What is tennis elbow?
Tennis elbow, or lateral epicondylitis, is pain over the bony prominence on the outside of the elbow where the tendons that extend the wrist and fingers attach. Repetitive gripping and lifting overload these tendons, causing small areas of degeneration rather than true inflammation. Despite the name, fewer than one in ten cases relate to racquet sports; manual work, keyboard and mouse use, DIY and lifting are the usual culprits. It most often affects people between 35 and 55 and is equally common in men and women.
Diagnosis is clinical: tenderness over the outer elbow and pain on resisted wrist extension are characteristic. Ultrasound or MRI is only needed when the diagnosis is in doubt or symptoms fail to settle, and occasionally to rule out nerve entrapment or joint problems.
Common symptoms
- Pain over the outside of the elbow
- Pain gripping, shaking hands or turning a door handle
- Aching that spreads down the forearm
- Weakness of grip
- Pain lifting a kettle or a full cup
- Stiffness in the morning or after activity
How long will you wait?
Most tennis elbow is managed by GPs and physiotherapy, and routine NHS referral to a specialist for persistent cases typically takes a few months, consistent with a national median wait of 12.4 weeks and around 34% waiting over 18 weeks.
Privately, you can typically see a specialist within 3–7 days, with physiotherapy, shockwave or an injection usually underway within 1–2 weeks.
NHS England median referral-to-treatment wait: 12.4 weeks, with 2.5 million people waiting over 18 weeks (May 2026). Individual waits vary by trust and urgency.
Treatment options
- Load management and ergonomics. Adjusting aggravating tasks, grips and workstation setup takes strain off the tendon while it recovers.
- Physiotherapy and strengthening. Progressive forearm-strengthening exercises are the most reliable route to lasting recovery.
- Bracing. A counterforce brace worn just below the elbow can reduce pain during unavoidable gripping tasks.
- Shockwave therapy or injection. Shockwave can help persistent cases; steroid injections give short-term relief but poorer long-term results, so are used selectively.
- Surgery. Release or debridement of the tendon origin is reserved for the small minority still limited after a year of thorough non-surgical care.
What does private treatment cost?
As a guide, a private guided injection typically costs around £300–£600, shockwave therapy around £250–£400 per session, and surgery for resistant cases around £3,500–£5,500.
Does health insurance cover tennis elbow?
Tennis elbow arising after your policy starts is normally covered, including specialist consultations, physiotherapy, imaging and injections, with surgery covered in the uncommon cases that need it. Symptoms that pre-date the policy are usually excluded as pre-existing. Some insurers direct musculoskeletal claims through a physiotherapy triage service first, which suits this condition well since exercise-based treatment is first line.
Frequently asked questions
How long does tennis elbow last?
It is often a stubborn condition: most cases resolve, but recovery commonly takes six months to a year, occasionally longer. The encouraging news is that around nine in ten people recover without surgery. Active treatment with progressive strengthening tends to shorten the course and reduces the chance of recurrence compared with simply resting and waiting.
Should I have a steroid injection for tennis elbow?
Usually not as a first step. Steroid injections often give impressive relief for a few weeks, but trials show outcomes at one year are no better, and sometimes worse, than exercise therapy, with higher recurrence. They still have a role when severe pain is preventing you doing rehabilitation, ideally as a bridge into a strengthening programme rather than a stand-alone fix.
Can I keep working with tennis elbow?
Almost always, with adjustments. Complete rest rarely helps, and staying active within tolerable pain is part of recovery. Practical changes make the difference: lifting with the palm up, using two hands, taking micro-breaks from repetitive gripping, adjusting mouse and keyboard position, and using a counterforce brace for heavier tasks while the tendon strengthens.