Tennis Elbow
Tennis Elbow
Patient Information
Therapy Services
- Author ID: BH
- Leaflet ref: Tpy 012
- Version: 6
- Leaflet title: Tennis Elbow
- Last review: June 2025
- Expiry Date: June 2027
Tennis Elbow
Tennis elbow is caused by alteration to the tendons on the outside of your elbow, leading to pain which can radiate down the forearm and affects tasks involving gripping, or fine dexterous skills. This condition is also known as lateral epicondylitis (LET).
Cause
The exact cause is unknown. We do know that males, who undertake heavy, repetitive manual jobs, may be more at risk.
Symptoms
The first signs of tennis elbow are usually tenderness and pain over the outside of the elbow. Pain often occurs when moving your hand back or making a fist. It is often worsened by activities that involve lifting, gripping, or twisting of the hand and wrist. In some cases, the pain can progress down the forearm.
Management
Tennis elbow is a self-limiting condition. This means that it will eventually settle. You can choose not to treat it, but to allow it to get better on its own. However, as the pain can be disabling, there are methods of management that can improve the pain and speed up recovery.
First Line Treatment
- Analgesics / non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen (topical/oral)
- Physical therapy and orthotics if available
- Reassurance: this is a self-limiting condition, and most symptoms respond within three months.
Injection Therapy
Current advice is to avoid steroid injections. Evidence has shown that while there may be a short-term improvement in symptoms, people had a worse outcome following a steroid injection in the long term. Alternative injection treatments include:
- Plasma Rich Protein (PRP) (blood plasma that is enriched with platelets and injected into an area of the body for the purpose of healing) - these injections are an alternative. However, patients being offered PRP for the treatment of LET should understand that it may have no benefit over a placebo (sham injection).
Surgery
Surgery is the last resort and can be performed as an open or keyhole (arthroscopic) procedure. Patients being offered surgery for tennis elbow should be made aware that there is no evidence of benefit compared to placebo (sham surgery).
Physiotherapy Exercises
For advice on rehabilitation exercises please visit the British Elbow and Shoulder Society webpage and watch the following video: Tennis Elbow Exercises