The most important part of treatment is tendon rest. Tennis elbow treatment works best when it starts as soon as symptoms appear. A long rest from the activity that caused the problem allows the small tears in the tendon to heal. You will probably feel better in a few weeks, but it may take 6 to 12 months for the tendon to heal. Surgery is a last resort if other treatment isn't helpful.

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.

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 cause your elbow pain.

Nonsurgical treatment

Nonsurgical 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.

This treatment includes:

• Reducing pain. You can use ice and over-the-counter medicines. Do this as soon as you notice the pain.
• Stopping or changing activities that may irritate the tendon.
• Using wrist and elbow splints
• Wearing a special counterforce brace.
• Rehabilitation (rehab). This can include exercise and other physical therapy.

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

You may need to work with an expert to see if 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, an occupational therapist, or a physical therapist can help with your workplace, including what tools you use, how your workspace is set up, and how you do your job.

Continued treatment

The longer you keep doing an activity that harms the tendon after tennis elbow symptoms start, 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 injection. This treatment is sometimes used when you still have pain after 6 to 8 weeks of rest and rehab. It may help relieve pain for a short time. But in the long term, having the steroid shot may not help any more than not having it. These steroid shots may be harmful to the tendon. But this is usually only a problem if you have many shots in the same year.
• Ultrasound therapy. It may help your tendon heal and stop pain.
• Surgery. But it's seldom used to treat tennis elbow.

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 surgery or not.

Other treatment choices

Other treatments may include:

• Acupuncture. Small studies report symptom relief after acupuncture treatment. But there isn't enough strong evidence to know if this treatment works or not.
• Extracorporeal shock wave therapy. A review of shock wave therapy for tennis elbow had conflicting findings. Some studies reported that it improved tennis elbow recovery. But others found that it offered no therapeutic benefit when compared to placebo treatment.
• Topical nitric oxide. A nitric oxide patch is applied to the elbow to speed recovery. This medicine has been used as a treatment for tennis elbow for a short time. One study showed positive results.
• Transcutaneous electrical nerve stimulation (TENS). TENS is sometimes used to treat tennis elbow, usually in a physical therapy setting.