of a 2020 meta-analysis of 30 randomized trials (2,123 participants) found exercise outperformed passive treatments for longstanding tennis elbow on pain intensity, elbow disability and pain-free grip strength. Some comparisons showed no difference, about 70% of trials had a high risk of bias, and no harm was found. The quality was low to moderate [6].
• Stretching and strengthening. A systematic review found moderate short-term evidence favoring stretching plus strengthening over ultrasound plus friction massage [7].
• Golfer's elbow. The review that examined both conditions included only trials on tennis elbow [7]. Guidance for golfer's elbow, including that eccentric exercises are "thought to be particularly beneficial" [2] and "particularly effective" [4], comes from clinical expertise, not trials we could find.

That gap matters. It means the approach below for golfer's elbow borrows from tennis elbow evidence and expert guidance. It is reasonable, but less proven. We also did not find evidence in these sources that any single exercise is best, and a separate review noted that most trials gave little justification for the exercises they chose [7].

Start gently and let pain guide progress. OrthoInfo says to stretch first to restore pain-free wrist motion, then strengthen, with a focus on wrist bending and forearm rotation [2]. Medical News Today lists ball squeezes, finger extensions with a rubber band, wrist extensions with a one-pound weight, and forearm rotation while holding a heavy object such as a hammer [5].

The doses below are common clinical starting points, not tested prescriptions. A clinician can adjust them.

Stop if the pain becomes sharp, the elbow swells or feels hot, or you notice numbness or tingling in your ring and little fingers [2]. Ease off and see a provider if it does not settle.

A mild ache that settles within a day is usually an acceptable load. Pain that builds or lingers is a sign to reduce the weight or repetitions. This is a clinical rule of thumb, not from a source.

For related reading, see our posts on runner's knee versus IT band syndrome and hip exercises for runners for load management in sport, and our tennis elbow page. Kai, Loosn's AI physio coach, can help you plan a gradual return to activity. It does not replace assessment if symptoms are severe, getting worse or unusual.

Expect weeks to months. Mayo Clinic says full relief from golfer's elbow often takes three to six months of consistent physical therapy [4]. Medical News Today says very chronic cases may take six weeks or longer even with treatment, and recovery is slower if the aggravating activity continues [5].

To reduce recurrence, Mayo Clinic suggests strengthening and stretching forearm muscles before activity, using lightweight equipment, avoiding overuse and taking a break when an activity causes discomfort [4]. In sport, check technique and equipment [1][2].

Loosn gives no diagnosis. Elbow pain after an injury is different from gradual overuse pain.

Emergency: call 911 (or your local emergency number) or go to the emergency department if:

• your elbow looks misshapen after a fall or injury, or you cannot use the arm at all
• you cannot put weight through the arm, or pain is severe after a fall
• you have chest pain, trouble breathing, or pain spreading from the chest to the arm or jaw

(Other common emergency numbers are 999 in the UK, 112 across the EU and 000 in Australia.)

Get seen the same day if:

• the elbow is red, hot and swollen, especially with fever
• you have severe pain, or pain at rest or at night that is getting worse
• you have numbness or tingling that is spreading or associated with weakness

See your provider soon if [3][4][5]:

• rest, ice and pain relievers do not ease the pain and tenderness [3]
• there is no improvement after several weeks of self-care [4]
• pain worsens with activity, or there is swelling [5]
• you have lingering, unexplained pain, or only limited relief after rest [5]
• you have numbness or tingling in the ring and little fingers [2]
• neck pain or other arm symptoms come with it [1]

Night pain can occur in tennis elbow [1], so it is not by itself an emergency. A change in pattern is what matters.

Loosn is not a substitute for assessment when symptoms are severe, getting worse or unusual.

What is the difference between tennis elbow and golfer's elbow? 

Location is the main clue. Tennis elbow (lateral epicondylitis) causes pain on the outside of the elbow [1]. Golfer's elbow (medial epicondylitis) causes pain on the inside, sometimes with shooting pain toward the hand [2]. Both are overuse tendon problems, and symptoms are similar [4]. An exam is the only way to confirm which one you have.

Do you have to play tennis or golf to get them? 

No. Mayo Clinic notes golfer's elbow does not only affect athletes [4], and OrthoInfo lists everyday household tasks among its triggers [2]. Tennis elbow is linked to jobs such as painting, plumbing, carpentry and cooking, and to heavy computer mouse use [1][3]. Repetitive gripping and wrist movements are the common thread.

How long does it take to heal? 

It is slow. Mayo Clinic says full relief from golfer's elbow often takes three to six months of consistent physical therapy [4]. OrthoInfo says roughly 80 to 95% of people with tennis elbow succeed without surgery, and surgery is considered only after 6 to 12 months of nonsurgical care [1]. Timelines vary, and continuing the aggravating activity slows recovery [5].

Should I get a cortisone injection? 

Discuss it with your clinician, because the evidence is mixed. A systematic review found steroid injections helped pain in the short term for tennis elbow but showed no clear benefit later, with a negative effect at intermediate follow-up [8]. OrthoInfo says injections should be used very sparingly for tennis elbow [1] and may lengthen rehabilitation for golfer's elbow [2].

Does a brace or strap help? 

It may help some people, but the sources we read give no figures. OrthoInfo lists bracing among nonsurgical options for tennis elbow [1], and a counterforce or wrist brace for golfer's elbow [2]. Treat a brace as a support while you modify activity and build strength, not as a cure on its own.

Which exercises work best? 

Strengthening, usually after gentle stretching. A summary of a 30-trial meta-analysis found exercise outperformed passive treatments for longstanding tennis elbow, though about 70% of trials had a high risk of bias [6]. OrthoInfo describes eccentric strengthening as thought to be particularly beneficial for golfer's elbow [2]. No trials on golfer's elbow exercise were found in one review [7].

Download the Loosn mobile app for new guides on tendon pain, load management and moving well, and ask Kai, Loosn's AI physio coach, for a gentle routine to follow.