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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Tennis elbow, referred to by medical professionals as lateral epicondylitis, is a common overuse injury. It usually strikes in people whose work involves repetitive wrist movement or gripping motions.
Of course, tennis players are the most well-known example, but this type of tendonitis can strike in all sorts of jobs including manual labor, computer work, painting, professional cooking, and much more.
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What is tennis elbow?
Essentially, overuse and repetitive motions strain a tendon that runs from your elbow to the muscle in your forearm. The pain typically appears on the outside of the elbow and gets worse the more you use your arm (Buchanan, 2021).
Rest is often the first recommendation for relieving tennis elbow. Short-term, you can use over-the-counter painkillers like ibuprofen to manage the pain. Depending on the length and severity of symptoms, further interventions, like the ones we’ll dig into below, may be necessary (Lenoir, 2019).
How to treat tennis elbow
It’s common for tennis elbow to resolve on its own without any intervention, although it can take a year or two. That timeframe stings, but the good news is it doesn’t always take that long––some people feel back-to-normal within just three months (Lenoir, 2019).
Here are some other ways to treat tennis elbow or speedup recovery (Buchanan, 2021):
1. Rest
Taking time off isn’t always an option, especially if your job is what’s triggering tennis elbow to begin with. But the first line of treatment is taking a break from the activity that’s causing tennis elbow. If you experience elbow pain, stop if you can, and don’t start up again until the pain has subsided (Buchanan, 2021).
2. Relieve pain
Icing the painful areas, commonly the outside of the elbow, after overuse and treating pain with either oral or topical non-steroidal anti-inflammatory drugs (NSAIDs) (like ibuprofen) can help with pain relief.
3. Wraps and straps
In some cases, you may want to reinforce the forearm muscles and elbow with extra support. Straps that wrap around your forearm just below the elbow, called forearm counterforce straps, can also relieve tension in the elbow, though the effectiveness of the braces is controversial since they can cause pain themselves. Consult with a healthcare professional before trying this route to see if a strap or splint could help.
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4. Stretch and strengthen
In some cases, a healthcare provider may refer you to a physical therapist or sports medicine specialist who will help you implement strengthening exercises into your treatment plan.
5. Cortisone
If these non-invasive methods don’t work, your healthcare provider may want to try other treatment options. Local steroid injections, specifically cortisone shots, are one of the most common treatments for tennis elbow that can’t be treated with non-invasive tactics.
The shots usually provide substantial pain relief that lasts for a few weeks, but can’t be used for long (Lenoir, 2019). Multiple studies have shown that cortisone shots improved pain in the short term but that the pain returned in as little as 12 weeks (Olaussen, 2015).
6. Botulinum toxin
Botox may ring a beauty bell for most people, but the substance in these shots can be used for a range of other conditions, including excessive sweating, and muscle problems. Studies have found that botulinum toxin (Botox) injections were equivalent to cortisone shots when it came to pain management, but also only produced results in the short term (Lin, 2017).
7. Platelet-rich plasma injections
Another injection pain management option your healthcare provider may recommend is platelet-rich plasma (PRP) injections. A review of seven randomized clinical trials found that while PRP injections didn’t work as well as cortisone shots in the first four to eight weeks post-treatment, they did work better after six months (Li, 2019).
8. Acupuncture
Research on acupuncture’s effectiveness for the treatment of tennis elbow is limited, but some small studies have found that acupuncture did help improve range of motion slightly (Tang, 2015).
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Is surgery an option?
It’s rare that tennis elbow will require surgery––and since 93% of people typically see improvement with the non-surgical treatments listed above, surgery is a last resort. If you can’t resume your normal activities after a year of treatment, ask your doctor if you may be a candidate for surgery (Buchanan, 2021).
Preventing tennis elbow
The best way to avoid a lengthy recovery from tennis elbow is to prevent it from happening in the first place.
Especially if it acts up during recreational activities rather than work, it’s critical to stop the motion (such as swinging a racket or club) that’s triggering your tennis elbow as soon as you feel it start. It can be tough to force yourself to take a break, sometimes for weeks or even months, but this will prevent the injury from progressing and avoid much more time off in the long run.
You may find further relief in stretching or through extra support, just be sure to talk to a healthcare provider or physical therapist if you find that the problem persists despite rest.
References
- Buchanan, B. K. & Varacallo, M. (2021). Tennis Elbow. [Updated Nov 15, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK431092/
- Hongzhi, T., Huaying, F., Chen, J., Yang, M., Yi, X., Dai, G., et al. (2015). Acupuncture for Lateral Epicondylitis: A Systematic Review. Evidence-Based Complementary and Alternative Medicine. doi: 10.1155/2015/861849. Retrieved from https://www.hindawi.com/journals/ecam/2015/861849/
- Lenoir, H., Maresb, O., & Carlier, Y. (2019). Management of lateral epicondylitis. Orthopaedics & Traumatology: Surgery & Research, 105(8), S241-S246. doi: 10.1016/j.otsr.2019.09.004. Retrieved from https://www.sciencedirect.com/science/article/pii/S1877056819302609?via%3Dihub
- Li, A., Wang, H., Yu, Z., Zhang, G., Feng, S., Liu, L., & Gao, Y. (2019). Platelet-rich plasma vs corticosteroids for elbow epicondylitis. Medicine, 98(51), e18358. doi: 10.1097/md.0000000000018358. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6940118/
- Lin, Y., Wu, W., Hsu, Y., Han, D., & Chang, K. (2017). Comparative effectiveness of botulinum toxin versus non-surgical treatments for treating lateral epicondylitis: A systematic review and meta-analysis. Clinical Rehabilitation, 32(2), 131-145. doi: 10.1177/0269215517702517. Retrieved from https://journals.sagepub.com/doi/10.1177/0269215517702517?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&
- Olaussen, M., Holmedal, Ø., Mdala, I., Brage, S., & Lindbæk, M. (2015). Corticosteroid or placebo injection combined with deep transverse friction massage, Mills manipulation, stretching and eccentric exercise for acute lateral epicondylitis: A randomised, controlled trial. BMC Musculoskeletal Disorders, 16(1). doi: org/10.1186/s12891-015-0582-6. Retrieved from https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0582-6
- Olaussen, M., Holmedal, O., Lindbaek, M., Brage, S., & Solvang, H. (2013). Treating lateral epicondylitis with corticosteroid injections or non-electrotherapeutical physiotherapy: A systematic review. BMJ Open, 3(10), e003564. doi: 10.1136/bmjopen-2013-003564. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816235/
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.
