Tennis Elbow Info
Last reviewed
Video transcript
Tennis elbow is a condition where you get pain on the outside of your elbow, right where the forearm tendons attach to the bone. It often starts as a nagging ache. The ache sharpens when you grip, lift, or twist. Despite the name, most patients do not play tennis. The pain can spread down the forearm as a burning sensation, and the sore spot is usually tender to press. Most cases settle without surgery. The tendon needs time and specific exercises to heal. A gradual progressive loading program, usually guided by a physiotherapist, is the best initial treatment. A counterforce brace can take the edge off during the day, and easing the activities that flare it up also helps. Most people improve over weeks to months. When the pain persists despite a fair trial of non-operative treatment, a small operation can help. It is done as day surgery through a short incision over the outer side of the elbow. The worn and painful part of the tendon is cut away, leaving healthy tendon to heal back to the bone, which may be helped with sutures. The procedure itself is quick, and you go home the same day, with the elbow in a simple dressing. Recovery is gradual. The arm is rested in a sling for comfort over the first few days. Gentle movement begins early, and most people are using the hand for light tasks within a couple of weeks. Strength returns over the following months, with heavy gripping and lifting last to return. It is normal for the elbow to grumble as it settles. The improvement is steady, and worth the wait.
Tennis elbow (lateral epicondylitis) — causes, symptoms, and conservative treatment options for pain relief.
What you're feeling
You likely have pain on the outside of your elbow. This condition is called lateral epicondylitis, or tennis elbow. The pain often starts gradually and feels like a burning or aching sensation. You might notice it is worse when you grip things tightly. Simple tasks like shaking hands, turning a doorknob, or lifting a coffee mug can become difficult.
Daily activities often trigger your symptoms. You may feel pain when you reach behind your back to fasten a bra or tuck in a shirt. Lifting objects with your palm facing down is usually the most painful movement. Even holding a briefcase or carrying groceries can hurt. Many people find that the pain flares up after you have been active all day. Some also report that the pain wakes them up at night or feels stiff when they first wake up in the morning.
This condition is very common and usually gets better on its own. Symptoms have a steady half-life of three to four months. Most cases resolve by 6 months no matter what treatment you use. About 90% of people with untreated tennis elbow achieve symptom resolution by 1 year. The chance of recovery remains fairly constant over a one-year timespan, regardless of how long you have had symptoms. Longer symptom duration does not mean a poorer outcome without surgery. If your pain persists, your surgeon will discuss your options, but most people find relief without an operation.
What's actually happening
Tennis elbow is a wear-and-tear problem where the tendon connecting your forearm muscles to the outer bump of your elbow gets irritated. Think of this tendon as a thick rope that helps you lift your wrist and grip objects. Over time, the repeated stress causes tiny tears and inflammation where this rope attaches to the bone. This area is often called the extensor carpi radialis brevis tendon origin.
The pain you feel comes from increased pressure between this bone and the tendon. This pressure gets worse when you straighten your arm, turn your palm down, or squeeze something tight. Your body tries to adapt by changing how your muscles fire, which can make the pain feel deeper or more persistent. Sometimes, the joint capsule—the sleeve around your elbow—becomes inflamed, adding to the discomfort.
Most of the time, your body heals this on its own. About 90% of people see their symptoms go away within one year without surgery. The pain usually follows a steady half-life of three to four months, meaning it improves gradually over time. If you do not get better after trying non-surgical treatments, your surgeon may discuss an arthroscopic release. This procedure uses a small camera to look inside the joint and carefully remove the damaged tissue to relieve the pressure on the tendon.
What we can do about it
Most people with tennis elbow get better on their own. Symptoms usually have a steady half-life of three to four months, and about 90% of people achieve symptom resolution by one year without surgery. Your first step is simple self-management and rest. You will likely work with a physical therapist to strengthen the arm and modify your daily activities. This non-operative approach is the mainstay of care for this condition. Most patients resolve their symptoms within six months using these standard methods. Longer symptom duration does not mean you will have a poorer outcome without surgery.
If simple rest is not enough, your surgeon may discuss medical options to manage pain. These include pain medication and anti-inflammatory treatments. You might also consider injections, such as cortisone or platelet-rich plasma. However, evidence shows that platelet-rich plasma or autologous blood injections do not reduce pain or improve function for this condition. While some treatments offer small pain relief, they can also increase the risk of side effects. Most patients are well-managed with these conservative therapies before considering anything more invasive.
Surgery is only considered if your symptoms persist despite trying non-operative treatments for a long time. It is a poor indication for surgery if you have not yet given conservative care enough time to work. For the small percentage of patients who do not respond to other approaches, surgery provides near 90% satisfaction rates. The procedure involves releasing the tight tendon to relieve pressure on the elbow. Your surgeon will discuss if this is right for you only after other options have failed.
When to see someone
Most cases of tennis elbow, also known as lateral epicondylitis, get better on their own within six months. About 90% of people see symptoms resolve by one year without surgery. The chance of recovery stays steady no matter how long you have had pain. See your GP if pain persists despite rest, or if you feel weakness, instability, or locking in the elbow. Ask for a specialist review if symptoms interfere with sleep or work, or if you experience sudden worsening. Your surgeon cannot reliably predict who will improve without treatment, so professional advice is best if you are unsure.
