Forearm Pain From Using a Mouse? It Could Be Tennis Elbow
When you hear the words “tennis elbow,” you might naturally assume it is something that happens to tennis players.
Despite its name, however, tennis players account for only around 10% of people affected by tennis elbow.
So what are the rest of them doing? Often, it is ordinary everyday activity.
Repetitive tasks such as using a computer mouse, typing, gripping tools, using scissors or repeatedly working with your hands can all place load on the muscles and tendons around the outside of the elbow.
And sometimes, the discomfort is felt more in the forearm than the elbow itself, which means tennis elbow may not immediately come to mind.
What is tennis elbow?
Tennis elbow is commonly known medically as lateral elbow tendinopathy or lateral epicondylitis. It affects the tendons attaching the muscles on the back of the forearm to the outside of the elbow, particularly around the common extensor tendon.
These muscles help to extend the wrist and fingers and are involved in many everyday activities involving gripping, lifting and using the hands.
Although the condition has traditionally been called “epicondylitis”, suggesting inflammation, current understanding is that persistent tennis elbow is better considered a tendon overload and degenerative process rather than simply inflammation.
That is why the term lateral elbow tendinopathy is increasingly used.
What does tennis elbow feel like?
The classic symptom is pain or tenderness around the outside of the elbow, but the discomfort can also travel into the forearm.
You might notice symptoms when:
using a computer mouse for prolonged periods
typing or performing repetitive hand movements
gripping or carrying something
lifting a kettle, mug or shopping bag
opening a jar or turning a door handle
extending your wrist against resistance
Sometimes the forearm may simply feel tight, tired, achy or uncomfortable, particularly towards the end of a working day.
This is one reason people may not immediately associate their symptoms with the elbow.
Why can using a mouse irritate the elbow?
Using a mouse does not involve particularly large or forceful movements. However, the muscles controlling the wrist and fingers can be working repeatedly and at a low level for long periods, particularly if you spend much of the day at a computer.
Typing, clicking, gripping the mouse and maintaining the wrist in a relatively static position can all contribute to the overall amount of work being asked of the forearm.
Importantly, it is not necessarily that using a mouse is “bad”.
It is often more useful to think about the balance between load and recovery.
Someone may have used a computer for years without difficulty and then develop symptoms during a period of:
longer working hours
increased typing or mouse use
a change in workstation or equipment
increased sport or exercise
additional DIY or gardening
other repetitive hand-based activities
reduced recovery time
The NHS includes computer work, including typing and using a mouse, amongst activities that can contribute to tennis elbow.
Forearm sensations can be difficult to describe
This is something I can relate to personally.
Years ago, I dislocated my shoulder and temporarily lost motor control in all of my fingers. Later, when I developed unusual sensations in my forearm, I assumed I was experiencing residual pins and needles and tingling from the previous injury.
At the time, however, I was also spending much of my working day typing and using a computer mouse. Looking back now, I realise that at least some of those symptoms may have been related to loading of the forearm muscles and tendons rather than necessarily being neurological.
It is a useful reminder that sensation is very subjective. One person may describe a symptom as tingling, while another may call it aching, burning, tightness or pins and needles.
That is why the words used to describe a symptom are only one part of the assessment. Where the symptoms are felt, what brings them on, and what happens when the muscles, tendons and nerves are tested are equally important.
How can osteopathy help?
During an osteopathic assessment, I would usually look at the elbow, wrist and forearm and assess which movements or loads reproduce your symptoms.
Depending on your presentation, I may also assess your shoulder, neck and upper back, particularly if symptoms travel down the arm or there are symptoms such as tingling or numbness.
Treatment will depend on the findings and may include manual therapy where appropriate, alongside advice about activity and rehabilitation exercises.
For tendon-related problems, gradually rebuilding the tendon’s ability to tolerate load is an important part of rehabilitation.
Current clinical guidance supports the use of resisted exercise for the wrist extensor muscles, with the load gradually progressed according to the individual's symptoms and ability.
Research also suggests that strengthening can help reduce pain and improve function, although there is no single exercise programme that is right for everybody.
The aim is therefore not necessarily to completely rest the arm, but to find an appropriate level of activity and then gradually increase what the tendon can tolerate.
If your elbow or forearm symptoms keep returning, are affecting your work or everyday activities, or you are unsure what is causing them, it may be worth having them assessed.
Experiencing forearm or elbow pain?
At Balance and Restore Osteopathy in Mortimer Common, I assess the elbow as part of the whole upper limb, including the wrist, shoulder and neck where appropriate, to help understand what may be contributing to your symptoms.
References
Lucado AM, Day JM, Vincent JI, MacDermid JC, Fedorczyk J, Grewal R, Martin RL. Lateral Elbow Pain and Muscle Function Impairments: Clinical Practice Guidelines. Journal of Orthopaedic & Sports Physical Therapy.2022;52(12):CPG1–CPG111.https://doi.org/10.2519/jospt.2022.0302 PubMed
Kinney WR, Anderson BR. Nonoperative Management of Lateral Epicondyle Tendinopathy: An Umbrella Review. Journal of Chiropractic Medicine. 2023;22(3):204–211.https://doi.org/10.1016/j.jcm.2023.04.004 PubMed
Lowdon H, Chong HH, Dhingra M, et al. Comparison of Interventions for Lateral Elbow Tendinopathy: A Systematic Review and Network Meta-Analysis for Patient-Rated Tennis Elbow Evaluation Pain Outcome. Journal of Hand Surgery American Volume. 2024;49(7):639–648.https://doi.org/10.1016/j.jhsa.2024.03.007 PubMed
NHS. Tennis elbow.
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