Tennis elbow, a common debilitating musculoskeletal enigma characterized by gradual or sudden insidious onset of pain and tenderness at the origin of wrist extensor tendon. It is a multi-factorial disorder having intrinsic and extrinsic factors; intrinsic factors includes excessive overloading of musculoskeletal tissues and articular/myofascial dysfunction at the elbow and extrinsic factors includes mechanical dysfunction of the cervical and thoracic spine and neurophysiological sequelae of these altered mechanics. Seventy percent of tennis elbow population has been reported with pain in the cervical and/or thoracic spine.