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Columbia Orthopedics Services

Diagnosis & Treatment

Tennis Elbow

Find a tennis elbow specialist

How is Tennis Elbow Diagnosed?

Diagnosis

To diagnose tennis elbow, your doctor will ask you about your symptoms, your daily activities, and your general medical history. They will conduct a physical exam in which they’ll press gently on the area where tendons attach muscle to your elbow and ask you to move your elbow, wrist, and fingers in various ways.

Further tests that can confirm a tennis elbow diagnosis and rule out other causes of pain include:

  • X-rays to check for arthritis of the elbow
  • MRI scans to check for damage in the tendon and other injuries
  • EMG (electromyography) to check for nerve compression
  • Arthroscopy, a surgical procedure using a scope to examine bone surfaces and soft tissues
  • Bone scan to check for stress fractures, disease, or infection

How is Tennis Elbow Treated?

Treatments

Tennis elbow often heals on its own if you start home treatment as soon as you notice symptoms. The longer you continue doing the activity that causes discomfort, the longer tennis elbow will take to heal. If the pain continues, your doctor may recommend physical therapy or, as a last resort, tennis elbow surgery.

Follow these steps to help relieve your tennis elbow symptoms:

  • Rest your arm and hand and avoid activities that worsen the pain for at least two or three weeks
  • Use ice or cold packs on the sore area several times a day for 10 to 15 minutes at a time. If a warm compress or hot bath provides more effective pain relief, use that instead
  • Take an over-the-counter pain reliever such as ibuprofen or naproxen (NSAIDs), or acetaminophen. Be sure to follow the instructions on the label
  • Try a counterforce brace, which wraps around the forearm and relieves pressure on the muscles
  • If the injury is from a sport, consider whether changes to your equipment or technique may help
  • If your symptoms are caused by working on the computer, get advice on how to change your workstation

Therapy

After two weeks of home tennis elbow treatment, if you still have soreness or pain when grasping, twisting, or lifting objects, your doctor may recommend treatment by a physical therapist. A physical therapist can teach you how to modify activities and improve overall fitness to avoid pain. Physical therapists also use:

  • Massage to improve mobility by reducing tightness in soft tissue and joints
  • Passive exercises during which the therapist gently moves your wrist and elbow
  • Active exercises that you perform yourself, including tennis elbow stretches, to improve flexibility, arm muscle strength, and range of motion

Procedures

For severe and long-lasting tennis elbow pain, your doctor may suggest:

  • Injections if pain persists after six to eight weeks of rest and physical therapy.  Ultimately, injections may help with pain and inflammation, but if the underlying overuse mechanisms aren’t addressed and reduced/eliminated, the pain will return
  • Ultrasound therapy may help the tendon heal
  • Surgery if pain continues after six to 12 months of tendon rest and rehabilitation, and if pain interferes with daily activities and work

FAQs

Healing time for tennis elbow depends on the injury. Mild soreness usually heals in a few weeks with rest. For severe injury, it can take six to 12 months or longer for the tendon to heal and for pain to go away completely. Your doctor can give you the best advice for your individual case.

Try sleeping on your back with the affected arm by your side and supported by a pillow. Using a heating pad on the sore area before going to sleep may also help relieve pain.

Taping should be applied so that the tape ‘pulls’ on the musculature back towards the bone on the elbow, where the pain is at its worst. The idea is that, by pulling, the tape helps create some slack so the tendon can relax. Counterforce bracing may also help.

One recommended tennis elbow stretch is the wrist flexor stretch, in which you extend the affected arm in front of you, palm up, and use the other hand to gently bend your wrist and pull the fingers toward the floor. Hold the stretch for 15 seconds.

Wearing a brace for a few weeks may relieve soreness and help a mild injury heal. If you still have pain after two to three weeks, consult your doctor for advice on further treatment.

Get Care

Trust NewYork-Presbyterian for Tennis Elbow Treatment

Understanding your symptoms and the causes behind them is key to recovery. Schedule an appointment with an experienced orthopedic specialist at NewYork-Presbyterian to have your tennis elbow symptoms evaluated.