Is surgery right for tennis elbow?
Most people with tennis elbow never need surgery. In fact, fewer than 2 in 100 people go on to have an operation¹.
Surgery may be considered when pain remains severe and limits daily function after many months of high-quality rehabilitation, activity modification, and other non-invasive treatments.
You and your doctor may discuss surgical options if:
- Pain persists for more than 6–12 months despite consistent exercise-based care
- Everyday tasks like lifting, typing, or gripping remain difficult
- Imaging suggests a partial tear of the affected tendon, and other causes of pain have been ruled out
Even then, surgery is not an automatic next step. Every decision should be shared between you and your healthcare provider, based on your goals, work demands, and personal recovery experience² ³.
Common surgical options for elbow pain
If surgery is recommended, it typically focuses on removing or releasing damaged tendon tissue at the outer elbow to reduce pain and restore strength. Common procedures include:
- Open debridement and tendon release: The surgeon removes degenerated tendon fibers from the origin of the extensor carpi radialis brevis (ECRB, one of the main wrist extensor muscles).
- Arthroscopic debridement: Similar to open surgery but performed through small keyhole incisions with a camera.
- Lateral ligament assessment or repair: In select cases, the nearby ligament is inspected for looseness or damage.
Both open and arthroscopic techniques aim to reduce tendon irritation and promote healing, with similar reported outcomes. The choice depends on surgeon expertise and your specific anatomy⁴.
What to expect during recovery
Recovery from tennis elbow surgery takes time and patience.
Typical timeline:
- First few weeks: Pain and swelling are common. The elbow is protected in a soft dressing or splint. Gentle movement begins early to prevent stiffness.
- Weeks 4–8: Gradual strengthening exercises start, focusing on wrist and forearm control.
- Months 3–6: Progressive return to normal work, sport, or lifting activities.
Most people notice steady improvement, though recovery can vary based on how long you had symptoms before surgery and how consistently you follow your rehab plan.
Possible risks include:
- Infection, bleeding, or nerve irritation
- Persistent pain or stiffness
- Incomplete relief of symptoms
- Rarely, the need for repeat surgery⁴ ⁵
Setting realistic expectations and preparing for structured rehabilitation are key to a good outcome. Tendons take months, not weeks, to rebuild strength.
Did you know?
Even though tennis elbow is common, only about 1–2% of people ever need an operation¹. Most recover with education, load management, and progressive strengthening. In Sword’s digital care programs, members with chronic elbow and shoulder pain report over 50% pain reduction within 12 weeks using guided, home-based exercise and education⁷.
Can surgery be avoided?
Yes, in most cases, tennis elbow improves without surgery.
Structured exercise-based rehabilitation, education, and activity modification are the mainstays of recovery. Studies show that nearly 89% of people report major improvement within a year, even without injections or surgery⁶. Early active care also helps prevent long-term weakness or recurrence.
Sword’s digital physical therapy programs use guided strengthening, real-time feedback, and education to help people recover at home. These programs have been shown to deliver outcomes comparable to traditional physiotherapy for chronic joint and tendon pain⁷.
How Sword can support you before and after surgery
Physical therapy can play an important role in preparing for surgery, supporting recovery, and, in some cases, helping people manage symptoms without surgery. Sword offers physical therapy programs designed to support you at different points along that journey.
Sword supports recovery before and after surgery, with care designed to fit into your life. You receive high-quality physical therapy at home, guided by licensed clinicians and supported by smart technology.
- Care that adapts as your body and recovery needs change
- Licensed physical therapists guiding your care at every stage
- Non-invasive, evidence-based physical therapy programs
Support for preparation, recovery, and long-term movement health
Clinical insight
