Inclusion Criteria:  Patients suffer from pain at the lateral part of the elbow and radiated to the forearm with tenderness increasing on pressure on the lateral epicondyle and on resistance of hand extension lasting of the symptoms for 3 months previous physiotherapy interventions.  Exclusion Criteria:  Internal or external fixation arthritis of elbow contraindications to electrotherapy like pacemaker, dermatological skin disease, epilepsy, abnormal sensation, and pregnancy.