Tennis elbow - Treatment 

Treating tennis elbow 

Painkillers and anti-inflammatory medication may help reduce mild pain and inflammation caused by tennis elbow 

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Take a look at a simple guide to the pros and cons of different treatments for tennis elbow

Tennis elbow is a self-limiting condition, which means it will eventually get better without treatment.

However, it can often last for several weeks or months because tendons heal slowly. In some cases, tennis elbow can persist for more than a year.

A number of simple treatments can help alleviate the pain of tennis elbow. The most important thing you can do is rest your injured arm and stop doing the activity that caused the problem (see below).

Holding a cold compress, such as a bag of frozen peas wrapped in a towel, against your elbow for a few minutes several times a day can help ease the pain.

Invasive treatments, such as surgery, will usually only be considered in severe and persistent cases of tennis elbow where non-surgical approaches have not been effective.

Avoiding or modifying activities

If you have tennis elbow, you should stop doing activities that strain affected muscles and tendons.

If you use your arms at work to carry out manual tasks, such as lifting, you may need to avoid these activities until the pain in your arm improves.

Alternatively, you may be able to modify the way you perform these types of movements so they do not place strain on your arm.

Talk to your employer about avoiding or modifying activities that could aggravate your arm and make the pain worse. 

Painkillers and NSAIDs

Taking painkillers, such as paracetamol, and non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may help ease mild pain and inflammation caused by tennis elbow.

As well as tablets, NSAIDs are also available as creams and gels (topical NSAIDs). They are applied directly to a specific area of your body, such as your elbow and forearm.

Topical NSAIDs are often recommended for musculoskeletal conditions, such as tennis elbow, rather than anti-inflammatory tablets. This is because they can reduce inflammation and pain without causing side effects, such as nausea and diarrhoea.

Some NSAIDs are available over the counter without a prescription, while others are only available on prescription. Your GP or pharmacist will be able to recommend a suitable NSAID.  

Read more about non-prescription and prescription-only medicines

Physiotherapy

Your GP may refer you to a physiotherapist if your tennis elbow is causing more severe or persistent pain. Physiotherapists are healthcare professionals who use a variety of methods to restore movement to injured areas of the body.

Your physiotherapist may use manual therapy techniques, such as massage and manipulation, to relieve pain and stiffness and encourage blood flow to your arm. They will also be able to show you exercises you can do to keep your arm mobile and strengthen your forearm muscles.

The use of an orthoses, such as a brace, strapping, support bandage or splint, may also be recommended in the short term.

Read more about physiotherapy.

Corticosteroid injections

Corticosteroid injections are sometimes used to treat particularly painful musculoskeletal problems. However, clinical evidence to support their use as an effective treatment for tennis elbow is limited.

Corticosteroids are a type of medication that contain manmade versions of the hormone, cortisol.

Corticosteroid injections may help reduce the pain of tennis elbow in the short term, but their long-term effectiveness has been shown to be poor.

The injection will be made directly into the painful area around your elbow. Before you have the injection, you may be given a local anaesthetic to numb the area to reduce the pain.  

Shock wave therapy

Shock wave therapy is a non-invasive treatment where high-energy shockwaves are passed through the skin to help relieve pain and promote movement in the affected area.

How many sessions you will need depends on the severity of your pain. You may have a local anaesthetic to reduce any pain or discomfort during the procedure.

The National Institute for Health and Care Excellence (NICE) states that shock wave therapy is safe, although it can cause minor side effects including bruising and reddening of skin in the area being treated.

Research shows that shock wave therapy can help improve the pain of tennis elbow in some cases. However, it may not work in all cases and further research is needed.

Surgery

Surgery may be recommended as a treatment of last resort in cases where tennis elbow is causing severe and persistent pain. The damaged part of the tendon will be removed to relieve the painful symptoms.

Page last reviewed: 27/09/2012

Next review due: 27/09/2014

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Comments

The 6 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Jenwade01 said on 08 April 2014

I have had tennis elbow in both arms for five years now
The treatments I have had include mri scans xrays nerve tests physio acupuncture high frequency cold compress deep tissue massage various splints bowen treatment and numerous steoid jabs and still ended up having both arms operated on
After 3 years no pain Ive been told that the ops need to be redone but theres only a 60/40 chance of it working this time
Please can anyone help me on what to do I dont want my arms to get any weaker than they are if op dosent work also op is very painful
Can anyone at all give me advice
I would appreciate your comments

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david lewis said on 27 February 2013

I have had tennis elbow for at least 10 years the pain now is unbearable. I have had cortisone injections and tryed tochange the way I do things . but being a fabricator welder it is ddifficult. I can't work at the moment as even reading a book causes me great pain , it even hurts as I lie in bed. any suggestions . I am seeing a consultant the end of April but my doctor wont give me a doctors note .
Dave Lewis .

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jac2 said on 12 September 2011

I got tennis elbow through using my walking stick.

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jimbob2 said on 12 May 2011

I have read a lot about PRP (Platelet Rich Plasma injection therapy) becoming a succesfull alternative treatment that can be used be to speed up the bodys natural healing process of the tendons in tennis elbow and all other types of tendinopathys. I see you don't mention it in the list of treatments but in this article it mentions there are a few NHS hospitals that are performing it, and I wondered if you ever refer people to clinics that are performing it, as in the article the lady says she was refered by her physio. link:http://www.dailyexpress.co.uk/features/view/135016/I-was-cured-by-my-own-blood#

It seems a very good option to try for chronic cases before having to go for surgery and seems to have a lot of positive results. Far better than having a cortisone shot which from my reachearch of tendinopathys, seems to only provide temporyary pain reilef. Stated in this disciption they are shown to be ineffective treatment, used to reduce immflamation. But in chronic tendonitis, which is actually called tendonosis ( the prefix "itis" meaning imflammation ) immflamation is not present and the problem is actual degeneration of the tendon. This is much more common and it actually tuns out tendonitis is rare compared to tendonosis. I have even read that cortisone shots can make things worse as they weaken the tissue.

I have been suffering with tennis elbow in both arms for around 4 months now, although the problem has been manifesting over about as far as I know 18 months ago. It all started due to leading an active life style and perticualary from doing heavy strength training over a long period of time. It has now completely disabled me and I can no longer do my Job.

I am due to see an NHS ortopedic specialist soon, and im hoping he has heard of PRP therapy. And I was wondering do they do any further diagnosis, so far all I have had is a GP press on my elbow and forearm. I read that an MRI scan would show the extent of damage to tendons.

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shankers said on 29 January 2010

Penetrex is only Arnica cream which has no benefit to Tennis Elbow.

The latest research suggests vibration therapy as a neuron pathway blocking pain reliever. Tenease is the only MHRA approved class IIa medical device for relieving the pain of lateral epicondylitis.

More information can be found here: http://tenease.com

There are other options for Tennis Elbow. Strapping, which can protect the joint, corticosteroid injections, which are now shown to be an ineffective treatment, and surgery, which is a last resort.

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troutman said on 10 November 2009

Can Penetrex be got from the NHS by prescription fo the condition of tennis elbow?

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