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Tennis Elbow: Should I Have Surgery?
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Tennis Elbow: Should I Have Surgery?
Get the facts
Your options
- Have surgery to treat tennis elbow.
- Try tendon rest and rehabilitation or other treatment.
Key points to remember
- Surgery to treat tennis elbow is usually done only when rest and rehabilitation don't work. If you still have elbow pain and stiffness after more than 6 to 12 months of rest and rehab, you might think about having surgery.
- Resting the tendon is important. With rest, rehabilitation, and sometimes steroid shots, tennis elbow usually heals in 6 to 12 months.
- Tennis elbow gets worse when you keep doing the activities that caused it. To keep pain from coming back after surgery or other treatment, you'll need to avoid the activity that caused tennis elbow or change the way you do it.
- There is more than one surgery for treating tennis elbow, but there is no proof that one works better than another.1
- Surgery may not cure tennis elbow.
What is tennis elbow?
Tennis elbow (lateral epicondylitis) is soreness or pain on the outside part of the elbow. You get symptoms when the tendon at the elbow is damaged.
Tennis elbow is caused by repeated twisting movements of the hand, wrist, or forearm during everyday activities, such as using a screwdriver or scissors, gardening, and playing sports.
Tennis elbow gets worse when you keep doing the activities that caused it.
What kind of surgery is done for tennis elbow?
Surgery for tennis elbow may involve:
- Cutting (releasing) the tendon.
- Removing inflamed tissue from the tendon.
- Fixing (reattaching) tendon tears if possible.
There is no proof that one kind of surgery works better than another, or that surgery is better than other treatment.1 Surgery may be done arthroscopically with a scope and a few small incisions, by open surgery through one large incision, or by more than one technique. The type of surgery will depend on the problem and which method the doctor prefers. Arthroscopy is not widely used.
What are the risks of tennis elbow surgery?
Tennis elbow surgery has some risks.
- You may not be able to completely straighten your arm.
- Surgery may not cure the problem. You may still have pain, or the pain may come back.
- There is a risk of infection, blood loss, and nerve damage (which are risks in all surgeries).
- There are also risks from general anesthesia, such as breathing problems.
Why might your doctor recommend tennis elbow surgery?
Surgery is usually done when there are large tears in the tendon from a sudden (acute) injury or if there is other severe damage to the elbow. Your doctor might recommend surgery if:
- You have elbow pain after more than 6 to 12 months of tendon rest and rehabilitation.
- You can't do your job or daily activities because of elbow pain.
- You have had steroid shots and still have elbow pain.
Compare your options
Compare
What is usually involved? |
| |
What are the benefits? |
| |
What are the risks and side effects? |
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- You may stay overnight in the hospital, depending on the type of surgery you have.
- Recovery takes 3 to 6 months.
- After surgery, you'll do rehabilitation exercises to restore flexibility and strength in the arm.
- Studies have not shown that surgery for tennis elbow is better than other treatment. But some people have less pain after surgery. So they are able to do more with their affected arms and hands. You may want to talk to your doctor about surgery if you still have pain that keeps you from doing your normal activities after 6 to 12 months of other treatment.
- You may not be able to completely straighten your arm.
- Surgery may not cure the problem.
- To keep pain from coming back after surgery, you'll need to avoid the activity that caused tennis elbow or change the way you do it.
- All surgery has risks, including bleeding, infection, nerve damage, and risks of anesthesia. Your age and your health can also affect your risk.
- You rest your tendon for weeks or months and avoid activities that cause pain.
- You do warm-up, stretching, and strengthening exercises. You may wear a brace or strap.
- You may have medicine or steroid shots to help relieve pain.
- With rest and rehabilitation, it may take 6 to 12 months to heal tennis elbow. The pain can last 2 years or more.
- You may relieve pain and stiffness without surgery.
- You avoid the risks of surgery.
- Rest and rehabilitation may not relieve your pain.
- You may have to limit your activities because of elbow pain.
- To keep pain from coming back after rest and rehabilitation, you'll need to avoid the activity that caused tennis elbow or change the way you do it.
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about tennis elbow treatment decisions
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I have seen a few of my tennis buddies go for months with elbow pain. They try to play through it, and it just doesn't seem to go away. I just started feeling this kind of pain, and I'm going to try to nip it in the bud by taking a complete break from tennis for a couple of months.
Joe, age 42
I can't stand it any longer. Last year, I raked leaves for hours and developed a nice case of tennis elbow. Even though I've spent the entire past 11 months avoiding things that make my arm hurt and have been doing exercises, it still hurts when I try to do simple things like sweep the floor. I'm going to talk to the surgeon my doctor has recommended.
Lara, age 57
I use scissors all day at work, and it has become so painful to cut anything now! I can't leave my job, so my boss and I have worked things out so I can work the cash register and stock instead. I still have to be careful, but the strap my doctor told me to wear below my elbow is helping a lot.
Sophia, age 39
I've had tennis elbow pain for years. It comes and goes, and lately has been more constant. My doctor says that I'm a good candidate for surgery, but I need to see more solid evidence that surgery will work. I'm going to see a physical therapist and look into some other possibilities like acupuncture.
Ramon, age 46
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery to treat tennis elbow
Reasons to try other treatment
I've tried tendon rest and rehabilitation, and they haven't worked.
I haven't yet tried resting the tendon.
My tendon pain gets in the way of daily activities.
I can do daily activities without too much pain.
I've tried steroid shots, and they haven't helped.
I haven't yet tried steroid shots.
I can accept the risks of surgery if it means getting rid of my tendon pain.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
Trying other treatment
What else do you need to make your decision?
Check the facts
Is surgery the only way to treat tennis elbow?
- YesSorry, that's not right. Surgery often isn't needed. With tendon rest, rehabilitation, and sometimes steroid shots, most people with tennis elbow heal within a year.
- NoYou are right. Surgery often isn't needed. With tendon rest, rehabilitation, and sometimes steroid shots, most people with tennis elbow heal within a year.
- I'm not sureIt might help to go back and read "What is usually involved?" in the "Compare your options" chart. With tendon rest, rehabilitation, and sometimes steroid shots, most people with tennis elbow heal within a year.
Will surgery always cure tennis elbow?
- YesSorry, that's not right. Surgery may not cure tennis elbow.
- NoYou're right. Surgery may not cure tennis elbow.
- I'm not sureIt may help to go back and read, "What are the risks and side effects?" in the "Compare your options" chart. Surgery may not cure tennis elbow.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
Certainty
How sure do you feel right now about your decision?
Check what you need to do before you make this decision.
Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Your decision
Next steps
Which way you're leaning
How sure you are
Your comments
Your knowledge of the facts
Key concepts that you understood
Key concepts that may need review
Getting ready to act
Patient choices
Credits and References
| Credits | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
| Specialist Medical Reviewer | David Bardana, MD, FRCSC - Orthopedic Surgery, Sports Medicine |
Tennis Elbow: Should I Have Surgery?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the facts
Your options
- Have surgery to treat tennis elbow.
- Try tendon rest and rehabilitation or other treatment.
Key points to remember
- Surgery to treat tennis elbow is usually done only when rest and rehabilitation don't work. If you still have elbow pain and stiffness after more than 6 to 12 months of rest and rehab, you might think about having surgery.
- Resting the tendon is important. With rest, rehabilitation, and sometimes steroid shots, tennis elbow usually heals in 6 to 12 months.
- Tennis elbow gets worse when you keep doing the activities that caused it. To keep pain from coming back after surgery or other treatment, you'll need to avoid the activity that caused tennis elbow or change the way you do it.
- There is more than one surgery for treating tennis elbow, but there is no proof that one works better than another.1
- Surgery may not cure tennis elbow.
What is tennis elbow?
Tennis elbow (lateral epicondylitis) is soreness or pain on the outside part of the elbow. You get symptoms when the tendon at the elbow is damaged.
Tennis elbow is caused by repeated twisting movements of the hand, wrist, or forearm during everyday activities, such as using a screwdriver or scissors, gardening, and playing sports.
Tennis elbow gets worse when you keep doing the activities that caused it.
What kind of surgery is done for tennis elbow?
Surgery for tennis elbow may involve:
- Cutting (releasing) the tendon.
- Removing inflamed tissue from the tendon.
- Fixing (reattaching) tendon tears if possible.
There is no proof that one kind of surgery works better than another, or that surgery is better than other treatment.1 Surgery may be done arthroscopically with a scope and a few small incisions, by open surgery through one large incision, or by more than one technique. The type of surgery will depend on the problem and which method the doctor prefers. Arthroscopy is not widely used.
What are the risks of tennis elbow surgery?
Tennis elbow surgery has some risks.
- You may not be able to completely straighten your arm.
- Surgery may not cure the problem. You may still have pain, or the pain may come back.
- There is a risk of infection, blood loss, and nerve damage (which are risks in all surgeries).
- There are also risks from general anesthesia, such as breathing problems.
Why might your doctor recommend tennis elbow surgery?
Surgery is usually done when there are large tears in the tendon from a sudden (acute) injury or if there is other severe damage to the elbow. Your doctor might recommend surgery if:
- You have elbow pain after more than 6 to 12 months of tendon rest and rehabilitation.
- You can't do your job or daily activities because of elbow pain.
- You have had steroid shots and still have elbow pain.
2. Compare your options
| Have surgery to treat tennis elbow | Try tendon rest and rehabilitation | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
Personal stories about tennis elbow treatment decisions
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I have seen a few of my tennis buddies go for months with elbow pain. They try to play through it, and it just doesn't seem to go away. I just started feeling this kind of pain, and I'm going to try to nip it in the bud by taking a complete break from tennis for a couple of months."
— Joe, age 42
"I can't stand it any longer. Last year, I raked leaves for hours and developed a nice case of tennis elbow. Even though I've spent the entire past 11 months avoiding things that make my arm hurt and have been doing exercises, it still hurts when I try to do simple things like sweep the floor. I'm going to talk to the surgeon my doctor has recommended."
— Lara, age 57
"I use scissors all day at work, and it has become so painful to cut anything now! I can't leave my job, so my boss and I have worked things out so I can work the cash register and stock instead. I still have to be careful, but the strap my doctor told me to wear below my elbow is helping a lot."
— Sophia, age 39
"I've had tennis elbow pain for years. It comes and goes, and lately has been more constant. My doctor says that I'm a good candidate for surgery, but I need to see more solid evidence that surgery will work. I'm going to see a physical therapist and look into some other possibilities like acupuncture."
— Ramon, age 46
3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have surgery to treat tennis elbow
Reasons to try other treatment
I've tried tendon rest and rehabilitation, and they haven't worked.
I haven't yet tried resting the tendon.
My tendon pain gets in the way of daily activities.
I can do daily activities without too much pain.
I've tried steroid shots, and they haven't helped.
I haven't yet tried steroid shots.
I can accept the risks of surgery if it means getting rid of my tendon pain.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
Trying other treatment
5. What else do you need to make your decision?
Check the facts
1. Is surgery the only way to treat tennis elbow?
- Yes
- No
- I'm not sure
2. Will surgery always cure tennis elbow?
- Yes
- No
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | William H. Blahd, Jr., MD, FACEP - Emergency Medicine |
| Specialist Medical Reviewer | David Bardana, MD, FRCSC - Orthopedic Surgery, Sports Medicine |
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Last Revised: January 21, 2011
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