Treatment of Tennis Elbow

Tennis elbow (lateral epicondylitis) is a common overuse condition that causes pain on the outer side of the elbow and forearm. It can make everyday activities such as lifting, gripping, typing or playing sport painful and difficult.

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What is tennis elbow?

Tennis elbow, also known as lateral epicondylitis, is an overuse syndrome affecting the elbow joint. It involves the extensor muscles of the forearm, which attach to the lateral epicondyle (outer bony part) of the humerus.

What causes tennis elbow?

Repeated strain and microtrauma damage the collagen fibres in the tendons. The body tries to repair this damage, replacing it with connective tissue and forming abnormal blood vessels. Blood supply becomes disrupted and calcifications may develop.

Typical movements

Repetitive wrist extension
Rotational movements of the forearm
Lifting with the elbow joint fully extended
Racquet sports and other impact sports

Who is at higher risk?

Adults aged 30–50
Office workers using a mouse or keyboard for long hours
Dentists, surgeons, electricians, bricklayers, locksmiths and construction workers
Players of tennis, badminton and squash (especially beginners or those using poor technique)

Symptoms of tennis elbow

Early symptoms

Pain on the outer side of the elbow, sometimes radiating into the forearm
Tenderness when pressing over the lateral epicondyle
Mild swelling, warmth or redness around the joint
Discomfort when gripping, lifting or twisting objects

Progressive symptoms

Weak and unsteady grip (dropping objects)
Pain when clenching a fist or shaking hands
Increased fatigue in the affected arm
Symptoms worsening after repetitive or heavy use of the limb

Treatment options for tennis elbow

For most patients, symptoms improve significantly within several months to a year with appropriate non-surgical treatment, and many achieve full recovery.

Reduce strain on the joint and avoid heavy lifting
Temporarily stop or modify sports and activities that aggravate symptoms
Use cold compresses (ice packs) in the acute phase
Take nonsteroidal anti-inflammatory drugs (NSAIDs) as advised

Additional therapies may include:

Physiotherapy and specific strengthening/stretching programmes
Kinesiotaping and therapeutic massage
Ultrasound, iontophoresis and magnetic field therapy
Extracorporeal shockwave therapy (ESWT)
Acupuncture
Steroid or local anaesthetic injections (for example procaine) in selected cases
Autologous growth factor preparations (e.g. PRP-type therapies)

Conservative treatment can relieve symptoms and delay progression, but it cannot fully reverse advanced deformity. Surgical correction may eventually be recommended.

Surgery is considered when symptoms have persisted for around 12 months despite comprehensive conservative treatment, or when pain is constant and significantly affects daily life or sport.

Release of the tendon attachment and removal of inflamed or degenerative tissue
Drilling into the bone at the tendon attachment site to stimulate stem cells and improve healing
Tendon repair or reinforcement, sometimes using implants
Extensor fasciotomy to reduce pressure on nerves and blood vessels
Extensor tendon reconstruction
Elbow joint denervation in selected cases

Surgery is considered when symptoms have persisted for around 12 months despite comprehensive conservative treatment, or when pain is constant and significantly affects daily life or sport.

Recovery after tennis elbow surgery

Immediately after surgery

Most patients go home the same day or the following day
A stabilising orthosis or support may be used for up to one week
Pain is controlled with prescribed medication
Gentle finger and wrist movements are encouraged as advised

Rehabilitation and long-term outcome

Typical full recovery time is around 4–6 months
Return to work is often possible after about 3 months (depending on job demands)
Athletes usually resume full training after approximately 5–6 months
Physiotherapy is essential to restore strength, mobility and function
Sport should only be resumed when movement, strength and function match the unaffected limb

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Disclaimer
*The Pax Medicus website provides information for guidance only and does not constitute medical advice, diagnosis, or treatment. Pax Medicus does not provide healthcare services and is not a substitute for consultation with a qualified medical professional. Always seek advice from your physician regarding any medical condition. Prices shown are indicative only and subject to confirmation by the healthcare provider. This is the official website of Pax Medicus; we do not operate through agents or third-party sites.

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