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Key Takeaways
- Tennis elbow develops at the lateral epicondyle of the elbow joint, where tendons strained by repetitive wrist extension become overloaded.
- Racket sports and repetitive motions like typing or using a computer mouse are equally common triggers.
- Any repetitive activity involving gripping or wrist extension puts sustained strain on the tendons around the elbow.
Your elbow has been hurting for three weeks. Gripping a coffee mug sets it off. Typing is uncomfortable by 2pm. You have tried icing it, resting it, wearing a compression sleeve your colleague recommended. The pain fades for a day, then returns the moment you go back to your routine.
At this point, the treatment itself is rarely the hard part. Rest, physiotherapy, bracing and injections are all well understood. What is harder to work out on your own is which of those applies to your specific stage of injury right now, and whether you actually need to see a physiotherapist, a sports medicine doctor, or an orthopaedic surgeon next.
That gap between knowing you have tennis elbow and knowing who to see about it is where most patients in Singapore lose time and money.
What is tennis elbow and why it keeps coming back
Tennis elbow or lateral epicondylitis is degeneration of the forearm extensor tendons where they attach to the bony outside of the elbow.
Despite the name, racquet sports account for a minority of cases. Office workers, cooks, parents lifting toddlers, padel and pickleball players, anyone who grips, twists or extends the wrist repeatedly is susceptible. In Singapore, the surge of padel and pickleball over the past two years has made this one of the most common overuse injuries physiotherapists see.
It's not just a tennis injury
An orthopaedic specialist interviewed by The Straits Times on common sports injuries made a point worth repeating here: tennis elbow is not limited to tennis. As more Singaporeans take up padel in particular, similar injuries are showing up in players who have not yet developed correct wrist and forearm technique for the sport.
The underlying mechanism is identical to tennis itself — repetitive, wrist-dominant motion without the conditioning or form to absorb it safely.
Because the underlying cause is a movement pattern rather than a single injury, symptoms often return once daily activity resumes — unless the aggravating motion itself is identified and modified.
How to treat tennis elbow
Treatment approaches for tennis elbow to reduce strain on the elbow tendons
Most cases of tennis elbow improve without surgery, but recovery is usually slow, often taking anywhere from six weeks to twelve months depending on how long the tendon has been overloaded before treatment starts. Treatment generally follows a step-up approach, starting with the simplest measures and escalating only if they aren't enough.
Conservative care
The initial goal is to calm the tendon down and stop the motion that's aggravating it, not to immobilise the arm completely.
- Relative rest: Avoid or modify the specific grip, twist, or lifting motion causing the pain, rather than stopping all arm use
- Ice: Apply an ice pack or cold compress through a thin towel for 10-20 minutes, several times a day, especially in the first few days
- Pain relief: Oral or topical anti-inflammatory medication (such as ibuprofen) can ease pain, though it doesn't speed up healing
- Counterforce bracing: A counterforce strap worn below the elbow reduces strain on the tendon during daily tasks
- Stretching: Gentle wrist extensor stretches, done consistently, help maintain flexibility while the tendon settles
Mild cases often improve within four to six weeks of consistent conservative care.
Did you know?
Morning pain is common with tennis elbow, and how you sleep may be part of why. Although evidence is limited, a small study found that sleeping with the affected arm by your side may help more than sleeping with it overhead. Consider it a simple addition to your rehabilitation, not a substitute for treatment.
Physiotherapy
If symptoms haven't eased with rest, ice, and bracing, physiotherapy becomes the next step.
A physiotherapist builds a structured programme around eccentric strengthening exercises, which load the tendon in a controlled way to rebuild its tolerance, along with manual therapy and guidance on adjusting how you perform aggravating tasks. This stage requires consistency between sessions, since the exercises rather than the sessions themselves are what drive recovery.
Quick tip
If a desk job is aggravating your elbow, turning up your mouse sensitivity so you need smaller wrist movements to navigate the screen often cuts strain more than a wrist brace alone.
Injection therapy
When pain and swelling don't settle with exercise and activity changes, a steroid injection may provide relief. It's generally used to ease pain and support progress in rehabilitation, but doesn't reduce the chance of the condition returning once the injection wears off.
Platelet-rich plasma (PRP) injections are another option some patients pursue, using their own blood components to support tendon healing, though outcomes vary between individuals.
Surgery
Surgery is uncommon and typically only considered after conservative treatment, physiotherapy, and injection therapy have all been given a genuine trial, usually over six to twelve months without meaningful improvement.
It involves removing damaged tendon tissue and can be done through open surgery or arthroscopic release, a minimally invasive technique orthopedic surgeons use to achieve the same result through smaller incisions.
Surgery carries a risk of reduced grip strength afterward, so it's reserved for cases where non-surgical options have clearly failed.
Who should you see first?
A consultation with your doctor can help identify the right next steps for your condition.
The right healthcare professional depends on how severe your symptoms are, how long they have lasted, and whether previous treatment has helped. Most people do not need to see a surgeon straight away. Starting with the appropriate provider can help you receive the right treatment at the right time.
Start with your GP or polyclinic doctor
This is usually the best first step if you're not sure what is causing your elbow pain.
A GP or polyclinic doctor can:
- Confirm whether your symptoms are consistent with tennis elbow (imaging is usually not needed)
- Recommend short-term pain relief or anti-inflammatory medication if appropriate
- Advise on activity modification
- Refer you for physiotherapy or to a specialist if needed
If you qualify for subsidised care, visiting a polyclinic also provides access to subsidised physiotherapy.
See a physiotherapist
For most people, physiotherapy is the first specialist treatment.
A physiotherapist with musculoskeletal or sports experience can:
- Assess how severe the tendon injury is
- Develop a progressive strengthening programme
- Correct movement patterns that may be contributing to the problem
- Provide treatments such as shockwave therapy when appropriate
- Monitor your progress and adjust rehabilitation over time
See a sports medicine doctor
A sports medicine doctor may be the right choice if your symptoms are related to activities such as:
- Tennis
- Padel
- Pickleball
- Gym or strength training
- Other repetitive sporting activities
They can assess your technique, advise on returning to sport safely, and discuss treatments such as injection therapy if conservative management has not been enough.
See an orthopaedic surgeon
An orthopaedic consultation is generally considered when:
- Symptoms persist after three to six months of structured conservative treatment
- Imaging suggests significant tendon damage or a tendon tear
- Your GP or physiotherapist recommends further assessment
- Surgery or advanced procedures may need to be considered
If you need surgery, look for an orthopaedic surgeon with a subspecialty in shoulder and elbow or sports surgery, as these specialists routinely manage tendon injuries around the elbow.
Insurance and cost: What to know before you book
A polyclinic visit with subsidised physiotherapy is the most affordable route. Private physiotherapy typically runs $120–$280 per session, with specialist sports physio clinics charging more. An orthopaedic consultation at a private clinic typically starts from $150–$300 for the initial visit, before imaging or procedures.
Medisave generally does not cover outpatient physiotherapy or injection therapies for tennis elbow, since these usually fall outside the standard outpatient claim list — coverage would only apply if a procedure is classified and performed as day surgery, which is uncommon for this condition. Integrated Shield Plans may cover specialist consultations and imaging, but it is essential to check your specific policy and obtain pre-authorisation where required."
The HiA Care Team can help clarify what your insurance is likely to cover before you commit to a specific provider or treatment pathway.
What to Do Next
If your elbow pain has been lingering for weeks, is starting to affect your grip, or keeps flaring each time you return to typing or sport, it’s worth a proper assessment rather than another round of self-diagnosis. HiA's care team can help you work out whether you’re at the stage where a GP, physiotherapist, sports medicine doctor, or orthopaedic surgeon makes the most sense, and match you to three suitable options over WhatsApp, usually within a day. Talk to us if you’d like help planning the next step.
Frequently asked questions
Tennis elbow doesn't have a single "cure" in the sense of an instant fix, but the vast majority of cases recover fully with the right approach — rest from the aggravating motion, progressive strengthening exercises, and time. Recovery is usually a gradual process rather than a quick resolution, often taking anywhere from six weeks to twelve months depending on how long the tendon has been overloaded before treatment starts. Surgery is rarely needed and reserved for the small number of cases that don't improve with conservative treatment.
The most effective approach combines relative rest (modifying, not eliminating, arm use), ice in the early stages, and a structured strengthening programme once the initial pain settles. Eccentric strengthening exercises, which load the tendon in a controlled way, are considered the most effective long-term intervention, and a physiotherapist can guide you through the right progression. Bracing and anti-inflammatory medication can help manage symptoms along the way, but they support recovery rather than resolve the underlying tendon issue on their own.
Tennis elbow is caused by repetitive strain on the tendons that attach the forearm muscles to the outside of the elbow, typically from repeated gripping, twisting, or wrist-extending movements. Despite the name, it's more commonly linked to activities like typing, using tools, carrying bags, or playing racquet sports such as padel and pickleball than to tennis itself. Contributing factors can include poor technique, inadequate equipment (such as an oversized racquet grip), and insufficient rest between repetitive tasks.
Prevention centres on reducing repetitive strain before it becomes a problem: use proper technique and appropriately sized equipment for sports, keep your forearm in a neutral position during repetitive tasks, and take regular breaks during activities that involve repeated wrist and elbow movement. Strengthening and stretching the forearm muscles regularly also builds resilience against overuse injury, and adjusting your workstation or tools (larger grips, ergonomic setups) helps if your daily activities are a contributing factor.
Recovery time varies widely depending on how early treatment starts and how consistently it's followed. Mild, early-stage cases often improve within four to six weeks with consistent conservative care, while more established or chronic cases can take six months to a year to fully resolve. Sticking with a structured treatment plan, rather than resting completely and hoping it resolves on its own, generally leads to a faster and more complete recovery.
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Disclaimer
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition. For decisions about your health or treatment, speak with a qualified doctor who knows your situation. An…
How we reviewed this article:
Health in Asia has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Gorski JM. Evaluation of sleep position for possible nightly aggravation and delay of healing in tennis elbow. J Am Acad Orthop Surg Glob Res Rev. 2019;3(8):e082 https://pmc.ncbi.nlm.nih.gov/articles/PMC6754212/
- Puah KL. From tennis elbow to ACL tears: The top five most common sports injuries and how to treat them. The Straits Times. Singapore Press Holdings; 2024 https://www.straitstimes.com/singapore/health/most-common-sports-injuries-symptoms-and-treatment-artisan-sports-and-orthopaedic-clinic
