What is the treatment for lateral or medial epicondylitis (elbow tendinitis)?

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Last updated: April 16, 2025View editorial policy

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From the Guidelines

The treatment for elbow tendinitis should prioritize relative rest and reduced activity to prevent further damage and promote healing and pain relief, as recommended by the American Family Physician 1. The goal of treatment is to reduce inflammation, relieve pain, and promote healing of the damaged tendon tissue.

Key Recommendations

  • Relative rest and reduced activity are essential to prevent further damage and promote healing and pain relief 1.
  • Cryotherapy, such as applying ice to the affected area for 15-20 minutes several times daily, can provide acute relief of tendinopathy pain 1.
  • Eccentric strengthening exercises, which can be performed 3 times daily with 10-15 repetitions, are an effective treatment for tendinopathy and may reverse degenerative changes 1.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (400-800mg three times daily with food) or naproxen (220-500mg twice daily) can help reduce pain and inflammation for 1-2 weeks, but have no effect on long-term outcomes 1.

Additional Treatment Options

  • Locally injected corticosteroids may be more effective than oral NSAIDs in acute-phase pain relief, but do not alter long-term outcomes 1.
  • Surgery is an effective option in carefully selected patients who have failed three to six months of conservative therapy, and typically includes excision of abnormal tendon tissue and performance of longitudinal tenotomies to release areas of scarring and fibrosis 1. It is essential to note that the treatment plan should be individualized, and a healthcare provider may recommend a combination of these options or other treatments based on the severity and duration of symptoms.

From the FDA Drug Label

Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis Because the sodium salt of naproxen is more rapidly absorbed, naproxen sodium is recommended for the management of acute painful conditions when prompt onset of pain relief is desired. Naproxen may also be used The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required.

The treatment for elbow tendinitis may include naproxen. The recommended starting dose is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required 2.

From the Research

Treatment Options for Elbow Tendinitis

The treatment for elbow tendinitis, also known as lateral epicondylitis or tennis elbow, can vary depending on the severity and duration of the condition. Some of the treatment options include:

  • Physical therapy intervention, which can provide intermediate to long-term effects, less additional treatment, and a low recurrence rate 3
  • Corticosteroid injection, which can provide beneficial short-term effects 3
  • Non-steroidal anti-inflammatory drugs (NSAIDs), which can be used to relieve pain and reduce inflammation, although the evidence for their effectiveness is limited 4
  • Other non-operative treatments, such as rest, analgesics, orthosis, and physical therapies, which can be used to manage the condition 5
  • Surgical treatment, which may be considered for severe, recalcitrant cases that do not respond to non-operative management 5, 6

Non-Operative Treatments

Non-operative treatments for elbow tendinitis can include:

  • Topical NSAIDs, which have been shown to be effective in relieving pain and improving function in the short term 4
  • Oral NSAIDs, which may provide some short-term benefit, but the evidence is limited and they can have adverse effects such as gastrointestinal problems 4
  • Corticosteroid injections, which can provide short-term pain relief and improve function, but the long-term effects are unclear 3, 4
  • Platelet-rich plasma (PRP) injections, which are a newer treatment option that involves injecting platelet-rich plasma into the affected area to promote healing 5

Surgical Treatment

Surgical treatment for elbow tendinitis may be considered for severe, recalcitrant cases that do not respond to non-operative management. The surgical options include:

  • Open, percutaneous, and arthroscopic approaches, which can be used to repair or remove the damaged tendon tissue 5, 6
  • Arthroscopic intervention, which is a minimally invasive surgical procedure that can be used to treat lateral epicondylitis 5

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Current Trends for Treating Lateral Epicondylitis.

Clinics in shoulder and elbow, 2019

Research

Lateral epicondylitis of the elbow: an up-to-date review of management.

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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