Tennis elbow is an overload of the tendons of the wrist extensor muscles where they attach to the lateral epicondyle of the humerus. It shows up as pain on the outer side of the elbow when gripping, lifting and twisting. It affects about 1–3% of adults, most often between the ages of 35 and 55, and tennis players make up only a small proportion of those affected.
Below we describe the symptoms, situations that require a doctor, the treatments with the best documented effect, 3 exercises with dosage and the role of physiotherapy.
In brief
- Tennis elbow affects about 1–3% of adults; in most people the symptoms resolve within about a year.
- The basis of treatment is modifying the load and exercise; a steroid injection gives short-term relief, but does worse in the longer term.
- Shockwave therapy costs PLN 100, with manual therapy PLN 200; TECAR PLN 150.
- Physiotherapy consultation: PLN 180, the clinic in Rydułtowy is open Mon–Fri 7:00–20:00.
- The clinic sees private patients only (not covered by NFZ, the Polish public health fund).
Contents
What are the symptoms of tennis elbow?
The main symptom is pain on the outer side of the elbow that gets worse when gripping objects, lifting a mug, opening jars, using a mouse and shaking hands. Pressing on the area of the lateral epicondyle is painful, as is straightening the wrist and middle finger against resistance. The pain may spread into the forearm, and grip strength is often clearly reduced.
The problem most often appears after a period of intensive work with the hands: renovation, gardening, computer work or work on a production line. The name is misleading – most people affected have never played tennis.
When should you see a doctor first about elbow pain?
It is worth seeing a doctor before physiotherapy if the elbow pain started after an injury or a fall, if the elbow is swollen, hot and red, if you cannot fully straighten or bend it, and also if you have numbness and tingling in your fingers, weakness in your hand, fever, or night pain with unintentional weight loss.
Numbness in the fingers may indicate nerve compression, and limited movement after an injury may indicate a fracture or joint damage. Elbow pain can also be referred from the cervical spine. You will find recommended specialists, including a neurologist, on the Recommended specialists page.
How is tennis elbow treated?
Treatment starts with reducing the loads that cause pain and gradual exercises that strengthen the forearm muscles. A counterforce strap, manual therapy and shockwave therapy are used as support. A steroid injection gives quick but short-lived relief, and in studies is associated with worse results after a year and a higher risk of recurrence than observation or physiotherapy.
Shockwave therapy may be considered when symptoms persist despite exercise; research results on its effectiveness are mixed, so it is treated as a complement to an exercise programme. At the clinic in Rydułtowy the physiotherapist chooses the type of treatments and the number of visits individually after the consultation. Surgery is considered by a doctor only if there is no improvement over a long period.
Shockwave therapyfor chronic overload of tendon attachments, after ruling out contraindications (including pregnancy and blood clotting disorders)100 PLN TECAR therapyfor pain and increased tension in the forearm muscles150 PLNPrices valid from 08.2026. You will find a comparison of the two treatments in our article TECAR or shockwave therapy.
Which exercises help with tennis elbow?
The best documented exercises are those that gradually strengthen the wrist extensors: first holding contractions without movement (isometrics), then slowly lowering a weight. They are done daily, accepting pain of up to 3–4 on a 0–10 scale that does not get worse the next day. The 3 exercises below are general in nature and do not replace a programme set after an examination.
- Isometric hold. Rest your forearm on a table with your hand palm down over the edge. Hold the back of your hand with your other hand and try to lift your wrist without moving it. 5 holds of 30 seconds, 1-minute break, once a day.
- Slow lowering. In the same position, hold a 0.5 l bottle of water. Use your other hand to help lift your wrist, then lower it slowly on its own over 3–4 seconds. 3 sets of 10–15 repetitions, once a day.
- Extensor stretch. Straighten your elbow, point your hand down and gently bend your wrist with your other hand. 3 times for 20 seconds, twice a day.
If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.
Good to know: when working at a computer, it helps to keep the mouse close to your body and to support your whole forearm on the desk.
We describe other joint pain in our guide joint pain and injuries.
Summary
Tennis elbow is an overload of the tendons at the lateral epicondyle, which resolves in most people, and the basis of treatment is modifying the load and strengthening exercises. Shockwave therapy (PLN 100) and TECAR (PLN 150) are a complement to exercise, not a replacement for it.
Frequently asked questions
How long does tennis elbow last?
How long tennis elbow lasts varies. In studies, most people’s symptoms ease considerably within about a year, even without specialist treatment, but in some they last longer. Regular exercise and reducing the load help to control the pain and return to work and activity.
Does a tennis elbow strap help?
A strap worn a few centimetres below the elbow can reduce pain when gripping and working, because it changes how forces are distributed at the tendon attachment. Some people feel noticeable relief, others only a little. The strap does not treat the cause, so it is worth using it together with exercise.
What is the difference between tennis elbow and golfer’s elbow?
Tennis elbow hurts on the outer side of the elbow and affects the muscles that extend the wrist. Golfer’s elbow hurts on the inner side and affects the muscles that bend the wrist. The overload mechanism and treatment principles are similar, but the exercises target a different muscle group. Both problems can occur at the same time.
Is shockwave therapy on the elbow painful?
During shockwave therapy you feel tapping and local tenderness, which is sometimes unpleasant. The physiotherapist sets the intensity so that it is bearable. After the treatment the area may be more sensitive for a while. Contraindications include pregnancy, blood clotting disorders and cancer in the treatment area.
Can I work at a computer with tennis elbow?
Usually yes, but it is worth changing how your workstation is set up: mouse close to your body, forearm supported on the desk, wrist in a neutral position. Frequent short breaks and switching hands for some tasks help. If work still makes the pain worse, it is worth discussing further workstation changes and the choice of exercises with a physiotherapist.
Do I need a referral to see a physiotherapist about tennis elbow?
For a private visit at the “W zdrowym ciele” clinic a referral is usually not required. The clinic has no contract with the NFZ (the Polish public health fund), and a consultation costs PLN 180. It is worth bringing elbow ultrasound results, if you have had one, and information about any previous injections and their dates.
Sources
- Coombes B.K. et al., Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia, JAMA, 2013.
- Bisset L. et al., Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow, BMJ, 2006.
- NICE Clinical Knowledge Summaries, Tennis elbow, updated.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish licence to practise as a physiotherapist). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
