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Tennis Elbow (Lateral Epicondylitis)

Tennis elbow is an overuse problem of the forearm tendons on the outside of the elbow, and it usually settles over weeks to months with activity changes and the right exercises. A sudden pop with loss of function, a hot swollen joint with fever, spreading numbness or pain after a major injury needs care right away.

Get urgent or emergency care right away if:

  • You feel or hear a sudden pop or snap, followed by sudden severe pain, weakness or loss of use of the arm. The NHS says sudden severe pain during an accident or activity, with a popping or snapping sound, can mean a torn (ruptured) tendon, and to get urgent help (NHS). At the elbow, a torn biceps tendon often comes with a pop, bruising and weakness in bending the elbow or turning the forearm palm-up, and repair works best in the first 2 to 3 weeks (AAOS OrthoInfo). MBHA suggests going to urgent care or an emergency room the same day.
  • The elbow (or any joint) is hot, red and swollen and you have a fever, or feel hot, cold or shivery. The NHS says sudden severe joint pain, trouble moving the joint, and hot, swollen or red skin over it can be septic arthritis, a serious joint infection that needs urgent help and usually hospital treatment (NHS).
  • You have pain after a fall, accident or other major injury, especially if the arm is very painful, badly swollen, hard to move, bent or twisted, or numb. These can be signs of a broken bone, and the NHS says a numb or tingling arm after an injury, a bone through the skin, or an arm at an odd angle means emergency care, without driving yourself (NHS). See our elbow guide.
  • Numbness, tingling or pins and needles in the arm or hand is new, spreading or comes with weakness. Nerve squeezing around the elbow can cause symptoms similar to tennis elbow (AAOS OrthoInfo), and a nerve squeezed for a long time can lead to muscle wasting in the hand that cannot be reversed (AAOS OrthoInfo). Call 911 for sudden numbness or weakness, especially on one side of the body, with a drooping face, trouble speaking or trouble seeing, which can be a stroke (NHLBI); see our stroke guide.

Don’t wait for a chiropractic, acupuncture or massage appointment, or try a brace or home remedy first, if you have any of these signs.

What is tennis elbow?

Tennis elbow, or lateral epicondylitis, is a painful overuse condition. The AAOS describes wearing down (degeneration) or, in some cases, tiny tears (microtearing) in the tendons that join the forearm muscles to the outside of the elbow, built up by repeating the same motions again and again (AAOS OrthoInfo). The NHS puts it more simply: the tendons in your elbow become inflamed (NHS). MedlinePlus says tendinitis is a common cause of elbow pain, often from tennis or golf but also from overuse (MedlinePlus). Researchers also say tendinopathy, a term for a tendon problem marked by pain, loss of function and changes inside the tendon (Millar et al., 2021); studies often call tennis elbow “lateral elbow tendinopathy.” We return to these words in the tendonitis section, and to the inner-elbow version in the golfer’s elbow section.

Who gets it?

You do not have to play tennis. The AAOS says painters, plumbers and carpenters are particularly prone to it, and that auto workers, cooks and even butchers get it more often than the rest of the population (AAOS OrthoInfo). The NHS lists computer work, sewing or using a screwdriver, and playing tennis or a musical instrument (NHS). Most people who get it are between 30 and 50 (AAOS OrthoInfo); the NHS says 35 to 54 (NHS). In a Finnish study of people aged 30 to 64, 1.3% had definite tennis elbow, men and women were equally affected, and current and former smokers were more likely to have it (Shiri et al., 2006).

What does it feel like?

The AAOS lists pain or burning on the outer elbow, a weak grip, and sometimes pain at night. Symptoms come on gradually, usually mild at first and slowly worsening over weeks and months, often with no specific injury, and are worse with forearm activity such as holding a racquet, turning a wrench or shaking hands (AAOS OrthoInfo). The NHS adds that pain can range from mild discomfort to constant pain that affects sleep, and that you may notice tenderness or swelling, forearm pain or trouble fully straightening the arm (NHS).

What else can feel like it, and how is it diagnosed?

Your doctor will ask how symptoms developed and about work and sports, press on the bony bump on the outside of the elbow, and may ask you to straighten your wrist and fingers against resistance. Tests are used to rule out other causes: X-rays for elbow arthritis, an MRI of the neck for a herniated disk or arthritic changes that can cause arm pain, and a nerve test (EMG) for nerve compression, which has symptoms similar to tennis elbow (AAOS OrthoInfo). Pain on the inside of the elbow points toward golfer’s elbow (below). Our elbow guide covers other elbow problems and our neck guide covers neck-related arm pain.

How long does it last?

The NHS says tennis elbow usually goes away with rest but can sometimes last over a year (NHS), and the AAOS reports that approximately 80 to 95% of patients succeed with nonsurgical treatment (AAOS OrthoInfo). In a Dutch trial, 83% of people who simply followed a wait-and-see policy had a successful outcome at 52 weeks (Smidt et al., 2002). A 2024 analysis of 13 trials concluded that patients should be told there is currently no strong evidence that any treatment produces faster pain improvement than control or placebo in the short and medium term (Network meta-analysis, 2024). That is not the same as saying nothing helps, but it is a reason to be patient and wary of anyone promising a quick fix.

When to see a provider (not an emergency): the NHS says to see a doctor (a GP, in the UK) if you still have elbow pain after resting the elbow and trying self-care for at least 2 weeks, and that physiotherapy may help if symptoms have not improved after 6 weeks of home treatment (NHS).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Activity changes and relative rest, a forearm strap or brace, pain relievers by class (including anti-inflammatory gel), physical therapy with strengthening exercise, and selectively injections, shock wave or surgery. Medicare Part B covers medically necessary outpatient physical therapy (20% of the approved amount after the deductible). A basic self-pay cortisone shot runs about $100 to $500, per The Pricer. Other costs: being researched. Most cases improve without surgery, though it can take months. Steroid shots help for a few weeks but did worse than placebo or physiotherapy at one year in trials. Cochrane found little benefit from PRP and shock wave.
Chiropractic Elbow, wrist or spine mobilization or manipulation, soft-tissue work and exercise advice — never on a fresh injury, a deformed elbow or a hot swollen joint. About $55 to $100 for a self-pay follow-up visit and $90 to $200 for a first visit, per The Pricer. Medicare covers only spinal adjustments for a subluxation. Low-certainty evidence: a 2024 Cochrane review found manual therapy and exercise may slightly reduce pain at the end of treatment, but not lastingly. Most trials were done by physiotherapists.
Acupuncture Fine needles or dry needling of the forearm and elbow, alongside exercise and activity changes. About $90 to $185 per follow-up visit, per The Pricer; dry needling about $45 to $100 per session. Medicare covers acupuncture only for chronic low back pain. An older Cochrane review found too little evidence either way. Newer reviews of dry needling and acupuncture report short-term benefits, but the evidence is low in certainty.
Herbal medicine No herb or supplement is proven for tennis elbow. Anti-inflammatory gels (a medicine, not an herb), arnica gel and turmeric are covered below. Cost estimate being researched. We found little research on herbs for tennis elbow. One trial found a fatty acid supplement added nothing to exercise. Check every product with a pharmacist if you take a blood thinner or NSAID.
Massage therapy Soft-tissue work on the forearm muscles, including friction massage and myofascial release, usually as part of an exercise plan. One national chain: about $125 to $160 for a 60-minute massage for non-members and about $65 to $90 for members, per The Pricer. Medicare does not cover massage. Friction massage showed no clear benefit in two small trials. One review found myofascial release helped compared with sham ultrasound. Best as one part of a plan, not the whole plan.
MBHA Wellness Coach Workstation, grip and tool set-up, sport equipment and technique, pacing your return to activity, sticking with your exercises, warm-ups, and quitting tobacco. Cost estimate being researched. Supports — never replaces — medical care. Reducing the forearm twisting and strain that started the problem is the most direct way to keep it from coming back.

Approach 1 of 6

Conventional medicine (AMA)

Tennis elbow is usually treated without surgery first. The AAOS describes a team approach, in which primary care doctors, physical or occupational therapists and, in some cases, surgeons work together (AAOS OrthoInfo).

1. Activity changes and relative rest

The AAOS says the first step is to stop or decrease sports, heavy work and other activities that cause painful symptoms for several weeks (AAOS OrthoInfo). The NHS advises avoiding or reducing activities that make symptoms worse, a hot or cold pack (or a bag of frozen peas) wrapped in a towel for up to 20 minutes every 2 to 3 hours, and simple exercises such as bending and straightening the arm (NHS). Its general advice for repetitive strain injury adds that you should not rest the area for more than a few days, because resting too long can leave it weaker and less flexible (NHS). The aim is to cut back what hurts, not to stop using the arm.

2. Pain relievers (by class)

We don’t list doses; ask your doctor or pharmacist what is safe for you.

3. A forearm strap or brace

The AAOS says a brace centered over the back of the forearm may help by resting the muscles and tendons (AAOS OrthoInfo), and the NHS says you can buy a forearm strap or a wrist or elbow brace at a pharmacy (NHS). The research is thin: a Cochrane review of five small trials could draw no definitive conclusions (Struijs et al., Cochrane, 2002), and a later review also called the evidence for an elbow brace inconclusive (Ontario review, 2017).

4. Physical therapy and strengthening exercise

The AAOS says specific exercises help strengthen the forearm muscles, and a therapist may also use ultrasound, ice massage or muscle-stimulating techniques (AAOS OrthoInfo). The NHS suggests physiotherapy after 6 weeks of home treatment, which may include massage, stretching and strengthening exercises for the wrist and forearm, and ultrasound therapy (NHS). The AAOS has a patient handout of a therapeutic exercise program and says to do it under your doctor’s supervision (AAOS OrthoInfo). What do studies say?

5. Steroid injections: quick relief, worse results later

A steroid (cortisone) shot can relieve tennis elbow pain, but the AAOS says it should be used very sparingly, because excessive use can weaken the part of the bone where the tendon attaches (AAOS OrthoInfo). Its general cortisone-shot page adds that a shot should generally not be used for tendinitis because it can raise the chance of a tendon rupture, especially in the biceps, patellar and Achilles tendons, and that pain may flare for 1 to 2 days first (AAOS OrthoInfo). The research pattern is consistent:

  • A 2010 review of 41 trials found steroid injections had a large short-term effect on lateral elbow pain compared with no treatment, but at the intermediate and long-term points no treatment came out ahead (Coombes et al., 2010).
  • In a trial of 185 people, success at 6 weeks was 92% with injections, 47% with physiotherapy and 32% with wait-and-see; by 52 weeks it was 69%, 91% and 83% (Smidt et al., 2002). In a second trial, 47 of 65 early injection successes later regressed (Bisset et al., 2006).
  • In a placebo-controlled trial of 165 people, 83% of those given a steroid injection had recovered or much improved at one year, compared with 96% given a placebo injection, and 54% versus 12% had a recurrence (Coombes et al., 2013).

If you are offered a shot, ask how it fits with an exercise plan and what to expect after a few weeks.

6. Platelet-rich plasma (PRP) and shock wave

PRP uses platelets from a sample of your own blood, injected into the area. The AAOS says some studies were inconclusive and others promising (AAOS OrthoInfo). A 2021 Cochrane review of 32 studies found PRP or blood injections probably give no clinically significant benefit over a placebo injection at three months, and concluded the evidence does not support their use (Karjalainen et al., Cochrane, 2021). Not every review agrees: a 2023 umbrella review said PRP and autologous blood were most effective in the long term, but urged caution (Umbrella review, 2023).

Shock wave therapy sends sound waves to the elbow. The AAOS says many doctors consider it experimental, though some sources show it can be effective (AAOS OrthoInfo). A 2005 Cochrane review of nine placebo-controlled trials concluded it gives little or no benefit (Buchbinder et al., Cochrane, 2005). A 2020 analysis of nine trials found it did not significantly reduce average pain compared with placebo, though more people reached a 50% pain reduction (Shock wave meta-analysis, 2020), and a 2026 review of 11 trials, only four at low risk of bias, called the evidence inconclusive (Shock wave review, 2026).

7. Surgery (uncommon)

Surgery may be considered if symptoms do not respond after 6 to 12 months of nonsurgical care (AAOS OrthoInfo, NHS). Most operations remove diseased tendon and reattach healthy tendon to bone. The AAOS lists infection, nerve and blood vessel damage, prolonged rehabilitation, loss of strength and flexibility, and the need for further surgery as risks; it is considered successful in 80 to 90% of patients, though some lose strength, and return to athletic activity is usually 4 to 6 months afterward (AAOS OrthoInfo). A Cochrane review found only five small trials, all highly susceptible to bias, and could neither support nor refute surgery (Buchbinder et al., Cochrane, 2011).

What it costs

  • Physical therapy: cost estimate being researched. Medicare Part B covers medically necessary outpatient physical therapy when your provider certifies you need it; after the Part B deductible you pay 20% of the Medicare-approved amount (Medicare.gov).
  • Cortisone shot: The Pricer says a basic self-pay injection in a medical office usually costs $100 to $500, and the appointment total can reach $300 to $1,000 or more when the exam, procedure, medicine, imaging and facility fee are billed separately (The Pricer).
  • Office visits, braces, imaging, PRP, shock wave and surgery: MBHA cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Some chiropractors treat tennis elbow with hands-on techniques at the elbow, wrist, upper back or neck, soft-tissue work, and advice about exercise and activities. The research on manual therapy for tennis elbow is real but modest, and most of it was done by physiotherapists rather than chiropractors.

What the research says

  • Cochrane review (2024): 23 trials, 1,612 people. One small trial (23 people) found manual therapy may reduce pain and disability compared with placebo manual therapy after 2 to 3 weeks (low certainty). Across 12 trials, manual therapy, exercise or both versus minimal or no treatment may slightly reduce pain (by about half a point on average) and disability at the end of treatment, but the reviewers said this may not be clinically worthwhile and was not sustained. Side effects, mostly pain, bruising and stomach upset, were mild and brief (Cochrane review, 2024).
  • Mobilization with movement: a 2019 review of 20 studies found it improved pain ratings and grip strength compared with control groups, and the authors concluded joint mobilizations have a positive effect (Lucado et al., 2019).
  • Spine manipulation as an add-on: a 2013 review found moderate evidence for short- and mid-term benefit from adding manipulation of the neck and upper back to stretching, eccentric and concentric exercise and wrist and forearm mobilization, with limited, conflicting or no evidence for other approaches (Exercise and mobilisation review, 2013).
  • Package of care: an Ontario review said care for persistent tennis elbow may include education, exercise, manipulation and massage, but called the evidence limited (Multimodal care review, 2016).

We found little research on chiropractic care specifically for tennis elbow, so ask any practitioner what results to expect and over what time frame.

Safety

Mild soreness, stiffness or headache are common after spinal manipulation and most go away within 24 hours; serious problems such as strokes involving neck arteries are very rare (NCCIH). MBHA suggests not having an elbow adjusted after a fall or injury until a doctor has ruled out a break, and never putting hands-on pressure on a hot, red, swollen joint.

What it costs

The Pricer lists about $55 to $100 for a self-pay follow-up visit and about $90 to $200 for a first visit (The Pricer). Medicare Part B covers only spinal adjustments by a chiropractor to correct a subluxation, and not other services the chiropractor orders, including massage and acupuncture (Medicare.gov).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture uses fine needles at specific points; dry needling, often done by physical therapists, places needles into tender spots in muscles. Both are used for tennis elbow and have been tested in small trials, with possible short-term benefit and a lot of uncertainty.

What the research says

  • Cochrane review (2002): four small, flawed trials. Needle acupuncture gave short-term pain relief in two, but no benefit lasting more than 24 hours after treatment was shown, and laser acupuncture was no better than placebo. The reviewers found insufficient evidence either way (Green et al., Cochrane, 2002).
  • Dry needling (2024): a review of 17 trials (979 people) found it improved pain within a week of treatment, and improved elbow disability and grip strength, compared with other treatments (Dry needling review, 2024).
  • Acupuncture plus manipulation (2026): a review of 14 trials found the combination improved elbow function and grip strength, but the authors rated the certainty low because of bias and differences between trials (Acupuncture and manipulation review, 2026).
  • Part of acupuncture’s benefit in pain studies appears to come from nonspecific (placebo) effects (NCCIH).

It may be worth discussing as an add-on for short-term relief while you work on exercise and activity changes, not as a replacement for them.

Safety

Relatively few complications have been reported; they have come from non-sterile needles and improper treatment, and the FDA requires acupuncture needles to be sterile and single-use (NCCIH). MBHA suggests telling the practitioner about any blood thinner and not having needles placed into a hot, red or swollen elbow.

What it costs

The Pricer lists about $90 to $185 per follow-up visit, up to about $230 for a first private visit, and community acupuncture around $50 to $90 (The Pricer). For dry needling it lists about $45 to $100 per session, sometimes bundled into a physical therapy visit (The Pricer). Medicare Part B covers acupuncture, including dry needling, only for chronic low back pain (Medicare.gov).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

We found no herb or supplement shown to treat tennis elbow, and we found little research on herbal remedies for it.

Anti-inflammatory gels (a medicine, sold over the counter)

The best-studied rub-on option is a topical NSAID, which may ease pain for up to about four weeks (low-quality evidence); some people get a mild rash (Pattanittum et al., Cochrane, 2013). Ask a pharmacist whether one suits you and your other medicines.

Supplements for tendon problems

A 2016 systematic review of nutraceuticals used for tendon problems (including glucosamine, collagen, bromelain, curcumin and boswellic acid) found encouraging laboratory results that clinical studies had not fully confirmed; those studies were few, poor in quality and often tested several products at once, so it could not recommend any (Fusini et al., 2016). In one trial of 55 people with tennis elbow doing eccentric exercise, adding a fatty acid supplement made no difference to pain or grip force (Fatty acid trial, 2005); we read only the abstract.

Turmeric

NCCIH says turmeric is promoted for osteoarthritis and other conditions, but we do not know enough to say it helps any health purpose; highly absorbable curcumin products may harm the liver, and turmeric supplements may be unsafe in pregnancy (NCCIH). We found no tennis elbow trials of turmeric.

Arnica gel

A few trials suggest topical arnica helps osteoarthritis, but one small study found it increased pain after calf exercises. It can irritate the skin, should not be used by people allergic to sunflowers, marigolds or ragweed, and may raise bleeding risk with blood thinners such as warfarin (Memorial Sloan Kettering). We found no trials of arnica for tennis elbow.

Herbs and your other medicines: ginkgo taken with the blood thinner warfarin is linked to more major bleeding, and St. John’s wort has an overall high risk of drug interactions (NCCIH). Tell your doctor or pharmacist about every herb and supplement, especially if you take an NSAID or a blood thinner. We don’t list doses. No herb treats a torn tendon, a broken bone or an infected joint. See our medication safety guide.

Approach 5 of 6

Massage therapy

Massage is often part of physiotherapy for tennis elbow (NHS), and a therapist may use ice massage (AAOS OrthoInfo). The evidence is mixed and depends on the technique.

What the research says

  • Deep transverse friction massage (firm rubbing across the tendon) had only two small trials in a Cochrane review that also covered knee tendinitis; the tennis elbow trial had 40 people. The review found no clinically important benefit, rated the pain evidence very low quality, and said there was not enough to determine its effects (Loew et al., Cochrane, 2014).
  • Other soft-tissue work: a 2016 Ontario review found myofascial release improved outcomes compared with sham ultrasound, and that movement re-education (contraction and passive stretching) gave better long-term benefit than a single steroid injection; the authors called for more high-quality research (Soft-tissue therapy review, 2016).

Safety and cost

The risk of harm from massage appears low, but rare serious problems such as a blood clot, nerve injury or broken bone have been reported, some with vigorous deep tissue massage or in older adults (NCCIH). MBHA suggests skipping massage on an elbow that is hot, red and swollen or has not been examined after an injury. Prices vary by location. At one national chain, franchise price lists show about $125 to $160 for a 60-minute massage for non-members and about $65 to $90 for members, whose memberships run about $70 to $90 a month (The Pricer). Tips are extra. Medicare does not cover massage therapy (Medicare.gov).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Tennis elbow comes from repeating the same forearm movements, so everyday habits matter. An MBHA Wellness Coach can help you spot and change them, alongside — never instead of — your medical care.

Work and daily-activity set-up

  • Find the trigger. One review of workers found a higher risk of tennis elbow with a high score on a work-task rating called the Strain Index and with forearm rotation for more than 4 hours a day; it found no association with gripping, wrist bending or repetitive movements on their own (Work-relatedness review, 2022). A 2021 review suggested the first approach could shift from passive watchful waiting to actively finding and reducing at-risk activities, by cutting force, compression and shearing on the wrist extensor tendons (Ergonomics review, 2021).
  • Ergonomics. MedlinePlus describes ergonomics as finding the best fit between you and your job, such as adjusting keyboard position and chair height, or using handle coatings or gloves to reduce tool vibration (MedlinePlus). The NHS suggests talking to your employer about changing the way you work, and says an occupational therapist can suggest exercises, equipment or workspace changes (NHS). A Cochrane review of work-related arm, neck and shoulder complaints (not tennis elbow alone) found very low- to low-quality evidence that ergonomic changes did not reduce pain in the short term but did at long-term follow-up (Cochrane review, 2013).

Sports, tools and warm-ups

  • For racquet sports, the AAOS suggests having equipment checked for fit: stiffer, looser-strung racquets can reduce stress on the forearm, and switching from an oversized head to a smaller one may help prevent a return. Improper stroke technique and equipment may be risk factors (AAOS OrthoInfo), and so may improper swing technique or equipment in golf (AAOS OrthoInfo).
  • The NHS advice for tendon injuries includes warming up before exercise and stretching gently afterward, taking regular breaks from repetitive exercise, not overexercising tired muscles, and not starting a new sport without some training or practice (NHS).

Pacing, sticking with exercise and habits

  • Keep doing the exercises. In the 2026 isometric-exercise review, adherence was nearly 100% at first but fell over time (Isometric exercise review, 2026). A coach can help you tie your therapist’s program to a daily routine and plan breaks.
  • Tobacco. In the Finnish study, current and former smokers were more likely to have tennis elbow (Shiri et al., 2006); a coach can support quitting.
  • Sleep and patience. Pain can affect sleep, and tennis elbow can last over a year (NHS). A coach can help you notice small gains; tell your provider if your nights are badly disrupted.

Another approach

Golfer’s elbow (medial epicondylitis)

Golfer’s elbow is the same kind of overuse problem on the inside of the elbow. The AAOS says the tendons of the forearm muscles that attach to the inner elbow can partially tear and wear down over time, and that it can come from golf, overhead throwing, tennis and weightlifting, or develop in non-athletes or without a specific injury (AAOS OrthoInfo).

  • Who and how common: it usually occurs in adults aged 40 to 60, and can come from household chores that repeat the same motion (AAOS OrthoInfo). In the Finnish study, 0.4% of people aged 30 to 64 had it; smoking, obesity, repetitive movements and forceful activities each showed independent links (Shiri et al., 2006).
  • Symptoms: pain or burning on the inner elbow, sometimes shooting toward the hand, a weak grip, and less wrist or elbow motion because of pain. The nearby ulnar nerve can become irritated, causing numbness and tingling in the ring and pinky fingers (AAOS OrthoInfo). See the cubital tunnel section of our elbow guide.
  • Treatment follows the same path: avoiding painful activities, ice, a short course of NSAIDs if you can tolerate them, a counterforce or wrist brace, then stretching and strengthening, with eccentric exercises thought to be particularly helpful (AAOS OrthoInfo). A 2026 review of five small studies found eccentric exercise may reduce pain and improve function, but the certainty is low (Eccentric exercise review, 2026).
  • Steroid shots: the AAOS says they give initial relief, but some research suggests they may lengthen rehabilitation and lead to worsening tendon damage. PRP, dry needling and shock wave are options for severe or stubborn symptoms, but it is not yet known how they compare with a stretching and strengthening program. Surgery is considered only after several months of nonsurgical care (AAOS OrthoInfo).

The warning signs at the top of this page apply here too. Most research we cite is on tennis elbow; golfer’s elbow has been studied far less, so treat the evidence in this guide as a rough guide for the inner elbow, not proof.

Another approach

Tendonitis and tendinopathy: the bigger picture

Tendons are strong cords that connect muscles to bones, and there are tendons all over the body, including at the knees, elbows and shoulders (NHS). Tennis elbow is one example of a problem that can affect many of them, so this section covers the general idea of “tendonitis.”

  • Two words, overlapping ideas. The NHS defines tendonitis as a tendon swelling (becoming inflamed) after an injury (NHS). Researchers note that tendonitis and tendinopathy are often used interchangeably but describe two distinct pathologies (Tendonitis and tendinopathy review, 2017). A 2021 review defines tendinopathy as a complex tendon problem with pain, decline in function and reduced exercise tolerance; the most common overuse sites are the rotator cuff, the elbow, the patellar tendon, the gluteal tendons and the Achilles tendon (Millar et al., 2021). In this guide, “tendon pain” covers both.
  • Signs and self-care: the NHS lists pain in a tendon that worsens with movement, difficulty moving the joint, a grating or crackling feeling, and swelling sometimes with heat or redness. For a mild injury it suggests 2 to 3 days of rest, ice for up to 20 minutes every 2 to 3 hours, and a snug (not tight) bandage or soft brace that comes off before bed, then gentle movement as pain allows; a mild injury should feel better within 2 to 3 weeks (NHS).
  • When it needs more: see a doctor if symptoms do not improve within a few weeks. Severe or long-lasting tendonitis may be treated with physiotherapy; some people with severe tendonitis are offered steroid injections that may give short-term pain relief; and surgery can remove damaged tissue or repair a ruptured tendon if physiotherapy does not help (NHS). A sudden pop with severe pain is covered in the warning signs at the top.
  • Evidence caution: the 2021 review says management consists of exercise and loading programs, therapeutic modalities and surgery, but that their effectiveness remains ambiguous (Millar et al., 2021).

Other MBHA guides cover tendon problems elsewhere: see our shoulder guide (rotator cuff tendinopathy), hand guide (trigger finger and de Quervain’s), knee guide (jumper’s knee) and heel pain guide (Achilles tendinitis). A dedicated Tendonitis guide may follow.

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