Why does my elbow hurt when I grip things?
The muscles that grip and stabilise your wrist all anchor to that one small spot on the outer elbow. Every grip transmits force through the irritated tendon — which is why even lifting a kettle or shaking hands can sting.
Will it heal on its own?
Often yes, but slowly — untreated cases commonly grumble for 12–18 months. A structured loading programme meaningfully shortens the journey and reduces recurrence, which is the real value of treatment.
Should I get a steroid injection?
The evidence says be very cautious: a landmark randomised trial (Coombes et al., JAMA, 2013) found corticosteroid injection led to worse one-year outcomes and higher recurrence than placebo. Short-term relief, long-term cost. We reserve injections for rare, carefully discussed situations.
What treatment actually works?
Progressive strengthening of the wrist extensors and grip — starting light and building systematically — plus dry needling of the overworked forearm muscles, manual therapy, and adjusting the loads that keep re-irritating it. A counterforce brace can ease symptoms during work.
How long until I’m better?
Expect meaningful improvement in 6–12 weeks of consistent loading, with full resolution commonly taking 3–6 months. Tendons rebuild on tendon time — but function returns much earlier than the last twinge disappears.
Can I keep working with tennis elbow?
Almost always. We modify grip sizes, tool handles, lifting technique (palm-up where possible), and break up repetitive gripping — keeping you working while the tendon adapts.
Is it ever something other than tennis elbow?
Yes — neck-referred pain, radial nerve irritation and elbow joint problems can mimic it. That’s why we screen the neck and nerve pathways before labelling any outer-elbow pain.
Does dry needling help tennis elbow?
Trials and reviews support needling of the forearm trigger points as a useful adjunct — it reduces pain and muscle overactivity so the loading programme can progress. It complements the exercise; it doesn’t replace it.
When is surgery indicated for tennis elbow?
Rarely — roughly nine in ten cases resolve without it. Surgery is considered only after 6–12 months of properly completed loading rehabilitation has genuinely failed, and even then results are mixed enough that guidelines treat it as a true last resort. Before any operation, the honest first question is whether the loading programme was actually completed — most “stubborn” tennis elbows turn out to be under-rehabilitated, not surgical.
