Elbow & Arm CareGonstead Method

Chiropractic Care for Tennis Elbow

That burning pain on the outside of your elbow is a repetitive strain problem that can build if it is ignored, so we assess the neck, shoulder, elbow and wrist together.

Understanding the Condition

What Is Tennis Elbow?

Tennis elbow (lateral epicondylitis) is irritation and gradual breakdown of the tendons that attach the forearm's extensor muscles to the bony point on the outside of the elbow, the lateral epicondyle. Despite the name, most people with it have never played tennis: repeated wrist and finger extension in typing, mouse use, gripping tools and lifting palm-down is the usual driver. It typically starts as an outer-elbow ache after activity, then hurts when gripping, lifting a kettle or shaking hands. Because the forearm's nerves come from the lower neck, a Gonstead chiropractor at Bewell's Novena clinic, opening soon, checks the neck, shoulder, elbow and wrist by hand, segment by segment, and adjusts by hand only where a joint is not moving well. If your elbow is hot and swollen, will not straighten, or the pain began with a fall or a sudden pop, see a registered doctor for diagnosis first.

About this page

Before you book

Prepared by the Bewell Chiropractic team.

Care at Bewell Chiropractic Novena is led by DC Michiko Liew, founder and principal chiropractor and Ambassador of the Gonstead Chiropractic Society Australia, with DC Lim C. Y. Both hold Doctor of Chiropractic qualifications and are not registered medical practitioners in Singapore.

This page is educational and not a diagnosis. Seek urgent medical care for severe weakness, loss of bladder or bowel control, fever, or trauma.

Root Causes

What Causes Tennis Elbow?

Tennis elbow is fundamentally a repetitive overload injury. The tendons attaching the wrist extensors to the lateral epicondyle are subjected to micro-tears faster than the tissue can repair itself. Several loading patterns accelerate this breakdown.

Desk Work & Mouse Use

Sustained wrist extension while mousing or typing places constant low-grade load on the extensor tendons — the leading cause in office workers.

Tool & Equipment Use

Screwdrivers, wrenches, and power tools transmit vibration and torque directly into the lateral epicondyle attachment point, causing cumulative micro-damage.

Racquet Sports Technique

Poor backhand mechanics or an oversized grip create excessive eccentric load on the extensor tendons — the original source of the condition's name.

Lifting & Gripping

Repeated lifting with palm facing down (pronated grip) — carrying bags, moving boxes, gym exercises — overloads the extensor musculature at its elbow attachment.

Cervical Nerve Involvement

Irritation around the C5–C6 nerve roots in the lower neck can add to pain along the outer forearm, which is why the neck is part of the assessment.

Sudden Load Increase

A sharp spike in activity volume — a new sport, a heavy renovation project, or returning to work after leave — overwhelms tendon adaptation capacity rapidly.

Progression

How Tennis Elbow Progresses

Tennis elbow tends to follow a recognisable pattern. What begins as soreness after activity can build into constant pain and grip weakness if the load on the tendon keeps outpacing its repair.

Stage 1Mild

Reactive Tendinopathy

A short-term, non-inflammatory response to a sudden increase in load. The outer elbow aches after activity and settles with rest. The tissue is irritated but structurally intact.

Stage 2Moderate

Tendon Dysrepair

Attempted but incomplete repair. Disorganised collagen and increased cell activity produce a thickened, lumpy tendon. Pain begins during activity and lingers for hours afterwards, and grip strength starts to decline.

Stage 3Severe

Degenerative Tendinopathy

Longer-standing structural change: parts of the tendon now have a poor blood supply and fewer healthy cells. Pain comes with light daily tasks such as lifting a kettle, opening a door or shaking hands, and settling at this stage usually takes longer.

Stage 4Critical

Partial or Full Rupture

Accumulated damage causes the tendon to partially or fully tear, with a sudden pop, immediate weakness and difficulty extending the wrist against resistance. See a doctor promptly for assessment.

Outer elbow pain that keeps returning is worth having assessed early.

The longer a tendon stays overloaded, the more its structure can change. Looking early at how your neck, shoulder, elbow and wrist share the load gives you a clearer picture sooner.

Recognition

Do You Experience These Symptoms?

Tennis elbow symptoms are often dismissed as minor until a weakening grip starts affecting daily tasks. If outer elbow pain lasts beyond two weeks or keeps returning, it is worth having it assessed.

Outer elbow pain

Tenderness and burning directly over the lateral epicondyle, especially on touch

Weak grip strength

Difficulty holding cups, tools, or shaking hands without elbow pain flaring

Pain lifting objects

Aching when lifting with a palm-down grip — lifting a plate or bag from a table

Pain with wrist extension

Discomfort when bending the wrist backwards against resistance or repetitively

Morning stiffness

Elbow tightness and dull ache on waking that eases slowly after movement

Visit Us

Where to find us in Singapore

Bewell offers precise, hands-only Gonstead chiropractic care at Novena Regency on Thomson Road, opening soon.

Bewell Chiropractic Novena

275 Thomson Road #01-19
Novena Regency
Singapore 307645

+65 8859 7326 Get directions

Book ahead

Opening soon in Novena

Bewell's Gonstead clinic opens soon at Novena Regency, 275 Thomson Road. WhatsApp or call +65 8859 7326 to enquire or book ahead.

WhatsApp us Find us

Bewell Chiropractic Novena · 275 Thomson Road #01-19, Novena Regency · near Novena MRT (NS20)

Frequently Asked

Common questions

Tennis elbow can come from repeated gripping, lifting, typing or wrist movements. It is not only caused by playing tennis.

It can be. Elbow pain is sometimes affected by how the shoulder moves or by irritation of nerves from the lower neck. In Gonstead care, we check the spine and the whole arm together instead of only looking at the elbow.

It varies with how long the problem has been there and whether the same strain is still repeated every day. Tendons adapt slowly, so recent, mild irritation usually settles sooner than a problem that has been building for months. We cannot predict a timeline before assessing you.

We assess the neck, shoulder, elbow and wrist by hand, looking for segments that are tender or not moving well, and adjust by hand only where it is appropriate. We also look at the daily tasks loading your elbow. If your symptoms suggest something else, such as a trapped nerve or a tendon tear, we will advise you to see a doctor.

Bewell Chiropractic is opening soon at 275 Thomson Road #01-19, Novena Regency, Singapore 307645, near Novena MRT station (NS20). Call +65 8859 7326 to enquire.

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