Joint & Extremity
Tennis Elbow
Outer elbow pain — and the modern treatments that actually work.
Tennis elbow (medically: lateral epicondylitis) is a tendon problem on the outer side of the elbow, where the wrist extensors attach to the bone. Despite the name, most patients with it don't play tennis — it's just as common from any repetitive gripping or wrist motion. Most cases resolve with conservative care, but stubborn cases respond to PRP injections or, occasionally, surgery.
Understanding the Condition
What is Tennis Elbow?
The wrist extensor tendons (muscles that pull the wrist back) all share a common attachment at a small bony prominence on the outer elbow called the lateral epicondyle. Repetitive use causes microtears in this attachment that the body fails to fully heal. The result is a tendon that's degenerated rather than acutely inflamed — which is why classical anti-inflammatory treatments only work modestly.
Common Causes
- Repetitive wrist extension or gripping (work, sport, hobbies)
- Tennis (especially with a heavy racket or improper backhand technique)
- Painting, plumbing, carpentry, manual trades
- Sudden increase in workload or activity
- Age (most common in 40s–50s)
Common Symptoms
- Pain at the bony prominence on the outer elbow
- Pain with gripping, lifting, or shaking hands
- Weak grip strength
- Pain reaching for a coffee mug or door handle
- Tenderness directly over the lateral epicondyle
When to Seek Care
When Should You See a Specialist?
See a specialist for elbow pain that has persisted more than 4–6 weeks despite home treatment, weakness that limits work or daily activity, or any pain with associated numbness or tingling (which suggests a nerve component that needs different treatment).
Treatment Options
How We Treat Tennis Elbow
We always begin with the least invasive treatment that's likely to work for you. Surgery is reserved for cases where conservative care has been given a fair trial — or when the situation truly requires it.
Conservative (Non-Surgical) Care
- Activity modification (the hardest and most important step)
- Counterforce strap (forearm brace)
- Stretching and eccentric strengthening (Tyler Twist exercises)
- Anti-inflammatory medications
- Corticosteroid injections (short-term relief, mixed evidence for cure)
- Platelet-rich plasma (PRP) injections (best evidence for recalcitrant cases)
- Physical therapy with manual therapy and progressive loading
Surgical Options
- Open or arthroscopic lateral epicondyle debridement (for refractory cases)
- Tenotomy with TENEX procedure (minimally invasive ultrasonic debridement)
Recovery & Outlook
What to Expect After Treatment
About 80–90% of tennis elbow resolves with non-surgical treatment within 6–12 months. PRP has the best evidence for recalcitrant cases. The minority that need surgery do well — most return to full activity within 3–6 months of the procedure.
Tennis Elbow — Frequently Asked Questions
Related Conditions
You May Also Want to Read About
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Carpal Tunnel Syndrome
Compression of the median nerve in the wrist causing numbness, tingling, and weakness.
Sports Injuries
A wide range of athletic injuries from sprains and strains to fractures and dislocations.
Get Expert Help for Tennis Elbow
Our specialists can diagnose your condition and design a personalized treatment plan that gets you back to the life you love.