Tennis elbow is pain on the outside of the elbow, and golfer’s elbow is pain on the inside. Both are caused by overloading the forearm tendons where they attach to the elbow. Around 80 to 90% of cases get better without surgery, using rest from the aggravating activity, targeted exercises and sometimes a brace. Surgery is only considered when pain persists for six to twelve months despite proper treatment. In Nelspruit, Dr George Oduah assesses and treats persistent elbow pain at his rooms in Sonheuwel.
You reach for the kettle, turn a key or shake someone’s hand, and a sharp pain shoots through the outside of your elbow. You have never picked up a tennis racket, yet you may well have tennis elbow.
Most people with tennis elbow are not tennis players. We see it in gardeners, builders, electricians, mechanics, office workers who use a mouse all day and, increasingly, padel players on Mbombela’s new courts. This guide explains what is going on in the elbow, what actually helps, and when it is worth seeing a specialist.
What Is Tennis Elbow?
Tennis elbow (medically called lateral epicondylitis or lateral elbow tendinopathy) affects the tendons that attach the forearm muscles to the bony bump on the outside of the elbow. These muscles bend your wrist back and help you grip.
When these tendons are overloaded by repeated gripping, twisting or lifting, tiny areas of damage build up faster than the tendon can repair them. The tendon becomes painful and weaker. Despite the “-itis” in the name, this is mainly a wear problem in the tendon, not ongoing inflammation. This is why anti-inflammatories alone rarely fix it.
It is most common between the ages of 35 and 55.
What Is Golfer’s Elbow?
Golfer’s elbow (medial epicondylitis) is the same type of tendon problem on the inside of the elbow. It affects the tendons of the muscles that bend the wrist and fingers and turn the palm down.
It is less common than tennis elbow. It is caused by repeated gripping, throwing, swinging or lifting with the palm facing up. Golfers, cricketers, gym-goers and manual workers are commonly affected.
| Tennis elbow | Golfer’s elbow | |
|---|---|---|
| Where it hurts | Outside of the elbow, spreading down the top of the forearm | Inside of the elbow, spreading down the inner forearm |
| Medical name | Lateral epicondylitis | Medial epicondylitis |
| Movements that hurt | Gripping, lifting with palm down, turning a key or doorknob, shaking hands | Gripping, lifting with palm up, throwing, swinging a club or bat |
| Common in | Manual workers, gardeners, office workers, padel and tennis players | Golfers, cricketers, gym-goers, tradespeople |
What Are the Symptoms?
- Pain on the outside (tennis elbow) or inside (golfer’s elbow) of the elbow, often spreading into the forearm
- Pain when gripping, lifting a cup or kettle, opening jars or turning a key
- A weak grip, so you drop things more easily
- Tenderness when you press on the bony bump of the elbow
- Stiffness or aching in the morning
- Pain that builds gradually over weeks rather than after one injury
See a doctor sooner if the elbow is swollen or deformed after a fall, you cannot fully straighten or bend it, it locks or catches, or you have numbness or tingling in the hand. These point to a different problem, like a fracture, joint damage or nerve compression.
How Is Tennis Elbow Diagnosed?
In most cases the diagnosis is made from your history and a simple examination in the rooms. Dr George will press on specific points around the elbow and test how your grip and wrist movements affect the pain.
It is also important to rule out conditions that can feel similar, such as:
- A trapped nerve in the forearm, at the elbow or in the neck
- Arthritis of the elbow joint
- Pain coming from the wrist or hand. Our guide to hand pain covers these.
A musculoskeletal ultrasound can show the damaged tendon in real time and is useful to guide an injection precisely. X-rays or an MRI are only needed if something else is suspected or symptoms are not improving.
Will Tennis Elbow Heal on Its Own?
Usually, yes, but slowly. Most cases settle within 6 to 12 months, and around 80 to 90% of people never need surgery. The right treatment can make that recovery faster and stop the problem coming back.
The mistake many people make is resting completely until it settles, then going straight back to the same activity. Without strengthening, the tendon is still weak and the pain often returns.
What Treatment Actually Works?
- Change the load, not total rest: reduce the gripping and lifting that trigger the pain, lift with your palm facing up for tennis elbow, and take breaks from repetitive tasks.
- Physiotherapy and loading exercises: a graded programme of strengthening exercises is the most effective long-term treatment, because it rebuilds the tendon’s strength.
- Elbow strap (counterforce brace): a strap worn just below the elbow can reduce pain during activity.
- Check your equipment and set-up: grip size and racket weight for padel and tennis players, tool handles for tradespeople, and mouse and keyboard position for office workers.
- Pain relief: anti-inflammatory gels or tablets can help in the short term, used with medical advice.
- Shockwave therapy: can help some patients with long-standing symptoms.
- Injections: a cortisone injection can bring quick relief, but research shows the pain often returns, and recovery at one year can be worse than without it. For this reason they are used sparingly. Other injections, such as PRP, have mixed evidence and are discussed case by case through our pain medicine service.
When Is Surgery Needed for Tennis Elbow?
Surgery is only considered for a small number of patients. You may be a candidate if:
- Pain has lasted six to twelve months or more
- You have properly tried physiotherapy, activity changes and bracing
- The pain is still affecting your work, sleep or daily life
- Other causes, such as a trapped nerve, have been ruled out
The operation removes the damaged part of the tendon and encourages healthy healing. It is a day-case or overnight procedure done at Mediclinic Nelspruit or Kiaat Private Hospital. Depending on the case, it may be done through a small open incision or as keyhole (arthroscopic) surgery.
What Is Recovery Like After Elbow Surgery?
- First 1 to 2 weeks: the arm rests in a sling or light dressing, with gentle finger and shoulder movement.
- Weeks 2 to 6: gentle elbow and wrist movement with a physiotherapist, and light daily use.
- Weeks 6 to 12: progressive strengthening and a gradual return to work, depending on how physical your job is.
- 3 to 6 months: return to full strength, sport and heavy manual work.
Most patients who have surgery for the right reasons have good pain relief and return to their normal activities.
How to Prevent Tennis Elbow Coming Back
- Keep doing your forearm strengthening exercises after the pain settles
- Build up slowly when starting a new sport, like padel, or a big DIY or gardening project
- Get your grip size and technique checked at your club
- Use tools with thicker, padded handles and let your shoulder do more of the work
- Take short breaks during repetitive gripping tasks
For sport-related elbow problems, Dr George’s sports medicine service can help you get back to playing safely.
When to See Dr George Oduah in Mbombela
If elbow pain has lasted more than six weeks, is getting worse, or is stopping you from working, gripping or playing sport, it is worth a proper assessment. An accurate diagnosis early on can save months of trial and error.
Dr George Oduah is an orthopaedic surgeon based at the Mediclinic Medical Centre in Sonheuwel, Mbombela. He treats elbow, hand and arm conditions, from non-surgical care through to surgery where it is needed. Patients travel to see him from Nelspruit, White River, Hazyview, Barberton, Lydenburg, Malelane, Komatipoort and across the Lowveld.
This article is for general information and does not replace a personal medical consultation.
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Frequently Asked Questions About Tennis Elbow and Golfer’s Elbow
Can you get tennis elbow without playing tennis? Yes. Most people with tennis elbow have never played tennis. It is caused by any repeated gripping, lifting or twisting that overloads the forearm tendons, such as gardening, building work, using tools, typing or using a computer mouse, and racket sports like padel.
How long does tennis elbow take to heal? Most cases of tennis elbow settle within 6 to 12 months, and around 80 to 90% of people recover without surgery. A structured strengthening programme with a physiotherapist, together with reducing aggravating activities, usually speeds up recovery and lowers the chance of it coming back.
What is the difference between tennis elbow and golfer’s elbow? Tennis elbow causes pain on the outside of the elbow, from the tendons that bend the wrist back. Golfer’s elbow causes pain on the inside of the elbow, from the tendons that bend the wrist and fingers. Both are overuse tendon problems and are treated in a similar way.
Should I rest my arm completely if I have tennis elbow? No. Complete rest weakens the tendon further and the pain often returns when you go back to normal activity. It is better to reduce the movements that cause pain, while doing graded strengthening exercises that help the tendon rebuild.
Do cortisone injections work for tennis elbow? A cortisone injection can reduce tennis elbow pain quickly, but the relief is often short-lived. Studies show recovery at one year can be worse than without an injection, so orthopaedic surgeons now use them sparingly and focus on exercise-based treatment first.
When does tennis elbow need surgery? Surgery is considered when tennis elbow pain has lasted six to twelve months or more despite proper physiotherapy, activity changes and bracing, and it is still affecting work or daily life. Only a small number of patients need an operation.
Do I need a specialist for elbow pain? See a specialist if elbow pain has lasted more than six weeks, keeps getting worse, weakens your grip or comes with numbness, tingling, locking or swelling. In Mbombela, orthopaedic surgeon Dr George Oduah assesses elbow pain at his rooms in Sonheuwel.
Where can I get tennis elbow treatment in Nelspruit? Dr George Oduah, an orthopaedic surgeon in Mbombela, treats tennis elbow and golfer’s elbow from his rooms at the Mediclinic Medical Centre, 1 Louise Street, Sonheuwel. Treatment ranges from non-surgical care to surgery where needed. Book on +27 13 742 0393.
