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Elbow Tendinopathy

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Condition

Understanding Elbow Tendinopathy: Tennis & Golfer’s Elbow

Elbow tendinopathy is a common cause of pain around the elbow and forearm and includes both tennis elbow (lateral epicondylalgia) and golfer’s elbow (medial epicondylalgia). Symptoms usually develop gradually and are often related to repetitive gripping, lifting, or wrist movements.

Tennis elbow affects the outer aspect of the elbow, while golfer’s elbow affects the inner side. Despite the different locations, both conditions share a similar underlying problem: overload and degenerative change within the tendon rather than acute inflammation. At Northern Medical, elbow tendinopathy is assessed and managed as a load-related tendon condition, with treatment tailored to symptom duration, functional impact, and response to previous care.
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Elbow 3

What causes elbow tendinopathy?

Elbow tendinopathy develops when the tendons around the elbow are exposed to repeated loading beyond their capacity to adapt. Common contributing factors include repetitive gripping, lifting, manual work, racquet sports, and sudden increases in activity or workload.

Tennis elbow most commonly involves the wrist extensor tendons on the outer elbow, while golfer’s elbow affects the wrist flexor tendons on the inner elbow. Symptoms may fluctuate and often persist if loading patterns are not modified. Identifying and addressing these contributing factors is central to effective management.

How is elbow tendinopathy diagnosed?

Elbow tendinopathy is primarily diagnosed clinically based on symptoms and physical examination. Pain is usually localised to either the outer or inner elbow and reproduced with specific resisted movements or gripping tasks.

Imaging is not always required but may be used in persistent or atypical cases. Ultrasound or MRI can assess tendon structure and help exclude other causes of elbow pain. Imaging may also assist in guiding treatment decisions when symptoms have not responded to standard conservative care.

Shockwave therapy for elbow tendinopathy

Focused shockwave therapy may be considered for chronic elbow tendinopathy that has not improved with rehabilitation alone. It works by delivering targeted acoustic energy to the affected tendon, stimulating biological healing processes and reducing pain over time.


Shockwave therapy is delivered in clinic and does not require injections or anaesthetic. It is usually provided as a short course of treatment and is most effective when combined with a structured progressive loading programme. Evidence supports its use in selected cases of chronic lateral and medial elbow tendinopathy.

Injection therapy and other treatment options

Injection therapy may be discussed for selected patients with persistent symptoms, particularly where pain significantly limits rehabilitation or daily activities. Different injection options may be considered during consultation, depending on individual clinical factors.


Injection treatments are not offered routinely and are considered alongside other evidence-based approaches, including shockwave therapy and structured rehabilitation. The aim is to reduce pain sufficiently to allow effective loading and long-term recovery, rather than provide short-term symptom relief alone.

Price List

Pricing

Consultation
Initial Remote Consultation

Free

Consultation
Face to Face Assessment

100

Focused Shockwave Therapy
Course of 4 Treatments

540

Focused Shockwave Therapy
Course of 6 Treatments

720

Injection Therapy
Ultrasound-Guided Steroid Injection

270

Injection Therapy
Advanced Treatments

POA

Frequently Asked Questions

Elbow Tendinopathy FAQs

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What is elbow tendinopathy?
Elbow tendinopathy is a chronic condition affecting the tendons around the elbow. It includes tennis elbow (lateral epicondylalgia), which causes pain on the outside of the elbow, and golfer’s elbow (medial epicondylalgia), which causes pain on the inside. Both conditions are caused by repetitive overload rather than acute inflammation.
The main difference is the location of pain. Tennis elbow affects the outer elbow and is usually related to overload of the wrist extensor tendons. Golfer’s elbow affects the inner elbow and involves the wrist flexor tendons. Despite this, both conditions are managed in a similar way.
Improvement is usually gradual and often takes several months with appropriate rehabilitation and load management. Chronic elbow tendinopathy is typically defined as symptoms lasting longer than three months. Recovery time varies depending on severity, activity demands, and adherence to rehabilitation.
A scan is not always required. Diagnosis is usually made clinically based on symptoms and examination. In Newcastle, ultrasound or MRI may be recommended in persistent or atypical cases to assess tendon structure or exclude other causes of elbow pain.

Shockwave therapy may reduce pain and improve function in selected cases of chronic elbow tendinopathy that have not responded to rehabilitation alone. At Northern Medical in Newcastle, focused shockwave therapy is offered following clinical assessment to ensure it is appropriate for your condition.

Injection therapy may be considered in selected cases where pain significantly limits rehabilitation or daily activities. Different injection options may be discussed during consultation, depending on individual clinical factors. Injection treatment is used cautiously and as part of a broader management plan.

Most people can continue work and daily activities, but tasks involving heavy gripping, lifting, or repetitive wrist movements may need to be modified temporarily. Progressive loading and structured rehabilitation are key to recovery. Your clinician in Newcastle will advise on appropriate activity levels.
Recurrence can occur, particularly if load is increased too quickly or rehabilitation is incomplete. Ongoing strength work, activity modification, and gradual return to full activity reduce the risk of symptoms returning.
You should consider clinical assessment if elbow pain persists for several months, affects work or daily function, or does not improve with initial conservative measures. Assessment at Northern Medical in Newcastle helps confirm the diagnosis and guide evidence-based treatment options.
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Rehabilitation and Progressive Loading for Elbow Tendinopathy

Rehabilitation is the cornerstone of effective treatment for elbow tendinopathy. While pain-modifying treatments may help settle symptoms, long-term improvement depends on restoring the tendons’ ability to tolerate load.

Rehabilitation focuses on progressive strengthening of the wrist and forearm muscles, alongside grip conditioning and activity modification. Exercises are introduced gradually and progressed over time to encourage healthy tendon adaptation.

At Northern Medical, rehabilitation advice is integrated into your treatment plan. Where more detailed or supervised rehabilitation is required, we can coordinate care with one of our recommended physiotherapy practices to ensure treatment and rehabilitation are aligned.
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