Houston Methodist. Leading Medicine

Elbow FAQ


How can you tell when it's time to have surgery for tennis elbow? I'm just not getting better on my own or with therapy.


There's no easy answer to this question but we can offer you some things to consider when making the decision. First, there are two types of lateral epicondylitis (tennis elbow): acute inflammatory and chronic degenerative. Treatment may vary depending on the underlying pathology. For example, steroid injection or other antiinflammatory medication is more appropriate in the acute cases where inflammation is ongoing. Strengthening and manual therapy such as soft tissue mobilization performed by a physical therapist may be a better approach for patients with degenerative disease. Whether acute or chronic, iontophoresis is a possible treatment option to consider. Iontophoresis uses a small electric current to drive steroid medication through the skin. It is a noninvasive method of reducing the pain of tennis elbow. Iontophoresis may be beneficial because it turns off pain signals. Turning off pain signals at the tendon-bone interface can help break the pain cycle. This gives the patient an opportunity to rehab under the guidance of the therapist. Some experts suggest that a less than 15 per cent improvement in grip strength after therapy may be an indication that surgery may be the next step. But there are some studies that show the problem eventually goes away on its own. This can take up to a year or more and requires management of activity modification, work restrictions, and both stretching and strengthening exercises. Amalia Stefanou, MD, et al. A Randomized Study Comparing Corticosteroid Injection to Corticosteroid Iontophoresis for Lateral Epicondylitis. In The Journal of Hand Surgery. January 2012. Vol. 37A. No. 1. Pp. 104-109.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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