How to Sleep Better With Tennis Elbow (8 Ways)

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Article written and researched by Dr. Albert Stezin (MBBS, Ph.D – clinician and neuroscientist) to ensure maximum factual accuracy and unique content.

Tennis elbow (lateral epicondylitis) is a condition where the tendons around the elbow become inflamed and painful due to overuse which can affect anyone that engages in repetitive actions (not just tennis players).

I have personally experienced tennis elbow on several occasions through boxing and weightlifting – so I know just how difficult it can be to get to sleep during a flare-up.

So how do you get better sleep when you have tennis elbow?

The most effective ways to sleep better with tennis elbow include: sleeping on your back with your arms by your side; sleeping on a memory foam topped hybrid mattress; wearing the correct elbow brace; managing pain effectively; and using herbal teas instead of pain medications.

The rest of this article expands upon these points in more detail to give you 8 actionable ways to sleep more comfortably when you have tennis elbow.

However, although this article was written by a qualified and practicing medical doctor, you should always talk to your own doctor first to get the best advice for your needs.

Need a new mattress for tennis elbow pain relief? I personally recommend the Puffy Lux Hybrid mattress if you have tennis elbow because the memory foam takes away the pressure on your joints, muscles, tendons, and ligaments for more comfort (click here to read my personal review and save $300 now).

8 Ways to Sleep Better With Tennis Elbow

Here are the 8 best ways to sleep better when you have tennis elbow:

1: Sleep On Your Back to Alleviate Pressure

The best sleeping position for most people with tennis elbow is sleeping on their back with the arms kept in their natural straight position by your side because this supine position prevents excess pressure on the elbow and allows for a more natural alignment of the joint for better comfort.

The worst sleeping position for those with tennis elbow is sleeping on the side of the affected arm; with the arm overhead; or on your front with the arm tucked under the pillow because this puts the most amount of pressure on your elbow joint.

A Brace or Pillow Can Help to Keep the Elbow in a Good Position at Night

Specialist doctors also recommend restraining the upper arm to be beneficial in sleeping more comfortably with tennis elbow.  

This can be achieved by using braces. 

A brace is worn on the forearm below the elbow to support the forearm muscles and prevent their contraction during sleep. 

You can also prop up and support the affected arm on a soft pillow.

Not only will this position relieve the tension in the upper arm muscles, but it will also keep your forearm in an untwisted position while you sleep.

A Cloth Belt Made Out of a Bath Towel Can Aid With Stability

A recent study published in the Journal of the American Academy of Orthopaedic Surgeons recommends the use of a makeshift cloth belt made out of a bath towel to be of significant benefit if worn during sleep.  

A bath towel is twisted into an asymmetric figure-of-eight shape.

The smaller and larger loops tether the wrist and thigh of the affected side, respectively. 

Additional knots can be put in between the loops to shorten the length of the tether. 

Sleep In a Nightshirt if Both Elbows Are Affected

If the elbow joints of both sides are affected, you should sleep with both arms inside of a long nightshirt without placing arms inside the sleeves. 

This limits the arm movement and will give your elbow a fighting chance to recover, especially over the long haul.

2: Sleep On a Memory Foam Hybrid Mattress for More Comfort

The best type of mattress to sleep on if you have tennis elbow is a hybrid mattress topped with adaptive memory foam with a pocket coil support core that provides excellent postural support and pressure relief to keep your arm in a good position and alleviate the pressure on your elbow.

I personally recommend the Puffy Lux Hybrid mattress (click here to read my personal review and save $300) if you have tennis elbow because the highly adaptive memory foam allows my elbows to sink more into the mattress materials for better pressure relief.

Orthopedic Mattresses Maintain Good Posture

Orthopedic mattresses are designed to support either your entire body with uniform support or to provide focused support to specific areas as required.

These beds help to maintain a neutral position for the affected muscles and bones to rest and recover. 

They are usually medium-firm, firm, or ultra-firm.

Since they are part of your treatment, they are usually prescribed by a doctor or a physical therapist.

You should opt for orthopedic mattresses made of memory foam, innerspring, latex, or bonded foam.

Memory Foam Provides Exceptional Pressure Relief for Tennis Elbow

Mattresses made out of high-quality memory foam are excellent if you have tennis elbow due to the pressure relief they provide that can significantly reduce the discomfort that you feel when the sensitive joint comes into contact with the surface of the mattress.

If the memory foam is dense enough, it can provide a medium-firm consistency that also allows you to remain in good posture whilst providing good pressure relief (the DreamCloud hybrid memory foam mattress does this very well).

You should look for memory foam mattresses that are at least 10 inches thick with at least 2-3 inches of memory foam in the upper comfort layers.

Choose Hybrid Over Traditional Spring Mattresses for Tennis Elbow

Innerspring mattresses are made of a series of spring systems and are commonly used in orthopedic mattresses.   

However, the newer hybrid models are better since the individually wrapped pocket coils adapt more precisely to the shape of your body than the fixed springs of a traditional spring mattress.

Furthermore, present hybrid models also offer better pressure relief via a latex or memory foam comfort layer when compared to the upholstered top layer of a traditional spring mattress.

Hybrid mattresses typically last for at least 6-8 years which is longer than regular spring mattresses on average, so you’ll get more for your money over the long run.

Latex Foam Provides Responsive Pressure Relief

Latex foam in the top layer of a mattress can provide responsive pressure relief that can help to alleviate the pain of tennis elbow whilst providing enough push back so that you can move around in the mattress without getting bogged down in the materials.

Latex foam topped mattresses are also very breathable and cooling – especially when layered over the pocket coils of a hybrid mattress – making them ideal if you’re a warmer sleeper.

The only downside is that latex foam mattresses are some of the most expensive mattresses that you can buy, but they do have the longest expected lifespan in excess of 8-10 years.

3: Sleep in the Right Elbow Brace (Sleeve, Strap, or Clasp)

The three common types of tennis elbow braces are sleeve elbow brace, strap elbow brace, and epicondylitis clasp.

Clasp braces are the best types of braces for sleeping in with tennis elbow because they provide targeted compression for the best support and pain relief.

Your doctor may recommend that you use a brace for your tennis elbow for only a few weeks if the condition is mild, but this may be extended to 6-12 months in more severe cases.

Sleeve Braces Are Lightweight But Provide the Worst Support

The sleeve elbow brace is lightweight and can be slipped on easily.

They can also be worn below your clothes without looking overly bulky.

Despite the perceived advantages, sleeve elbow braces do not provide the best support and should be used only if other braces are not available.

Strap Elbow Braces Provide Better Stability

The strap elbow braces provide more stability to the elbow than sleeve elbow braces.

They are secured in place with the help of one or two Velcro straps and are easily adjustable.

This ensures that they fit in snugly.  

However, do not tighten the straps too much – this cuts off the blood supply and causes more damage.

Clasp Braces Provide the Best Targeted Compression for Tennis Elbow

Epicondylitis clasps are braces that provide targeted compression to the tendons of the forearm muscles.

They hold the tendons in parallel and allows healing of the affected tendons.

The compression is only so much that it relieves the inflammation without restricting the circulation.

This allows functionality without being too restrictive.

4: Get Physical Therapy to Speed Up Recovery

The faster you heal, the earlier you can get back to your normal life.  

Physical therapy plays an important role in how quickly you recover and is universally recommended for tennis elbow. 

It works by improving the blood flow to the tendons and speeds up healing.  

A trainer can assess and design a series of exercises specific to your needs.

Do not overwork your elbow. 

If any of these exercises seem to be putting too much strain on your elbow, skip them. 

These exercises, if performed properly, can strengthen your muscles and tendons with minimal effect on tennis elbow. 

They can also be prophylactically performed to prevent tennis elbow.

Here are few exercises you can do at home:

i) Wrist Turn

Start with the affected elbow bend at a right angle with the forearm and palm facing up.

Twist your wrist around gradually until your palm is facing down.

Hold this position for 3-5 seconds and repeat.

Do 10 repetitions. 

If the pain is severe, stop at the point of fatigue. 

A modification of this exercise is to use weighted wrist turns using a dumbbell.

ii) Wrist Lift

Grip a light dumbbell with elbow bend at right angle and forearm extended outwards with palm facing upwards.  

Bend the wrist up towards your body, hold for 5 seconds, and then release.

Do 10 repetitions or stop earlier if fatigue or pain sets in.

iii) Elbow Flex

Stand up straight with arms on the side.

Slowly bend the elbow until the hand touches the shoulder and hold a position for up to 30 seconds.

Repeat this 10 times.

iv) Passive Wrist Extensor Stretch and Flex

Stretch your affected arm straight out in front of the body.

With your palm facing downwards, bend the wrist down.

With your other hand, gently pull the hand back towards your body.

Hold this position for 30 seconds or until pain or fatigue sets in.  

Finally, straighten out the wrist.

With palm facing upwards, bend the wrist up.

With your other hand, gently pull the hand back towards your body.

Hold the position for 30 seconds or till pain or fatigue.

Finally, straighten out the wrist.

Do each set three times alternatively or one after the other.

v) Make a Fist

Hold a softball in the palm of your hand.

Squeeze tightly and hold for 10 seconds.

Repeat 10 times.

vi) Friction Massage

Use your thumb or index finger to rub across the tendon with mild to moderate pressure.

Do this for 5 minutes daily.

Do this circuit once daily.

5: Manage Pain Using Several Techniques

Pain in tennis elbow can range in severity from mild to severe pain. 

Here are some strategies for managing the pain of tennis elbow effectively:

i) Apply Cold to Reduce Inflammation

It is well known that the application of cold to an injured site can decrease inflammation.

This usually works best immediately after the injury, at the beginning of inflammation.

Doctors recommend the application of cold immediately after pain is felt.

Apply an ice pack or a frozen packet of peas to your elbow (on the lateral epicondyle).

Do this for 5 to 10 minutes and repeat every 4-5 hours.

Ensure not to use freezing temperatures directly on your skin.

Instead, place them in a plastic bag and apply them over the skin. 

Do not exceed the application beyond 5-10 minutes each time.

You should also never ice your elbow before physical therapy or exercise.

ii) Apply Heat to Promote Healing

Heat can relieve pain and promote healing.

Application of heat promotes blood flow to the affected area and relaxes the muscles around your elbow.

This hastens the healing process.

Whereas heat should not be applied in the acute stage due to the possibility of worsening inflammation, heat can work wonders in the chronic stages of tennis elbow.

Apply heat using a hot water bag, heated sandbag, or gel pack.

Use it for 10-20 minutes and repeat every 6 hours.

Use heat before exercise or activity to loosen up your muscles.

iii) Doctor Prescribed Pain Medications

Use pain relievers such as ibuprofen and naproxen for pain relief.  

In addition to alleviating pain, they also reduce inflammation and shorten the disease duration.  

While these are over-the-counter medicines and can be obtained without a medical prescription, I still advise you to consult your general physician.

These medicines have side effects that may be severe in some individuals – such as interacting with certain food items and medications. 

They are best taken in the initial stage of tennis elbow and for a short duration (7-10 days).

Pain medicines are also available as ointments, creams, and gels.

These should be applied directly to the area of injury.

Since they are not ingested, topical preparations do not have any systemic side effects. 

Also, they can be used for a longer duration.

iv) Steroid Injections

Steroid injections are used to treat tennis elbow after other measures have failed. 

They are powerful anti-inflammatory agents and can help with pain and inflammation.

Steroids are available as injections to be directly injected into the painful area around the elbow.

They are to be infrequently used due to their side effects.

Use steroids for short-term relief rather than a long-term option. 

Ensure that you consult your general physician before opting for steroid injections.  

v) Ultrasound Therapy

This technique is relatively new in tennis elbow management.

Using ultrasound imaging, the damaged area is surveyed and all landmarks are identified.

Through a small incision made on the overlying skin, a high-frequency probe is pushed inside.

The probe generates ultrasonic vibrations which break down the damaged area with precision.

The debris is cleared away leaving only the intact tissue.

Over the next 4-6 weeks, the area will heal and provide relief from pain and inflammation.

vi) Surgery

For very severe symptoms not responding to conservative treatment, surgery should be attempted. 

Surgery is performed to remove the damaged tendon.

It also improves pain and helps you move your elbow more easily.

This surgery can be performed either through open surgery or arthroscopy.

In open surgery, the surgeon makes an incision on the side of the elbow.

The damaged piece of the tendon is removed and the healthy part is reattached to the bone.

In arthroscopic surgery, the entire procedure is performed through tiny cuts made in the skin over your elbow.

Using a camera and tiny instruments, the damaged parts of the tendon are identified and removed.

Arthroscopic surgeries are becoming more popular nowadays due to their less invasive nature.

6: Rest the Elbow to Deter Pain and Promote Healing

Tennis elbow is caused by the repetitive overuse of muscles attached to the lateral part of the elbow.

This causes microscopic tears, inflammation, and pain. 

Once the inflammatory process and pain begin, it may persist for months or years. 

During this period, you should rest your elbow and give sufficient time for your body to heal itself. 

Here are few strategies that can help:

i) Refrain from the Aggravating Movement

You should avoid the movement pattern that caused your tennis elbow.

If your condition is due to over-indulgence in racquet sports, opt-out and abstain from all racquet sports that puts stress on your elbow. 

Being a recurrent condition, you should ideally think of permanently hanging up your racquet. 

However, this may not be possible especially if you are a professional player. 

In such cases, give complete rest to your elbow at least until the pain and inflammation go away. 

Get a physiotherapist or a sports physician to work with you to identify strategies that may work for you.

ii) Invest in Braces and Splints

Resting your elbow is easier said than done.

This is because common movements such as gripping, twisting, or lifting can directly or indirectly exert pressure on the elbow and worsen the pain.  

Special forearm braces and splints designed for tennis elbow can decrease pressure on the elbow joint effectively. 

These are available pre-made from the market or can be customized for the best results.

iii) Use Tennis Elbow Friendly Equipment

Tennis elbow can often affect gardeners, painters, carpenters, plumbers, mechanics, musicians, and chefs. 

If you cannot refrain from work, start using tennis elbow-friendly equipment.

Use power tools or tools with padding to decrease the tension on your elbow. 

Hold tools with a looser grip and learn to use your shoulder and upper arm muscles instead of your forearm muscles.

Refrain from bending or straightening your arm completely. 

An occupational therapist can help you to use these tools with the least impact on your elbow.

7: Take Supplements to Promote Healing and Sleep

Diet plays an important role in speeding up the healing process. 

The following supplements have proven their effectiveness in fighting inflammation and pain.  

Although not specific to tennis elbow, they have been proven to be useful in joint-related diseases.

This is not an exhaustive list and contains only commonly available supplements.

Introduce at least a few of these into your diet after talking to your doctor first:

i) Omega-3 Fatty Acids

Omega-3 fatty acids (O3FA), especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), acts as alternate substrates in the biosynthesis of inflammatory mediators and decrease the inflammation.

They are abundant in seafood such as anchovies, bluefish, mackerel, salmon, sardines, tuna, and trout. 

If you are vegan, try walnuts, flaxseed and flaxseed oil, canola oil, soybean oil, and chia seeds. 

Commercial O3FA is available as an over-the-counter diet supplement. 

However, if you are on blood thinners, you run the risk of excessive bleeding.   

Speak to your doctor before starting O3FA supplements.         

ii) Glucosamine and Chondroitin

Glucosamine and chondroitin are natural structural components of the cartilage.

It also forms a part of the joint capsule and tendon attachments.

Given exogenously, these proteoglycans are known to promote bone and joint health.

Although the proof for benefit of these components in tennis elbow is questionable, anecdotal evidence points towards mild improvement in joint diseases such as osteoarthritis.

They are commercially available as single-component supplements or in combination with other drugs such as NSAIDs.

iii) Ginger

Ginger (Zingiber officinale) has active molecules called shogaols that inhibit pro-inflammatory prostaglandins and decrease inflammation.

Preliminary clinical trials have reported improvement in joint-related pain.  

While ginger is available as capsules, tinctures, teas, powders, oils, and dried ginger, experts recommend capsules over natural products for better benefits.

iv) Capsaicin

Capsaicin is a component derived from chili peppers. 

It works by reducing Substance P, a neurotransmitter in the nervous system. 

Few studies have ascertained the role of capsaicin in reducing pain and tenderness in joint disease, especially in osteoarthritis. 

Skin creams with 0.025%-0.075% capsaicin can act as a counter-irritant and soothe joint pain.

It has no major side effects since it is applied on the skin.   

v) Turmeric

Turmeric has been a chief component in Asian cuisine, especially Indian foods, for many centuries.

The active component in turmeric is curcumin and its beneficial effects in rheumatoid arthritis is well known.

It acts as a powerful antioxidant and curbs inflammation.

While incorporating them into your regular diet as a spice may be difficult, you can make an anti-inflammatory turmeric tea.  

Curcumin is also available nowadays as a capsule for ease of consumption.

8: Try Herbal Remedies Instead of Sleep Medications

If you have significant sleep disturbance, your doctor may prescribe a short course of sleeping pills.

However, use them strictly for the time period prescribed as some of these medicines have the potential for dependence.

If you have only mild to moderate symptoms, try these following herbal remedies instead (if you are taking medicines for other medical conditions, consult your general physician for potential interactions):

i) Chamomile Tea

Chamomile tea is a mild sedative and can help calm your nerves and ease insomnia.  

Existing research hints that chamomile tea may function like benzodiazepine drugs.

Some research also suggests that the active component of chamomile binds to the benzodiazepine receptors. 

However, the exact mechanism of chamomile is not clearly understood.   

Herbalists recommend drinking strong chamomile tea using 2-3 tea bags to get the sleep-promoting effect.

ii) St. John’s Wort

St. John’s wort can ease anxiety, depression, and insomnia by increasing the serotonin levels in the brain.  

Almost all parts of this plant, including flowers, leaves, bark, fruit, seeds, stems, and roots are used for treating insomnia and depression.

It also modulates REM sleep and deep sleep stages.

In vitro studies have shown significant affinity of the active components to many receptors such as GABA, benzodiazepines, inositol triphosphate, and monoamine oxidase A and B. 

Preparations of St John’s wort notoriously interact with many medicines.

Consult your doctor before using St John’s wort.

iii) Valerian Root

Valerian extract contains components such as valepotriates and valerenic acid which is responsible for the sedative properties of valerian.

Herbal practitioners swear on the root of this flowering plant as a safe, anti-anxiety, and sleep-promoting substance. 

In-vivo animal studies and clinical trials have also demonstrated sleep-inducing, anxiolytic, and tranquilizing effects.

Valerian root is known to improve sleep quality by decreasing sleep latency and night awakenings.

How Tennis Elbow Affects Sleep

Below is a short guide that explains what tennis elbow is and how it can affect your sleep.

Tennis Elbow is an Inflammatory Condition

Tennis elbow is an inflammatory condition that affects the outer part of the elbow joint.

While it is most commonly seen in people who pursue racquet or swinging sports, other professions such as gardeners, painters, carpenters, plumbers, mechanics, musicians, and chefs often report tennis elbow.

Technically, any hobby or profession which causes the overuse of the elbow joint and forearm muscles can lead to the condition.

Tennis Elbow is Diagnosed Through ROM Testing

Your doctor will test your arm’s range of motion (ROM) to identify if you have tennis elbow. 

He/she may also like you to undergo an x-ray or an MRI to rule out other possibilities such as arthritis. 

If nerve entrapment is suspected, a nerve conduction test may also be performed.

If you have symptoms of tennis elbow, here is a home-based self-test you could do:

  • Stand behind a chair of suitable height with both your palms facing downwards and with elbow kept at a right angle.
  • Grasp the top of the chair and lift the chair up.
  • If you feel pain on the outside of your elbow, you probably have tennis elbow. 

The Pain of Tennis Elbow can Disrupt Sleep

Tennis elbow does not have a direct impact on sleep, in terms of pathogenic mechanism.  

However, tennis elbow can cause pain which can affect the quantity and quality of sleep.

At the same time, a decrease in sleep and certain specific sleep postures can worsen tennis elbow.   

The combination of these factors can impede healing and make tennis elbow last longer.

Conclusion: Try Multiple Remedies

To sleep better when you have tennis elbow, you should talk to your doctor to find the best treatment plan and consider using multiple remedies such as sleeping on your back, sleeping in a hyrbid memory foam mattress, using an elbow brace, and managing pain.

If you’d like to buy a new mattress to help alleviate your tennis elbow and get a more comfortable night’s sleep overall, then my top personal recommendation is the Puffy Lux Hybrid.

Click the button below to read my review based on my own experience of sleeping in the Puffy Lux Hybrid and get $300 off now.

Sources and References

[1] Gorski J.M. “Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow”- retrieved on 01 May 2021.

[2] Lenoira H, Maresb O, Carlierc Y. “Management of lateral epicondylitis”- retrieved on 06 May 2021.

[3] Razavipour M, Shayesteh M, Hosein K M, Gaffari S, Fazli M. “The Short Term Effects of Shock-Wave Therapy for Tennis Elbow: a Clinical Trial Study”- retrieved on 06th May 2021.

[4] Chung-Soo K, Jin-Yi H, Seunghwan K, Jin Tae H, Ki-Wan Oh. “Herbs for the Treatment of Insomnia” – retrieved on 10th May 2021.

Medical Disclaimer

No part of this article or website offers medical advice – always consult with a qualified professional for such guidance.

Image Attribution and Licencing

Main image: ‘Elbow Pain’ by Panya_sealim (Getty Images) used with permission under the terms of Canva’s One Design Use License Agreement.