What Do Doctors Recommend for Tennis Elbow?

That nagging ache on the outside of your elbow started subtly. Maybe after a weekend of gardening, a big project at work, or even just carrying groceries. Now, simple things like picking up a coffee mug or turning a doorknob send a sharp, focused pain down your forearm. If this sounds familiar, you might be dealing with lateral epicondylitis, more commonly known as tennis elbow.

And here’s the first surprise: most people who get it have never even stepped onto a tennis court. This condition is about overuse, not just backhands. But what does a doctor actually do when you show up with this frustrating pain? The path to recovery isn't a single magic bullet; it's a logical, step-by-step process focused on calming the tissue and then rebuilding its strength. Let's walk through that clinical playbook together.

The First Step: Understanding What’s Happening in Your Elbow

Before any treatment begins, a doctor’s goal is to confirm the diagnosis and help you understand the root cause. Tennis elbow is an overuse injury affecting the tendons that connect your forearm muscles to the bony bump on the outside of your elbow (the lateral epicondyle). Specifically, it involves the Extensor Carpi Radialis Brevis (ECRB) tendon, which helps you extend your wrist.

However, a critical point that is often misunderstood is the nature of the injury itself.

Myth Buster: It's More "Wear and Tear" Than "Inflammation"

For years, the "-itis" in epicondylitis led everyone to believe this was purely an inflammatory condition. While some inflammation can be present, modern research shows that chronic tennis elbow is more accurately a degenerative condition called tendinosis. Think of it less like a single, fiery event and more like a rope that has become frayed from repetitive strain. This distinction is crucial because it changes the focus of treatment from simply reducing swelling to actively encouraging tissue repair and remodeling. Understanding the true causes and early signs of tennis elbow is the first step toward effective management.

This diagram clarifies that tennis elbow is a degenerative tendon condition, not simply inflammation, highlighting causes and key symptoms for better understanding.

The Conservative Care Playbook: Your Doctor’s First-Line Strategy

For the vast majority of cases, clinicians recommend a conservative, phased approach. The goal is to first reduce the load on the injured tendon to let it calm down, and then gradually reintroduce specific stresses that promote healing and strength.

This infographic visualizes the step-by-step treatment progression doctors recommend for tennis elbow, from initial rest to advanced therapies.

Phase 1: Calming the Pain

The immediate priority is to stop aggravating the frayed tendon. This phase includes:

• Activity Modification & Targeted Rest: This doesn't mean sitting on the couch for weeks. It means identifying the specific motions that cause pain—like lifting with your palm down or forceful gripping—and finding ways around them. It's about being smarter with your movements, not stopping them entirely.
• Icing: Applying a cold pack for 15-20 minutes several times a day can help manage pain and any minor, acute swelling.
• Short-Term Pain Relievers: A doctor might suggest a short course of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs). Because the condition is primarily degenerative, these are mainly used for temporary pain control rather than as a long-term solution.

Phase 2: Rebuilding Strength and Mobility

Once the initial, intense pain subsides, the real work begins. This is the most important phase for long-term recovery.

• Physical Therapy: The Cornerstone of Recovery: This is where the magic happens. A physical therapist will guide you through exercises designed to heal the tendon. The gold standard is eccentric strengthening. These are exercises where the muscle lengthens under tension (like slowly lowering a light weight after lifting it). This specific type of load has been shown to stimulate collagen production and help remodel the disorganized, frayed tendon fibers into strong, healthy tissue.
• Progressive Exercises: Therapy will also include stretching to improve forearm flexibility and mobility, as well as exercises to strengthen the supporting muscles in the shoulder and wrist. It's crucial not to do too much too soon. You might wonder what upper body exercises can i do with tennis elbow to stay fit without derailing your recovery, and a therapist can provide excellent guidance on this.

Adding Support: When Do Braces and Sleeves Come In?

As part of a conservative care plan, a doctor will often recommend a non-invasive support. It's important to see these as tools that assist your recovery, not replace physical therapy. They work by reducing the strain on the injured tendon while you go about your day or perform your exercises.

How Non-Invasive Supports Help

There are two primary types of support your doctor might suggest, and they work in different ways:

1. Counterforce Braces (Straps): These are the classic "tennis elbow straps." They are worn around the thickest part of your forearm, just below the elbow. The brace applies targeted pressure that effectively changes the angle of pull on the tendon, redirecting the force away from the painful insertion point. This can provide significant relief during gripping and lifting activities.
2. Compression Sleeves: These provide broad, gentle compression to the entire elbow joint and surrounding muscles. This can help increase blood flow, reduce minor swelling, and improve proprioception—your brain's sense of where your arm is in space—which can lead to more controlled, less painful movements.

Deciding between a counterforce brace and a sleeve often comes down to the nature of your activity and personal preference.

Choosing the Right Support: Key Evaluation Criteria

If your doctor recommends a brace, they're empowering you to find a tool that makes your recovery more manageable. Here’s what to look for:

• Support Type: Is your pain sharp and activity-specific? A counterforce strap might be ideal. Is it more of a general ache and you want overall support? A sleeve could be better.
• Adjustability: A good brace should allow you to customize the level of pressure. This is vital because your needs may change throughout the day or during different activities.
• Comfort & Material: You’re going to be wearing this. It needs to be made from breathable, non-irritating material that doesn’t slip or bunch up.
• Fit: It should be snug enough to provide support but not so tight that it cuts off circulation. Proper fit is key to effectiveness.

Knowing how to wear a tendonitis brace correctly is just as important as choosing the right one.

This visual guide helps users understand different brace types and essential factors to consider when selecting tennis elbow supports.

When Conservative Care Isn't Enough: Escalating Treatment

Over 90% of people with tennis elbow recover fully with conservative care. However, if months go by with no improvement, a doctor will consider the next steps:

• Injections: Corticosteroid injections can provide powerful short-term pain relief, but their long-term benefit is debated as they don't address the underlying tendon degeneration. Other options like Platelet-Rich Plasma (PRP) are also being explored.
• Referral to a Specialist: An orthopedic specialist may be consulted for further evaluation, which could include imaging like an MRI or ultrasound, to assess the extent of the tendon damage.
• Surgery: In rare, persistent cases where the pain is debilitating and hasn't responded to at least 6-12 months of non-surgical treatment, surgery may be an option to remove the damaged tissue.

Frequently Asked Questions About Tennis Elbow

How long does tennis elbow take to heal?

Patience is key. With consistent, active management, most people feel significant improvement within 6 to 12 weeks, but full recovery can take several months.

What activities should I absolutely avoid?

Listen to your body. Generally, avoid heavy lifting with your palm facing down, forceful or repetitive gripping, and any activity that causes a sharp increase in your elbow pain. A proper upper body workout with tennis elbow should be modified to prevent such movements.

Can tennis elbow go away on its own?

While the pain may subside with rest alone, the underlying tendon weakness remains. Without addressing it through physical therapy, the condition is very likely to return once you resume your normal activities.

Is a tennis elbow brace vs compression sleeve better for me?

A brace (strap) is often better for targeted pain relief during specific activities like lifting. The tennis elbow sleeve is great for general, all-day support, warmth, and proprioception. Some people use a strap over a sleeve for combined benefits.

Your Path to a Pain-Free Elbow

The doctor-recommended approach to tennis elbow is a marathon, not a sprint. It’s a proactive journey that starts with understanding the injury, moves through a phase of calming the pain, and is anchored by the crucial work of rebuilding strength through physical therapy. Supportive braces act as your trusted allies along the way, helping you stay active with less pain while the tendon heals.

By following this logical progression, you’re not just masking the pain—you’re addressing the root cause and building a more resilient, pain-free elbow for the long term.