What we are talking about
Lateral epicondylitis is a problem of the tendons attaching on the outer side of the elbow, the ones that extend the wrist and fingers. Medial epicondylitis is the same thing on the inner side. Despite the sporting names, they come far more often from manual work, from hours on a mouse and keyboard, or from a sudden increase in activity with the hands.
The structure of the problem is that of a tendinopathy: the tendon received more load than it could take. That is why the same rules apply — rest relieves but does not repair, and the part that changes things is well-dosed progressive loading.
Then there is the ulnar nerve, the one behind the «funny bone» tingling: when it stays irritated in its tunnel it gives tingling in the little and ring fingers. It is a different picture and needs to be recognised, because the programme changes.
When it makes sense to get seen
The most frequent reasons:
- Pain on the outer side of the elbow when you grip or lift something
- Pain picking up a coffee cup or turning a door handle
- Pain on the inner side after manual work or weight training
- Tingling in the little and ring fingers, especially with the elbow bent
- It has lasted months and every time you start again it goes back to square one
- You have tried a brace and anti-inflammatories without lasting change
What can be done remotely, and what cannot
The elbow is very convenient to assess on a video call: it shows well, and almost everything runs through what you do and the load.
What can be done remotely
- Reconstructing what changed in the weeks before it appeared
- Distinguishing a tendinopathy from a nerve problem, which are treated differently
- Setting the progressive loading programme, the treatment with most evidence
- Watching you perform the exercises and correcting execution
- Adapting work movements, tools and grips that light your symptom up
What cannot
- Manual therapy and soft-tissue work
- Shockwave, tecar and instrument-based therapies
- Injections and nerve conduction studies
If the tingling is constant or you feel the hand losing strength, you need a medical assessment: nerves do not wait.
Frequently asked questions
How long does tennis elbow take to settle?
Months, like every tendinopathy. It is an inconvenient fact but better known up front: people expecting two weeks abandon the programme right when it would start working.
Does a brace help?
It can reduce pain during activities and is useful as temporary support. On its own it does not resolve it, because it does not do what the tendon needs, which is to be loaded progressively.
Do I have to stop working or training?
Almost never completely. You reduce and modify the movements that light the symptom up, keeping the rest. Complete inactivity weakens the tendon and makes the return harder.
Do cortisone injections work?
They give quick relief, but months later the studies show worse outcomes than exercise. It is a medical decision: if you have one, it makes sense to pair it with loading work, not to use it instead.
