Outer Elbow Pain When Gripping or Lifting? It Could Be Tennis Elbow
You pick up a coffee mug and notice a sharp pain on the outside of your elbow.
Maybe opening a jar has become uncomfortable. Carrying grocery bags hurts, or your elbow begins aching after working at a computer, using tools, or spending time at the gym.
At first, you might assume you have simply strained a muscle.
But when the discomfort keeps returning during gripping or lifting, one possible explanation is lateral elbow tendinopathy, commonly known as tennis elbow.
Despite its name, you do not need to play tennis to develop this condition.
Understanding why these movements hurt can help you decide when an assessment may be useful and what types of treatment have the strongest supporting evidence.
Why Does Outer Elbow Pain When Gripping Happen?
Outer elbow pain when gripping is a common symptom of tennis elbow, also known as lateral elbow tendinopathy. It can make everyday activities such as lifting, carrying groceries, and using tools uncomfortable.
Several muscles responsible for moving your wrist and fingers attach through tendons near the outside of your elbow.
These muscles are particularly active when you grip objects, stabilize your wrist, or lift something with your hand.
The tendon most commonly associated with tennis elbow is the extensor carpi radialis brevis (ECRB) tendon.
When the tendon and surrounding tissues become painful or less tolerant of repeated loading, everyday activities can become surprisingly uncomfortable.
You might notice pain when:
Lifting a kettle or coffee mug
Carrying grocery bags
Shaking someone’s hand
Opening jars or turning doorknobs
Using a screwdriver or other tools
Playing tennis, pickleball, or golf
Performing certain exercises at the gym
Working with a computer mouse for prolonged periods
Pain may remain localized near the outside of the elbow or extend into the upper forearm.
These symptoms are consistent with lateral elbow tendinopathy, but they do not confirm the diagnosis on their own.
Why Does Gripping Make Tennis Elbow Worse?
Gripping requires more than your fingers.
Your wrist-extensor muscles help stabilize the wrist so that your hand can generate force efficiently.
When you lift a heavy object or squeeze something firmly, these muscles and their tendons must tolerate additional load.
If the tissues are already sensitive, gripping can reproduce pain near the outside of the elbow.
This explains why someone with tennis elbow may experience relatively little discomfort while resting but significant pain when lifting even a moderately heavy object.
Interestingly, the problem is not necessarily the weight itself.
The position of your wrist, how firmly you grip, how frequently you repeat the movement, and your current tolerance for that activity may all influence symptoms.
What Causes Tennis Elbow?
Tennis elbow is often associated with repetitive or increased loading of the wrist-extensor tendons.
However, the condition is not always caused by one specific activity.
Some people develop symptoms after suddenly increasing their exercise intensity. Others notice gradual discomfort after months of repetitive work.
Common contributing situations include prolonged tool use, repetitive gripping, racquet sports, weight training, and returning to demanding activities after a period of reduced activity.
Importantly, lateral elbow tendinopathy is not simply a matter of having a weak muscle or poor technique.
Research suggests that tendon changes, muscle function, loading demands, and pain-processing mechanisms can all contribute to symptoms.
That is why identifying one supposedly incorrect movement does not necessarily explain the entire problem.
Can Tennis Elbow Go Away Without Treatment?
Yes. Many people experience improvement over time, even without intensive treatment.
However, recovery can be slow, and symptoms sometimes persist or return.
Some people find that discomfort gradually interferes with work, exercise, or normal household activities.
The 2023 British Elbow and Shoulder Society (BESS) clinical pathway recommends offering physiotherapy to patients with lateral elbow tendinopathy, while acknowledging that evidence for long-term treatment superiority remains limited.
An assessment may therefore be useful when pain repeatedly limits activities, particularly if symptoms are not improving as expected.
What Does Research Say About Exercise?
Exercise-based rehabilitation is commonly recommended for lateral elbow tendinopathy.
Programs may focus on progressively improving the capacity of the wrist-extensor muscles, grip strength, and the arm’s tolerance for loading.
However, the evidence is more nuanced than simply saying that strengthening exercises cure tennis elbow.
A 2024 Cochrane systematic review examined 23 trials involving 1,612 participants.
The researchers found low-certainty evidence that manual therapy, prescribed exercise, or both may produce small improvements in pain and disability compared with minimal intervention.
These improvements were generally modest and were not clearly sustained over longer follow-up periods.
What does this mean for patients?
Exercise can be a reasonable part of conservative management, but no single program has been established as a guaranteed solution.
The type and progression of exercise should reflect the person’s symptoms, functional limitations, and activity demands.
Should You Stop Using Your Arm?
Not necessarily.
Avoiding every painful activity may temporarily reduce discomfort, but it does not automatically improve your arm’s ability to tolerate those activities again.
On the other hand, repeatedly forcing your way through significant pain may aggravate symptoms.
The appropriate approach often involves modifying activities while gradually rebuilding tolerance.
For example, someone working with tools may need a different strategy from someone whose symptoms began after increasing their gym training.
The objective is not necessarily complete rest.
It is finding a manageable balance between activity and recovery.
Where Can Osteopathic Care Fit?
At OsteopathyNearMe, assessment of elbow pain involves more than examining the painful tendon.
Depending on your symptoms, we may evaluate:
Elbow and wrist movement
Forearm muscle tenderness and tension
Grip-related discomfort
Wrist and forearm loading tolerance
Relevant shoulder and upper-limb movement
Activities that reproduce symptoms
Recent changes in work, exercise, or recreational activity
When appropriate, osteopathic treatment may include soft-tissue techniques, gentle joint mobilization, and muscle-energy techniques to address relevant musculoskeletal restrictions.
The aim is to help manage discomfort and support comfortable movement.
Manual treatment may also be combined with guidance about activity modification and the need for progressive rehabilitation.
What About Cortisone Injections?
Corticosteroid injections have historically been used for tennis elbow because they may reduce pain relatively quickly.
However, short-term symptom relief does not necessarily translate into better long-term outcomes.
The 2023 BESS clinical pathway makes a strong recommendation against corticosteroid injections for lateral elbow tendinopathy, citing evidence of poorer outcomes at later follow-up despite possible early pain relief.
A newer systematic review published on March 27, 2026, analyzed 27 randomized trials and found that corticosteroid injections were among the treatments showing short-term pain benefits.
However, no intervention demonstrated a statistically significant advantage over placebo in the review’s long-term analysis.
The authors emphasized that treatment rankings should be interpreted cautiously because of differences in study quality, follow-up periods, and available comparisons.
These findings reinforce the importance of considering both immediate symptom relief and longer-term function when discussing treatment options with a physician.
Does Shockwave Therapy Help Tennis Elbow?
Shockwave therapy is sometimes promoted for persistent tendon pain.
However, the evidence does not establish that it is necessary or consistently effective for tennis elbow.
The 2023 BESS guideline recommends against routinely using extracorporeal shockwave therapy for lateral elbow tendinopathy.
The March 2026 network meta-analysis found some intermediate-term pain benefits compared with placebo, but did not establish long-term superiority.
These findings are not necessarily contradictory: a treatment may show a short-term benefit without providing a reliable long-term advantage.
For patients, the practical message is that shockwave should not automatically be considered an essential treatment for tennis elbow.
Is Every Outer Elbow Pain Tennis Elbow?
No.
Although tennis elbow is a common cause of pain on the outside of the elbow, other conditions can produce similar symptoms.
These may include nerve-related pain, referred pain from the cervical spine, joint-related problems, or injuries involving other structures around the elbow.
For example, persistent numbness, tingling, or pain extending significantly into the hand may suggest that something other than isolated tendon pain needs to be considered.
This is one reason assessment should focus on the entire presentation rather than assuming that all outer elbow pain has the same cause.
When Should You Seek an Assessment?
Consider seeking professional assessment if your elbow pain:
Continues for several weeks without meaningful improvement
Repeatedly returns when gripping or lifting
Interferes with work or household activities
Prevents you from exercising comfortably
Is associated with noticeable weakness
Is progressively becoming more limiting
Seek prompt medical assessment if pain follows significant trauma or is accompanied by substantial swelling, deformity, fever, marked redness, or sudden loss of function.
New or progressive neurological symptoms also warrant appropriate medical evaluation.
Getting Back to Comfortable Everyday Movement
Tennis elbow can be frustrating because the movements that aggravate it are often difficult to avoid.
You still need to work, carry groceries, cook, exercise, and use your hands throughout the day.
Fortunately, many people improve with conservative management.
Current evidence supports considering appropriate rehabilitation and activity modification, while recognizing that the effects of individual treatments can vary and long-term outcomes remain difficult to predict.
At OsteopathyNearMe Health Studio in Etobicoke, we provide individualized osteopathic assessment for elbow and other musculoskeletal complaints.
Our approach considers your symptoms, movement, daily activities, and the demands placed on your arm.
When appropriate, gentle manual techniques may be used to help manage discomfort and improve movement. If your presentation requires additional rehabilitation or medical assessment, we can recommend appropriate next steps.
If elbow pain is making gripping, lifting, working, or exercising uncomfortable, book an osteopathic assessment at OsteopathyNearMe in Etobicoke.
Frequently Asked Questions
Why does my elbow hurt when I lift a coffee mug?
Lifting a mug requires your wrist-extensor muscles to stabilize the wrist while gripping. If the tendons near the outside of the elbow are sensitive, this movement may reproduce pain. Tennis elbow is one possible explanation, although other conditions can cause similar symptoms.
Can you get tennis elbow without playing tennis?
Yes. Tennis elbow frequently affects people who do not play racquet sports. Repetitive gripping, tool use, lifting, and changes in physical activity can all be associated with lateral elbow tendinopathy.
Is tennis elbow caused by a pinched nerve?
Not usually. Tennis elbow primarily involves pain associated with the common wrist-extensor tendon region. However, nerve-related conditions can sometimes resemble tennis elbow and should be considered when symptoms include numbness, tingling, or unusual pain patterns.
Should I stretch or strengthen my arm if I have tennis elbow?
Exercise is commonly included in conservative management, but the most appropriate approach depends on your symptoms and current tolerance. Research does not establish one universally superior exercise program for everyone with lateral elbow tendinopathy.
Does massage help tennis elbow?
Soft-tissue techniques may provide temporary symptom relief for some patients. However, evidence supporting lasting improvements from manual therapy alone is limited. A 2024 Cochrane review found that benefits from manual therapy and exercise were generally small and not clearly sustained.
Do I need an MRI for tennis elbow?
Usually not for a typical presentation. Diagnosis is generally based on the history and physical examination. Imaging may be appropriate when the diagnosis is uncertain, another condition is suspected, or symptoms do not progress as expected.
Can an osteopath help with tennis elbow?
An osteopath can assess elbow movement, muscular tension, and relevant upper-limb restrictions. Gentle manual treatment may help manage discomfort in selected patients, although the evidence does not establish osteopathy as a stand-alone cure for lateral elbow tendinopathy.
How long does tennis elbow take to heal?
Recovery varies. Some people improve within weeks or months, while others experience symptoms for considerably longer. The duration of symptoms, activity demands, and individual response to management all influence recovery.
References
1. Clinical practice guideline
Singh HP, Watts AC, on behalf of the BESS LET Guideline Development Group. BESS patient care pathway: Tennis elbow. Shoulder & Elbow. 2023;15(4):348–359.
DOI: 10.1177/17585732231170793
PMID: 37538521
2. Cochrane systematic review
Wallis JA, Bourne AM, Jessup RL, Johnston RV, Frydman A, Cyril S, Buchbinder R. Manual therapy and exercise for lateral elbow pain. Cochrane Database of Systematic Reviews. 2024;5:CD013042.
DOI: 10.1002/14651858.CD013042.pub2
PMID: 38802121
3. Recent systematic review and network meta-analysis
Ouyang C, You Q, Yang C, Yu D. Time-dependent comparative efficacy of non-surgical treatments for pain relief in lateral epicondylitis: a systematic review and network meta-analysis. Frontiers in Physiology. 2026;17:1782562.
Published: March 27, 2026
DOI: 10.3389/fphys.2026.1782562
PMID: 41971661
Comments