Treatment Overview

Tennis elbow treatment is most often successful. The most important part of treatment is tendon rest. A long rest from aggravating activity allows the small tears in the tendon to heal. Depending on how severe your condition is, you may need to rest your tendon for weeks to months. Surgery is a last resort if other treatment isn't helpful.

Initial home treatment

Treatment for tennis elbow works best when it starts as soon as symptoms appear. If your condition is just starting, rest may be all you need. But in most cases, more treatment is needed to protect and heal the tendon.

You can treat your tennis elbow by:

• Reducing pain.
  • As soon as you notice pain, use ice or cold packs for 10 to 15 minutes at a time, several times a day. Always put a thin cloth between the ice and your skin. Keep using ice a long as it relieves pain. Or use a warm, moist cloth or take hot baths if they feel good. Do what works for you.
  • You can also take nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin (such as Bayer), ibuprofen (such as Advil), or naproxen (such as Aleve). Do not give aspirin to anyone younger than 20 because of the risk of Reye syndrome, a serious illness. Or try an NSAIDs cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain.
• Stopping or changing activities that may irritate the tendon. Learn new techniques for certain movements, and use different equipment that may reduce the stress on your forearm muscles.

Wrist and elbow splints can be used in the treatment of tennis elbow. Splints are sometimes helpful for other bone, joint, and tendon problems. But splints have not been shown to help with pain or recovery for tennis elbow injuries.

Ongoing treatment

Over the first months of recovery from tennis elbow, continue your initial treatment and begin:

• Rehabilitation (rehab). This can include exercise and other physical therapy treatments to decrease pain and increase range-of motion. Exercises for flexibility and arm muscle strength include:
  • Warm-up exercises for tennis elbow.
  • Stretching exercises for tennis elbow.
  • Strengthening exercises for tennis elbow.
• Wearing a special counterforce brace. This strap, worn around your forearm just below the elbow, may spread pressure throughout the arm instead of putting it all on the tendon. With a counterforce brace, you may do some grasping and twisting activities. It won't help, though, if you continue using a poor technique or the wrong equipment that originally caused your tennis elbow. You don't need a doctor's advice before trying a counterforce brace. You can find these braces in most drugstores or sporting goods stores.
• Working with an expert to see whether you need to change how you do an activity or what equipment you use. A sports trainer can help with sports activities and equipment. An ergonomic specialist, occupational therapist, or physical therapist can help with your workplace, including what tools you use, how your workspace is set up, and how you do your job.

Treatment if the condition gets worse or does not improve

The longer you continue activity that harms the tendon after tennis elbow symptoms begin, the longer rehab will take. This ongoing activity can cause severe tendon damage and may someday require surgery. If your symptoms don't go away, your doctor may suggest:

• Corticosteroid injections, which can help relieve pain for a short time.¹ This treatment is sometimes used when you still have pain after 6 to 8 weeks of rest and rehab. Corticosteroids may be harmful to the tendon. But this is usually only a problem after having many injections in the same year.
• Ultrasound therapy. Ultrasound may help your tendon heal and stop pain.
• Surgery, which is seldom used to treat tennis elbow (less than 5 out of 100 cases).² Surgery may be a treatment option if persistent elbow pain doesn't improve after 6 to 12 months of tendon rest and rehab. Surgery usually involves cutting (releasing) the tendon, removing damaged tissue from the tendon, or both. In some cases, tendon tears can be repaired.

What To Think About

Your treatment choices will depend in part on whether elbow pain affects your job or daily life. It also depends on whether you are willing or able to change habits or activities that are causing your elbow pain.

Non-surgical treatment is usually started if the injury is:

• A result of overuse.
• A sudden (acute) injury that doesn't have large tears in the tendon or other severe damage in the elbow.

Most cases of tennis elbow respond to rest, ice, rehab exercises, pain medicine, and counterforce braces. This injury does take from 6 months to 12 months to heal. Patience helps.

Surgery is considered as a last resort when all other nonsurgical treatments have failed. You may be referred for surgery if:

• The injury is from a sudden (acute) injury that left large tears in the tendon or other severe damage in the elbow.
• The injury is from chronic overuse and more than 6 to 12 months of tendon rest and rehab haven't relieved elbow pain. (If the tendon is very weak, surgery may not improve your situation much.)
• Pain continues despite other treatment.
• You have had a corticosteroid shot and it hasn't helped.

In as many as 9 out of 10 people who have tennis elbow, symptoms go away and the people can return to their normal activities whether they have had surgery or not.³