Tennis elbow (lateral epicondylitis) is a painful condition caused by chronic inflammation of the tendons in the elbow. It’s a common condition among people who play sports like tennis, racquetball, or golf, but it can also result from on-the-job repetitive motions. For example, tennis elbow is common in assembly-line workers, carpenters, and other workers who repeat movements for long periods. Elbow joint pain is the most frequent symptom, but tennis elbow can also result in burning pain that goes all the way down the arm to the hand and affects grip strength and range of motion.
To diagnose tennis elbow, we start by asking questions about your symptoms, medical history, and life—what daily activities do you typically perform that might result in elbow joint pain? Next, we’ll do an external examination and then tests, which might include an MRI, an X-ray, a CT scan, an ultrasound, or an electromyography (EMG).
With a confirmed diagnosis, we’ll create a treatment plan. Here are some non-surgical treatment options for tennis elbow.
At-Home Treatment for Tennis Elbow
At MOSH, we like to help our patients avoid surgery whenever we can. Tennis elbow is one of those injuries that may improve with behavior changes and simple steps you can do at home. We advise the least invasive treatments first to try to avoid the need for surgery. Here are treatments we try first.
Protect the area from further injury.
Rest the injured arm. Taking a break from activities that bring on or worsen the pain allows time for the injury to heal. Sometimes a short respite period is enough to ease off the inflammation and pain caused by tennis elbow. Don’t stop movement altogether, though. Gentle stretches and mindful exercises will encourage healing more than not moving at all. Range-of-motion movements should remain pain-free. Basic isometric contractions of the muscles and joints surrounding the injured area will further promote healing. Gentle exercises cause the elbow joint muscles to contract without moving the joint to avoid causing more stress or additional pain to the injury while strengthening the muscles.
Ice applied to the injured area (also known as cryotherapy) minimizes and reduces swelling and pain. It’s important to place a layer of paper towel or cloth between the ice and the skin to protect the skin from extreme cold. Limit the use of ice packs to 10-15 minutes at a time. Reapply the ice pack after an hour or two for another 10-15 minutes. Repeat this cycle as necessary for pain relief and swelling control.
Compress the area using a clean bandage or compression wrap. Compressing the injured area provides support and helps reduce swelling. Use a medium tension—the bandage shouldn’t be loose enough to sag or shift but shouldn’t cause tingling, numbness, or a change of skin color. Start by applying the bandage a few inches below the injured area. Then, continue wrapping in a spiral or figure-of-8 manner until a couple of inches above the injury. The compress should be loosened or removed for sleeping and reapplied once the injured person is awake.
Elevate the injury above heart level to reduce swelling and reduce pooling of blood and fluids near the injury.
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs)
Over-the-counter NSAIDs like ibuprofen are commonly used to relieve pain and reduce inflammation, which can help reduce the physical distress caused by tennis elbow. In addition, they can be effective for treating the symptoms of chronic inflammatory conditions. Always follow the directions regarding any medications; overuse of OTC medications can be dangerous. If the recommended dose does not relieve your pain, call your doctor.
Wear a Brace
A counterforce brace prevents you from twisting your wrist, which lessens the stress on the injured elbow.
Non-Surgical Medical Treatments for Tennis Elbow
Tennis elbow usually heals without further intervention. If at-home treatment for tennis elbow doesn’t help or makes the pain worse, your doctor might decide it’s time to escalate to the subsequent non-surgical treatment for tennis elbow, which may include PT, injections, or ultrasound.
Physical Therapy (PT)
Physical therapy is the next step to recovery from persistent elbow pain. A physical therapist teaches you specific exercises to strengthen the muscles in your forearm and around your elbow.
Platelet Rich Plasma (PRP) Injection
High concentrations of platelets taken from the patient’s blood are injected directly into the injured elbow to stimulate healing. Studies have shown a 50-70 % success rate in patients whose recovery wasn’t satisfactory using traditional non-surgical treatments for tennis elbow (like basic at-home remedies).
Ultrasonic Tenotomy (TENEX Procedure)
Ultrasonic tenotomy involves using ultrasound to identify the precise areas in the elbow needing treatment, then treating the area with percutaneous ultrasound with a specific wavelength to resect and aspirate the damaged tissue. The treatment is performed under local anesthetic and takes around 10-15 minutes. It is a safe and effective treatment method for chronic tennis elbow that lasts for up to one year.
Around 80% of tennis elbow cases heal on their own without intervention. At MOSH, our orthopedic specialists will look at all the treatment options before deciding on the best treatment plan for you. Your health is our greatest concern, and we will explore every opportunity to help you recover without the need for surgery. If non-surgical treatments for tennis elbow fail, we’ll discuss surgical options to put you on the road to your recovery.