Tennis Elbow vs. Golfer’s Elbow: Key Differences and the Right Treatment for Each

A painful elbow does not become “tennis elbow” simply because gripping hurts, and pain after playing golf is not automatically “golfer’s elbow.” The distinction is anatomical.

Tennis elbow usually affects the tendon attachment on the outside of the elbow. Golfer’s elbow affects the tendon attachment on the inside. That location change also changes which muscles are overloaded, which resisted movements reproduce the pain, what other conditions need to be ruled out, and how rehabilitation should be targeted.

This matters in everyday life. Someone with tennis elbow may feel a sharp ache on the outside of the elbow when lifting a kettle, carrying a laptop bag, shaking hands, using a screwdriver or hitting a backhand. Someone with golfer’s elbow may instead feel pain on the inner side while gripping, flexing the wrist, turning the forearm or repeatedly handling a racquet, golf club or gym weight.

Neither condition is limited to the sport in its name.

They are both load-related tendon problems around the elbow, and most cases do not require surgery. But treating them as the same problem can miss important differences—particularly when inner-elbow pain is accompanied by tingling in the ring or little finger, or when supposed “tennis elbow” is actually pain coming from a nerve, joint, or neck.

This guide explains how to distinguish tennis elbow vs. golfer’s elbow, what is actually happening in the affected tendon, and how treatment should be adapted to each condition.

Tennis Elbow vs. Golfer’s Elbow at a Glance

The table is useful for orientation, but pain location alone should not be used to self-diagnose persistent elbow pain.

What Is Tennis Elbow?

Tennis elbow is the familiar name for lateral epicondylitis, although contemporary clinical literature also uses terms such as lateral elbow tendinopathy or lateral epicondylalgia.

The affected tendon attaches the wrist-extensor muscles of the forearm to the lateral epicondyle, the bony prominence on the outside of the elbow.

One muscle frequently implicated is the extensor carpi radialis brevis (ECRB).

These muscles are active every time you stabilize or extend the wrist while gripping. That explains why the condition can develop in people who have never touched a tennis racquet.

Repeated or suddenly increased loading can exceed the tendon's current capacity. The problem is better understood as a tendon overload/tendinopathy process than simply as an elbow that is “inflamed.”

Modern clinical guidance on lateral elbow tendinopathy recognizes structural tendon changes, altered muscle function and, in some patients, changes in pain processing as part of the clinical picture.

Where Does Tennis Elbow Hurt?

The typical pain is centred around the outer bony prominence of the elbow.

It may also spread a short distance down the outer forearm.

Common descriptions include:

• pain when gripping firmly
• pain when lifting a cup, kettle or bag
• discomfort opening a jar
• pain using a screwdriver or hand tool
• discomfort with mouse or keyboard-intensive work
• pain during racquet strokes
• tenderness when pressing over the outer elbow
• reduced grip strength because gripping provokes pain

A useful clinical clue is that resisted wrist extension can reproduce the patient's familiar pain.

That finding is not something patients need to repeatedly test themselves. It forms part of a broader clinical examination.

What Is Golfer’s Elbow?

Golfer’s elbow is the common name for medial epicondylitis.

This condition affects the common tendon attachment of muscles responsible for wrist flexion and forearm pronation on the inner side of the elbow.

The tendon attaches around the medial epicondyle, the bony prominence you can feel on the inside of the elbow.

The flexor-pronator group includes muscles such as:

• pronator teres
• flexor carpi radialis
• flexor carpi ulnaris
• palmaris longus
• flexor digitorum superficialis

The American Academy of Orthopaedic Surgeons notes that the pronator teres is commonly involved, although several of these tendons can contribute to medial epicondylitis.

Where Does Golfer’s Elbow Hurt?

Pain is usually focused over the inside of the elbow.

It may extend into the inner forearm.

Symptoms may appear during:

• forceful gripping
• wrist flexion
• rotating the forearm
• golf swings
• throwing
• weight training
• repetitive manual work
• carrying objects
• racquet sports

The pain may be reproduced clinically by resisted wrist flexion or forearm pronation.

There is one additional feature that deserves particular attention with medial elbow pain:

Tingling in the ring or little finger is not typical tendon pain

The ulnar nerve passes close to the medial epicondyle.

If a patient with presumed golfer’s elbow also develops:

• tingling
• numbness
• electric-shock sensations
• altered feeling in the little finger
• altered feeling in part of the ring finger
• hand weakness

the clinician should consider whether the ulnar nerve is also being irritated.

That is an important distinction because treating nerve-related symptoms as simple tendon overload may delay the correct diagnosis.

The Most Important Difference: Which Side Hurts?

If you remember only one anatomical distinction:

Tennis elbow = outside of the elbow.

Golfer’s elbow = inside of the elbow.

But a high-quality diagnosis goes further than geography.

The clinician should determine:

1. exactly where the tenderness is
2. which movement reproduces the pain
3. whether grip strength is affected
4. what activity caused or increased the symptoms
5. whether neurological symptoms are present
6. whether the elbow joint itself is involved
7. whether pain may be referred from somewhere else

This is important because not every case of lateral elbow pain is tennis elbow, and not every case of medial elbow pain is golfer’s elbow.

Why Do People Get Tennis Elbow?

The word “tennis” can be misleading.

Tennis elbow is fundamentally associated with repeated or excessive loading of the wrist-extensor tendon system.

Potential triggers include:

Racquet Sports

Repeated backhand strokes, late contact with the ball, poor load tolerance, increased playing volume or changes in equipment can increase demand on the extensor tendons.

Manual Work

Examples include repetitive:

• screwdriver use
• painting
• plumbing
• carpentry
• cutting
• lifting
• gripping tools

Computer and Desk Work

Mouse use itself does not automatically cause tennis elbow, but prolonged repetitive hand and wrist activity combined with poor load tolerance may contribute in some people.

Gym Training

Heavy gripping during:

• rows
• pull-ups
• deadlifts
• curls
• loaded carries

can aggravate an already sensitive lateral elbow tendon.

Sudden Increase in Activity

Tendons generally cope better with load when it is introduced progressively.

A sudden jump from little activity to several hours of tennis, DIY work, gardening or weight training may exceed the tendon’s current capacity.

The important concept is therefore not simply repetition.

It is the relationship between:

the load being placed on the tendon and the amount of load that tendon is currently prepared to tolerate.

Why Do People Get Golfer’s Elbow?

Golfer’s elbow follows a similar overload principle, but the affected muscle-tendon group is different.

It is associated with repeated loading of the wrist flexors and forearm pronators.

Possible triggers include:

• golf
• racquet sports
• cricket
• throwing sports
• weightlifting
• climbing
• repetitive gripping
• manual labour
• sudden increases in training volume

Golf can produce medial elbow stress, particularly when swing mechanics, repeated practice or striking the ground increase load through the flexor-pronator system.

But many people with medial epicondylitis do not play golf at all.

Can You Have Tennis Elbow and Golfer’s Elbow at the Same Time?

Yes.

The conditions affect different tendon groups, so it is possible for both the medial and lateral sides of the elbow to become symptomatic.

However, pain on both sides should also encourage a careful reassessment of the diagnosis.

A clinician may need to consider:

• generalized tendon overload
• cervical referred pain
• elbow arthritis
• nerve irritation
• inflammatory disease
• compensation after another upper-limb injury
• a substantial recent change in workload

The correct response is not necessarily to label the problem “double epicondylitis.”

Tennis Elbow vs. Golfer’s Elbow: Symptoms Compared

Tennis Elbow Symptoms

Typical features include:

• outer elbow pain
• tenderness over the lateral epicondyle
• pain during gripping
• pain with resisted wrist extension
• aching into the outer forearm
• reduced grip strength
• difficulty lifting with the affected arm

Golfer’s Elbow Symptoms

Typical features include:

• inner elbow pain
• tenderness over the medial epicondyle
• pain during gripping
• pain with wrist flexion
• pain with forearm pronation
• aching into the inner forearm
• reduced grip strength

If the ulnar nerve is also irritated, symptoms can include numbness or tingling extending toward the ring and little fingers.

Is Tennis Elbow an Inflammation?

The name “epicondylitis” suggests inflammation because the suffix “-itis” normally refers to an inflammatory process.

The biology of chronic tennis elbow is more complicated.

Modern research describes lateral elbow tendinopathy as involving changes within the tendon rather than simply persistent acute inflammation.

This distinction matters clinically.

If the condition were merely inflammation, treatment would revolve around suppressing inflammation and resting until it disappeared.

Instead, contemporary rehabilitation focuses heavily on restoring the tendon’s ability to tolerate load.

That is why appropriately progressed strengthening exercises can be more valuable than prolonged total rest.

The same principle applies broadly to golfer’s elbow.

How Are Tennis Elbow and Golfer’s Elbow Diagnosed?

In many cases, the diagnosis is primarily clinical.

A detailed history and examination are often more useful initially than immediately ordering an MRI.

An orthopaedic assessment may examine:

• exact pain location
• onset and duration
• occupation
• sports participation
• recent changes in activity
• grip strength
• elbow movement
• wrist movement
• tenderness
• resisted wrist extension
• resisted wrist flexion
• resisted pronation
• nerve function

Does Every Patient Need an MRI?

No.

MRI is generally not required simply because the elbow hurts.

Further imaging may become appropriate when:

• symptoms are atypical
• there was significant trauma
• the diagnosis remains uncertain
• symptoms persist despite appropriate treatment
• substantial tendon damage is suspected
• another structural condition needs to be excluded

An X-ray may be appropriate when the clinical picture suggests arthritis, previous trauma or another bony problem.

Ultrasound can sometimes help assess tendon structure.

For medial elbow pain associated with neurological symptoms, additional nerve assessment may occasionally be needed.

Conditions That Can Be Mistaken for Tennis Elbow

This is an important part of diagnosis.

Persistent outer-elbow pain can also arise from:

Radial Tunnel Syndrome

Irritation or compression involving the radial nerve can produce pain in the lateral/proximal forearm and may mimic tennis elbow.

Referred Pain From the Neck

A cervical spine problem can sometimes produce pain extending into the arm.

Elbow Arthritis

Joint disease can cause pain, stiffness, and reduced elbow movement.

Tendon Tear

More substantial tendon damage may produce a different clinical picture from routine tendinopathy.

Joint or Ligament Problems

Pain after trauma or instability needs a broader examination.

A patient whose symptoms do not fit the expected pattern deserves diagnostic reconsideration rather than an endless sequence of treatments for “tennis elbow.”

Conditions That Can Be Mistaken for Golfer’s Elbow

Inner elbow pain deserves the same diagnostic discipline.

Possible alternatives include:

Ulnar Nerve Irritation

Particularly important when numbness or tingling involves the ring or little finger.

Ulnar Collateral Ligament Injury

This can be especially relevant in throwing athletes and people exposed to repeated valgus stress.

Referred Pain

Neck and other upper-limb conditions can sometimes generate symptoms around the elbow.

Arthritis or Trauma

Joint pathology or previous injury may produce medial-sided symptoms.

This is why the correct treatment begins with confirming what tissue is actually causing the symptoms.

What Is the Right Treatment for Tennis Elbow?

Most tennis elbow cases are treated without surgery.

The treatment should be progressive rather than based on indefinite rest.

1. Modify the Load Rather Than Abandon the Arm

The first task is identifying what is repeatedly exceeding the tendon’s tolerance.

For example, a patient may temporarily need to reduce:

• heavy gripping
• repeated wrist extension
• racquet volume
• heavy pulling exercises
• repetitive tool use

The goal is not necessarily complete inactivity.

Instead, reduce provocative load enough to allow symptoms to settle while maintaining appropriate movement.

2. Progressive Wrist-Extensor Strengthening

This is where tennis-elbow rehabilitation becomes specific.

Clinical practice guidance supports resisted exercise for the wrist extensor muscles, which can include:

• isometric loading
• concentric strengthening
• eccentric strengthening

depending on the stage and irritability of the condition.

A rehabilitation programme should progressively build:

• tendon load tolerance
• wrist-extensor strength
• grip capacity
• muscular endurance
• functional control

The precise exercise dose should be individualized rather than copied blindly from an online exercise sheet.

3. Address the Activity That Created the Problem

Recovery is incomplete if symptoms settle, but the same overload immediately returns.

A tennis player may need to review:

• training volume
• technique
• racquet setup
• grip requirements
• return-to-play progression

A manual worker may instead need adjustments to:

• tool grip
• lifting method
• repetition frequency
• task rotation
• work-rest cycles

A gym user may need progressive modification of pulling and gripping volume.

4. Pain Relief When Appropriate

Short-term pain-relief measures may sometimes help a patient remain active enough to rehabilitate.

Medication suitability depends on individual health, other medications, and contraindications, so medication choices should be discussed with an appropriate healthcare professional.

5. Brace or Counterforce Strap

A forearm strap or brace can reduce symptoms in some patients during particular tasks.

It should be viewed as an adjunct, not the treatment itself.

The long-term objective remains restoring the tendon’s capacity.

What Is the Right Treatment for Golfer’s Elbow?

Golfer’s elbow uses the same broad principle—control excessive load and progressively rebuild capacity—but the rehabilitation target changes.

1. Reduce Provocative Flexor-Pronator Loading

Temporarily modify movements that provoke medial elbow pain, such as:

• forceful gripping
• repetitive wrist flexion
• heavy curls
• throwing
• repetitive golf practice
• painful forearm rotation

Again, complete immobilization is rarely the long-term answer.

2. Strengthen the Flexor-Pronator System

Rather than focusing primarily on wrist extensors, golfer’s-elbow rehabilitation targets the muscles responsible for:

• wrist flexion
• gripping
• forearm pronation

Progressive loading may include controlled isometric, concentric, or eccentric exercises depending on symptoms and rehabilitation stage.

3. Check the Ulnar Nerve

This is one of the major differences from routine tennis-elbow management.

If medial elbow pain includes:

• tingling
• numbness
• altered sensation
• hand weakness

the ulnar nerve should be assessed.

Exercises intended for a tendon problem will not correct significant nerve compression.

4. Review Sport or Work Technique

For golfers, treatment may need to address:

• excessive practice volume
• repeated ground impact
• gripping force
• swing mechanics
• abrupt increases in play

Throwing athletes may require analysis of throwing volume and mechanics.

Manual workers may require a different ergonomic solution.

Tennis Elbow vs. Golfer’s Elbow Exercises: Why They Should Not Be Identical

It is common to see both conditions given the same generic forearm exercise programme.

That misses the key anatomical difference.

Tennis elbow

The rehabilitation emphasis is usually on the wrist-extensor tendon system.

Golfer’s elbow

The rehabilitation emphasis is usually on the wrist flexor-pronator system.

Both programmes may also address:

• grip strength
• shoulder and scapular control
• overall upper-limb capacity
• endurance
• movement technique

particularly in athletes and patients performing high-demand work.

The 2022 clinical practice guideline for lateral elbow tendinopathy recommends resisted isometric, concentric and/or eccentric wrist-extensor exercises for subacute or chronic lateral elbow tendinopathy.

A good rehabilitation programme therefore asks:

What exact load does this patient's tendon need to tolerate again?

—not merely—

Which standard elbow exercises can we give everyone?

Should You Completely Rest Tennis or Golfer’s Elbow?

Usually, prolonged complete rest is not the objective.

Short-term reduction of aggravating activity may be helpful when pain is highly irritable.

But tendon rehabilitation ultimately requires appropriate loading.

Think of it as finding the difference between:

too much load → repeatedly aggravating the tendon

and

too little load → failing to rebuild its capacity.

The aim is to progressively move the patient toward the level of gripping, lifting, sport or work that they actually need.

Do Steroid Injections Cure Tennis Elbow?

This deserves a careful answer because rapid pain relief can be attractive.

Corticosteroid injections may provide short-term symptom relief, but current evidence does not demonstrate a reliable long-term advantage for tennis elbow, and recurrence/poorer intermediate outcomes have been reported.

Recent NHS clinical guidance similarly cautions that steroid injections provide limited long-term benefit and are no longer routinely favoured as the default treatment for elbow tendinopathy.

Therefore, the key question is not:

“Can an injection make the pain disappear this week?”

It is:

“Does this treatment improve the tendon problem and function over the period that matters to the patient?”

Injection decisions should be individualized rather than used routinely as the first response to persistent elbow pain.

What About Steroid Injections for Golfer’s Elbow?

The same caution applies.

Steroid injections are not a dependable long-term solution for medial epicondylitis.

When pain persists, it is usually more useful to reconsider:

• diagnosis
• tendon load
• rehabilitation quality
• occupational exposure
• sporting technique
• ulnar nerve involvement

than to repeatedly suppress the symptom without addressing the underlying loading problem.

Does PRP Work for Tennis Elbow?

Platelet-rich plasma, or PRP, is sometimes considered for persistent lateral elbow tendinopathy that has not improved sufficiently with appropriate conservative treatment.

This is an area where nuance is important.

Some studies have reported sustained improvement after PRP in selected patients with refractory tennis elbow, while broader systematic reviews and clinical guidance have found the overall evidence inconsistent.

So PRP should not be presented as a guaranteed cure or routine first-line treatment.

Does PRP Work for Golfer’s Elbow?

PRP has also been used for medial epicondylitis, but evidence is less definitive and protocols vary.

Questions remain regarding:

• patient selection
• PRP preparation
• injection technique
• number of injections
• timing
• rehabilitation after injection

It should therefore not be marketed as an automatic next step when exercises have not produced rapid improvement.

Persistent symptoms should first trigger a reassessment of the diagnosis and rehabilitation strategy.

Is Shockwave Therapy Useful?

Extracorporeal shockwave therapy is another non-surgical option sometimes considered for persistent tendinopathy.

Some patients improve, while evidence does not support describing it as universally effective.

It may be considered selectively after assessment, but it should complement—not replace—a structured loading programme when rehabilitation is appropriate.

When Is Surgery Considered for Tennis Elbow?

Surgery is unusual.

Most people with lateral elbow tendinopathy improve without an operation.

Surgical assessment is generally reserved for patients with:

• prolonged symptoms
• substantial functional limitation
• a confident diagnosis
• appropriate non-surgical treatment that has failed
• symptoms severe enough to justify operative risk

NHS guidance indicates that surgery may be considered when symptoms persist despite approximately 6–12 months of appropriate conservative management.

Before surgery, the diagnosis should be critically reviewed.

Operating on the tendon will not solve symptoms whose true source is radial nerve irritation, cervical referred pain or another condition.

When Is Surgery Considered for Golfer’s Elbow?

Surgery is similarly uncommon for uncomplicated medial epicondylitis.

It may be considered after persistent symptoms despite prolonged, appropriately performed non-operative treatment.

The situation becomes more complex if the patient also has significant ulnar nerve involvement.

In those cases, treatment planning may need to address both the tendon and nerve pathology.

Patients experiencing persistent elbow symptoms can review the clinic's broader orthopedic services in Pune for assessment and treatment options.

How Long Does Tennis Elbow Take to Recover?

Recovery is often slower than patients expect.

Tendon symptoms can fluctuate, and improvement usually occurs over weeks to months rather than days.

Some cases persist substantially longer.

Recovery time depends on:

• duration of symptoms
• occupational load
• sporting demand
• tendon irritability
• treatment adherence
• strength deficits
• whether the diagnosis is correct
• whether the aggravating load has been modified

A useful measure of progress is not simply pain at rest.

Better questions include:

• Can I grip more comfortably?
• Can I lift more weight?
• Can I work for longer before symptoms begin?
• Has grip strength improved?
• Can I tolerate progressively greater training load?

Functional progress is more meaningful than chasing a completely pain-free elbow from one day to the next.

How Long Does Golfer’s Elbow Take to Recover?

Medial elbow tendinopathy can follow a similarly gradual course.

The tendon needs time to adapt to progressive loading.

Patients with long-standing symptoms, substantial work exposure, or associated ulnar nerve irritation may require a more individualized recovery plan.

There is therefore no medically reliable promise that either condition will disappear in a specific number of days.

When Is Elbow Pain Probably Not Simple Tennis or Golfer’s Elbow?

Certain findings should prompt a more careful assessment.

Seek medical advice when elbow pain is associated with:

• a significant injury or fall
• visible deformity
• inability to move the elbow normally
• marked swelling
• a hot or red joint
• fever or feeling systemically unwell
• persistent numbness or tingling
• progressive hand weakness
• pain spreading from the neck
• unexplained persistent night pain
• symptoms that continue to worsen
• failure to improve despite an appropriate rehabilitation programme

These features can indicate a condition other than uncomplicated epicondylitis.

Do You Need an Orthopaedic Specialist for Tennis or Golfer’s Elbow?

Many straightforward cases improve with load modification and appropriate physiotherapy.

Specialist assessment becomes more useful when:

• the diagnosis is uncertain
• symptoms are severe
• symptoms persist despite appropriate treatment
• there is substantial weakness
• neurological symptoms are present
• the elbow was injured traumatically
• imaging needs to be considered
• injections or other procedures are being discussed
• surgery is being considered
• the patient needs to return to high-demand sport or work

The purpose of assessment should not be to escalate every patient toward a procedure.

It should be to determine why the tendon continues to hurt and what is preventing recovery.

Tennis Elbow and Golfer’s Elbow Treatment in Pune

Patients searching for treatment for persistent elbow pain in Pune should look beyond the label attached to the condition.

The important questions are:

• Is the pain genuinely tendon-related?
• Is it lateral or medial?
• Which movement is overloading the tendon?
• Is the diagnosis complicated by nerve symptoms?
• Is the current exercise programme loading the correct muscle group?
• Has the patient's sport or occupational load been addressed?
• Is imaging genuinely required?
• Has enough appropriate non-operative treatment been attempted before considering a procedure?

Dr. Ulhas Sonar holds an MCh in Upper Limb Surgery from Wrightington, UK, in addition to his orthopaedic qualifications, and his published research includes work specifically involving refractory lateral epicondylitis.

That background is especially relevant when elbow pain has persisted despite initial treatment or when distinguishing tendon pathology from another upper-limb problem is important.

Patients with ongoing elbow pain can explore orthopedic treatment services or book an orthopaedic consultation in Pune for an individualized assessment.

 

Tennis Elbow vs. Golfer’s Elbow: Why Getting the Side Right Is Only the Beginning

The difference between tennis elbow and golfer’s elbow is easy to summarize but important to apply correctly.

Tennis elbow affects the outer elbow and primarily involves the wrist-extensor tendon origin. Golfer’s elbow affects the inner elbow and involves the flexor-pronator tendon origin.

But that distinction is only the start of good treatment.

A patient with tennis elbow does not simply need “less arm use.” The wrist-extensor system needs its load reduced enough to settle symptoms and then progressively rebuilt to tolerate gripping, lifting, work, or racquet sport again.

A patient with golfer’s elbow requires the same underlying rehabilitation logic, but applied to the flexor-pronator system. If that patient also has tingling in the ring or little finger, treating the tendon alone may miss an associated ulnar nerve problem.

That is why persistent elbow pain should not become a cycle of rest, temporary pain relief, return to the same workload, and another flare.

The more useful treatment sequence is:

identify the correct structure → identify the load that exceeds its capacity → rule out important mimics → progressively rebuild that capacity → return to the patient's actual work or sport.

For most people, that process remains non-surgical.

For the smaller group whose symptoms persist despite well-structured rehabilitation, the next step should not automatically be an injection or operation. It should be diagnostic reassessment and a discussion of the evidence, expected benefit and limitations of each additional treatment option.

That distinction—between simply reducing pain and actually restoring durable upper-limb function—is what should guide treatment for both tennis elbow and golfer’s elbow.