April 26, 2026

Despite its name, tennis elbow (lateral epicondylalgia) affects far more non-tennis players than athletes. In the UK, it is estimated to affect 1–3% of the adult population at any one time — that’s around 600,000 to 1.8 million people. It’s one of the most common reasons for time off work in physically demanding jobs, and one of the most frequently injected conditions in musculoskeletal practice.

The frustrating truth? Up to 40% of cases don’t resolve with rest, ice, and over-the-counter pain relief alone. So what do you do when conservative treatment isn’t working?

1–3%UK adults affected at any time
40%Cases that don’t respond to rest alone
12 wksTypical NHS physiotherapy wait time in Norfolk

What Is Tennis Elbow?

Tennis elbow is inflammation and micro-tearing of the tendons that attach the forearm muscles to the bony prominence on the outer elbow (lateral epicondyle). It typically causes a burning or aching pain on the outer elbow, which worsens with gripping, lifting, typing, or twisting motions. In severe cases, even lifting a cup of tea becomes painful.

It is caused by repetitive overuse — common in manual workers, office workers who type extensively, gardeners, chefs, and yes — racquet sports players.

The Treatment Ladder

  • Step 1 (0–6 weeks): Rest, ice, ibuprofen gel, activity modification and a tennis elbow brace (counterforce strap)
  • Step 2 (6–12 weeks): Physiotherapy with eccentric strengthening exercises — shown to be the most effective conservative treatment
  • Step 3 (12+ weeks with no improvement): Steroid injection — targets inflammation at the tendon insertion directly
  • Step 4 (persistent cases): Further review, possible referral for ultrasound-guided injection or surgical assessment

The Evidence for Steroid Injections in Tennis Elbow

A Cochrane systematic review found that corticosteroid injections provide superior short-term pain relief (up to 8 weeks) compared to physiotherapy alone or watchful waiting, particularly in patients who have failed conservative management. Most patients report meaningful improvement within 1–2 weeks of injection.

Importantly, the injection is most effective when combined with a structured rehabilitation programme. Jon Gardner can advise on appropriate exercises and activity modification alongside the injection.

Don’t ignore it: Untreated tennis elbow that persists beyond 12 months becomes significantly harder to treat and may lead to chronic tendon degeneration (tendinopathy), which is far less responsive to injection. Early treatment saves long-term suffering.

What About Golfer’s Elbow?

Golfer’s elbow (medial epicondylalgia) is the same condition affecting the inner elbow. It is treated in the same way and responds equally well to steroid injection. Norfolk Health & Joint Care provides injections for both conditions, as well as other elbow tendinopathies.

Getting Seen Quickly in Norfolk

NHS physiotherapy waits in Norfolk can extend to 12 weeks or longer. If your tennis elbow has already not responded to home measures, waiting months more is not only painful — it may make the condition harder to treat. Norfolk Health & Joint Care offers same-week appointments in central Norwich, allowing rapid assessment and treatment.