Treatment options for tennis elbow 

Treatment
Pros
Cons
Simple painkillers

Tablets such as paracetamol or aspirin, which are available over the counter

  • easy to take
  • readily available
  • may not be suitable for long-term pain relief or if pain is severe
  • children under 16 years of age should not take aspirin
Anti-inflammatory creams and gels (NSAIDs)

Creams and gels containing non-steroidal anti-inflammatory drugs (NSAIDs), which are applied directly to the elbow to relieve pain and reduce inflammation

  • easy to apply
  • some types are available over the counter
  • cannot be used during pregnancy or breastfeeding
  • some are unsuitable for children
  • lack of evidence to support use of NSAIDs for long-term pain relief
  • possible side effect of ketoprofen is hypersensitivity to light (photophobia)
Corticosteroid injections

Medicine containing steroid hormones that is injected into the elbow area to reduce pain and swelling

  • quick relief of symptoms
  • effective short-term pain relief
  • injections can be painful
  • potential side effects can include atrophy (wasting away of surrounding tissue) and lightening of the skin
  • ineffective for long-term pain relief (after six weeks)
  • six-week interval required in between treatments
  • symptoms may return
Physiotherapy

Physical techniques, such as massage, manipulation, and stretching and strengthening exercises to relieve symptoms. Bandages and tennis elbow splints can also be used as part of treatment

  • may provide more effective long-term pain relief than corticosteroid injections
  • could be a long waiting time for physiotherapy treatment
Shock wave therapy

High-energy sound waves are passed through the skin into the area that is causing pain. The aim is to relieve pain and improve movement

  • can be repeated as many times as necessary
  • can help to relieve pain and improve movement of the arm
  • lack of evidence to show how effective the procedure is
  • possible side effects include skin damage, bruising, reddening and rupture (tear) of the extensor tendon, which is attached to the forearm muscle and allows the fingers and thumb to straighten
  • follow-up appointments needed for at least a year following treatment
  • limited availability on the NHS
Acupuncture

A complementary medicine; needles are inserted directly into the skin surrounding the affected area to provide pain relief

  • side effects usually mild and short-lived
  • lack of evidence to show that it is effective for treating tennis elbow
  • access on the NHS can be limited in some parts of the country (many people pay for private treatment)
Surgery

The damaged part of the tendon is removed; recommended when non-surgical treatments have failed

  • may work when all other treatment options have failed
  • an invasive form of treatment that requires a long recovery period
  • lack of evidence regarding the effectiveness of surgery