How is Tennis Elbow Diagnosed?

An orthopaedic surgeon, sports medicine specialist, or physiotherapist diagnoses tennis elbow through a clinical examination. The diagnosis process of tennis elbow includes:

  • Medical history and physical examination

  • Assessment of tenderness over the lateral epicondyle

  • X-ray to rule out fractures or arthritis

  • Ultrasound to assess tendon

  • MRI if symptoms persist or tendon tears are suspected

How is Tennis Elbow Treated Based on Severity?

The following table outlines the treatment approaches for tennis elbow based on the severity:

Severity Symptoms Recommended Treatment
Mild Mild pain during gripping or lifting Rest, activity modification, ice therapy, physiotherapy and pain-relieving medicines
Moderate Persistent pain affecting daily activities Bracing, oral medications, physiotherapy, corticosteroid injection or PRP in selected patients
Severe Chronic pain, significant loss of strength and failure of conservative treatment Injection therapy (PRP or corticosteroid in selected patients), extracorporeal shock wave therapy (ESWT), or surgery

Stages of Tennis Elbow and Their Treatment

Various stages of tennis elbow, along with their usual treatment approach, are given in the table below:

Stage Characteristics Treatment
Early Stage Mild tendon injury with intermittent pain Rest, physiotherapy, ice packs, topical or oral medicines
Intermediate Stage Persistent tendon degeneration and reduced grip strength Physiotherapy, bracing, PRP or corticosteroid injection if required
Chronic Stage Symptoms lasting more than 6 - 12 months ESWT, PRP and surgery for selected patients who do not respond to conservative treatment

Topical Treatments for Tennis Elbow

Topical treatments aim to relieve symptoms rather than cure the condition. Various topical treatments for tennis elbow are the following:

    1. Topical NSAID Gels Topical diclofenac or similar anti-inflammatory gels help reduce pain and inflammation around the elbow.

    2. Pain Relief Sprays Topical pain-relieving sprays may provide temporary relief from mild discomfort.

    3. Cold Therapy Gels Cooling gels may help relieve pain after physical activity.

    4. Lidocaine Gel Lidocaine gel provides temporary local anaesthetic relief by numbing the painful area.

    5. Capsaicin Cream Capsaicin cream may help reduce chronic pain by decreasing the transmission of pain signals from nerves.

    6. Menthol-Based Pain Relief Gels Menthol-containing gels create a cooling sensation that temporarily relieves muscle and tendon discomfort.

Note: Topical treatments provide symptomatic relief but do not repair damaged tendons.

Other Treatments for Tennis Elbow

Various other treatments for tennis elbow are the following:

  1. Physiotherapy Physiotherapy is one of the most effective treatments for tennis elbow. It includes stretching exercises, eccentric strengthening exercises, manual therapy and progressive rehabilitation to improve tendon healing.

  2. Counterforce Brace A tennis elbow brace can help take pressure off the injured tendon during everyday tasks and while playing sports.

  3. Platelet-Rich Plasma (PRP) Therapy PRP therapy uses a sample of your own blood to create a concentrated mix of platelets, which is then injected into the injured tendon to help it heal. Doctors may suggest this treatment if your symptoms persist for a prolonged period and do not improve with other methods.

  4. Corticosteroid Injection Corticosteroid injections can give short-term pain relief for some people. However, doctors usually avoid giving these shots too often because they can make the tendon weaker over time.

  5. Extracorporeal Shock Wave Therapy (ESWT) ESWT uses sound waves to stimulate tendon healing and reduce pain in chronic tennis elbow.

  6. Dry Needling Dry needling may be used by trained specialists to stimulate healing in damaged tendon tissue.

  7. Surgery Doctors may suggest surgery if your symptoms last for 6 to 12 months and do not get better with other treatments. During surgery, the damaged tendon tissue is removed, and the healthy tendon is repaired.

Oral Medications for Tennis Elbow

Oral medicines can lower pain and swelling. Rehabilitation exercises help the tendon heal. Here are some common oral medicines for tennis elbow:

  • Paracetamol: Helps relieve mild to moderate pain.

  • Ibuprofen: Helps reduce pain and inflammation.

  • Naproxen: May be prescribed for short-term pain relief.

  • Etoricoxib: May be used in selected patients who cannot tolerate conventional NSAIDs.

  • Thiocolchicoside: Occasionally prescribed for associated muscle spasm.

Ayurvedic and Alternative Treatments for Tennis Elbow

Some complementary therapies may support symptom management for tennis elbow, but should not replace evidence-based treatment. But there is not much scientific evidence to support them.

Supportive options to manage tennis elbow include the following:

  • Ayurvedic therapies given by qualified AYUSH practitioners

  • Acupuncture

  • Therapeutic massage

  • Yoga can help improve flexibility and posture

  • Heat therapy during the recovery phase

Alternative therapies should be used with evidence-based treatments, not as a replacement.

Home Care for Managing Tennis Elbow

Here are some recommended home-care steps to manage tennis elbow:

  • Rest the affected arm.

  • Try to avoid gripping or lifting things repeatedly.

  • Use ice packs for 15 to 20 minutes at a time, several times a day, when you have pain.

  • Do the stretching and strengthening exercises your doctor or therapist recommends.

  • Wear a counterforce brace if your doctor suggests it.

  • Pay attention to your posture and ergonomics while working or playing sports.

  • Return gradually to sports or heavy work after symptoms improve.

  • Go back to your usual activities slowly once your symptoms get better.

How Long Does Tennis Elbow Treatment Take?

Treatments for tennis elbow and their approximate duration are given in the table below:

Treatment Approximate Duration
Mild cases with conservative treatment 6 - 12 weeks
Physiotherapy 6 - 12 weeks
Oral pain medications Several days to a few weeks
PRP therapy 1 - 3 sessions with recovery over several months
ESWT 3 - 5 treatment sessions
Recovery after surgery 3 - 6 months

Tennis Elbow Treatment Side Effects

Common side effects of tennis elbow treatment include:

  • Stomach irritation, nausea or indigestion due to NSAIDs

  • Injection-site pain, bruising or swelling

  • Temporary soreness after ESWT

  • Tendon weakening after repeated corticosteroid injections

  • Infection or stiffness after surgery (rare)

Lifestyle Changes for Managing Tennis Elbow

Lifestyle modifications that support recovery of tennis elbow include:

  • Avoid repetitive wrist movements.

  • Use proper lifting techniques.

  • Perform regular forearm strengthening exercises.

  • Warm up before sports.

  • Improve workplace ergonomics.

  • Take frequent breaks during repetitive activities.

  • Maintain a healthy body weight.

Triggers That Can Worsen Tennis Elbow Symptoms

Some common triggers that can worsen tennis elbow symptoms are:

  • Doing the same gripping motion over and over.

  • Lifting heavy objects.

  • Using poor technique during sports.

  • Having a workstation that is not set up correctly.

  • Bending your wrist back repeatedly.

  • Suddenly doing more physical activity than usual.

  • Inadequate rehabilitation.

  • Going back to sports before you are fully healed.

Tennis Elbow Treatment Cost in India

In India, the cost of treating tennis elbow depends on how severe your condition is and the treatment procedure chosen by your doctor. The average cost of treating tennis elbow is between ₹30,000 and ₹150,000. Basic options like doctor visits, medicines and physiotherapy usually range from ₹2,000 to ₹15,000. Surgery can cost between ₹50,000 and ₹200,000, depending on the hospital, the surgeon and the type of rehabilitation you need.

Does Health Insurance Cover Tennis Elbow Treatment in India?

In India, most health insurance plans cover hospital stays and surgery for tennis elbow if recommended by the doctor. They might also cover tests, surgery fees, anaesthesia, hospital room charges (up to policy limits) and care during your stay. Outpatient physiotherapy, PRP therapy, extracorporeal shock wave therapy (ESWT), braces and regular doctor visits are covered if your policy specifically offers OPD benefits. Coverage for physiotherapy and rehab after surgery can differ between insurers, so check your policy before starting treatment.

FAQs

  • Q1. Can tennis elbow heal without surgery?

    Ans: Yes. Most cases of tennis elbow improve with non-surgical treatments such as physiotherapy, activity modification, medications, and the use of an elbow brace.

  • Q2. Which treatment is most effective for tennis elbow?

    Ans: Physiotherapy combined with activity modification is the first-line treatment for tennis elbow. For persistent cases, treatments such as platelet-rich plasma (PRP) therapy or extracorporeal shock wave therapy (ESWT) may be recommended.

  • Q3. How long does tennis elbow treatment take?

    Ans: Most people notice improvement within 6 to 12 weeks of treatment. However, chronic cases may require several months for complete recovery.

  • Q4. Is PRP better than corticosteroid injections?

    Ans: PRP therapy may provide longer-lasting relief for some people, while corticosteroid injections usually offer faster pain relief that may not last as long.

  • Q5. When is surgery recommended for tennis elbow?

    Ans: Surgery is generally considered only if symptoms do not improve after 6 to 12 months of appropriate non-surgical treatment.

  • Q6. Which doctor should I consult for tennis elbow?

    Ans: You should consult an orthopaedic specialist, sports medicine physician, or physiotherapist for the diagnosis and treatment of tennis elbow.

  • Q7. Can physiotherapy cure tennis elbow?

    Ans: Yes. Physiotherapy is one of the most effective treatments for tennis elbow. Regular exercises help strengthen the tendons, reduce pain, and restore normal arm function.

  • Q8. Can tennis elbow recur after treatment?

    Ans: Yes. Tennis elbow can return if repetitive arm movements continue, rehabilitation exercises are stopped, or proper posture and technique are not maintained.

  • References

    • https://www.ckbhospital.com/treatment/tennis-elbow

    • https://www.ckbhospital.com/treatment/tennis-elbow-in-delhi

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