Lateral epicondyle release
Content reviewed by✓Mr Andrew Davies, PhD FRCS (Tr & Orth)· Reviewed June 2026Surgery for tennis elbow is considered only when at least 6–12 months of conservative treatment has not provided relief. This guide explains what to expect before and after the procedure.
Step 1 - Your pre-operative assessment
ℹ️ Your pre-assessment is usually 2–4 weeks before surgery. Tennis elbow release is a day-case procedure with a relatively straightforward recovery.
Lateral epicondyle release is a smaller procedure than shoulder surgery, and pre-operative assessment is correspondingly simpler.
Blood tests
Routine bloods to check general health before anaesthesia.
Medication review
Anti-inflammatory medications such as ibuprofen or naproxen should be stopped 5–7 days before surgery to reduce bleeding risk.
Anaesthetic options
The procedure can be performed under general anaesthesia, regional nerve block (brachial plexus block), or local anaesthesia with sedation. You will discuss the options with the anaesthetic team.
Corticosteroid injection history
Let your surgeon know if you have had a steroid injection into the elbow in the past 3 months, as this can affect tissue quality.
Realistic expectations
Surgery relieves pain in around 85–90% of patients. Some stiffness or weakness during the recovery phase is normal, and full return to sport or heavy manual work may take 6–12 months.
The day of surgery
ℹ️ You will be given a specific arrival time. Have no food from 2am on the day of surgery; you may drink clear water until 6am. Bring your medication list and any documents sent by the hospital.
Arrive at the time given
You will be admitted to the ward or day surgery unit, change into a gown, and be seen by the nursing, anaesthetic, and surgical teams before theatre.
Consent and marking
Your surgeon will confirm the procedure, mark the operative side, and you will sign a consent form before going to theatre.
Anaesthetic
You will meet the anaesthetist in the anaesthetic room. Once anaesthesia is established, the procedure will begin.
Recovery room
After surgery you will wake in the recovery room where nurses monitor your vital signs until you are stable and comfortable.
In hospital
Most patients having arthroscopic or day-case procedures go home on the day of surgery. Those having joint replacement typically stay 1–2 nights. Before discharge, the team will check your pain is controlled, give you wound care instructions, and confirm your follow-up appointment.
Pain control
You will be given oral pain relief before discharge. Take it regularly for the first 48 hours rather than waiting until pain is severe.
Wound check and dressing
A nurse will check the wound before you leave and explain how to keep it clean and dry.
Discharge letter and follow-up
You will receive a letter for your GP and details of your next outpatient appointment - usually at 2 weeks for a wound check.
You must not drive yourself home
Arrange for a family member or friend to collect you. You must not drive on the day of surgery if you have had a general anaesthetic or sedation.
Going home
⚠️ Important: Avoid heavy gripping, twisting, or lifting with the operated arm for the first 6 weeks after surgery. Using the arm too forcefully too soon may disrupt the repair and delay recovery.
Keep the wound clean and dry
Avoid getting the wound wet until it is fully healed - usually 10–14 days. Use a waterproof cover or cling film when showering.
Take your pain relief as prescribed
Do not wait until pain is severe before taking medication. Regular simple analgesia (paracetamol, ibuprofen if appropriate) is more effective.
Attend your wound check appointment
This is usually 2 weeks after surgery. Sutures or clips will be removed if used.
When to contact the hospital
Seek urgent advice if you develop increasing redness, warmth, swelling, discharge from the wound, or a temperature above 38°C - these may indicate infection.
Recovery week by week
Pre-assessment
Blood tests, medication review, and anaesthetic discussion.
Day-case procedure
The operation takes 30–45 minutes. The damaged tendon tissue is released or removed at the lateral epicondyle. You will go home the same day.
Wound care and rest
Keep the wound clean and dry. A light dressing is applied. The elbow may feel sore and swollen initially.
Gentle mobilisation
Physiotherapy starts with range-of-movement exercises. Avoid heavy gripping and lifting.
Strengthening and return to activity
Progressive strengthening under physiotherapy guidance. Return to sport or heavy work is usually possible at 3–6 months.
Will I need a sling?
A sling is not usually required after tennis elbow release. A light dressing is applied for the first 1–2 weeks.
When can I return to work?
Desk-based work is usually possible within 1–2 weeks. Manual or heavy work typically requires 6–12 weeks off, depending on the demands of your job.
How long until the pain improves?
Pain often improves significantly within 6–8 weeks, but complete resolution can take 3–6 months. Some patients notice improvement more gradually over the first year.
Can the problem come back?
Recurrence after surgery is uncommon. Ongoing physiotherapy and activity modification help maintain the result.
Recovery calendar
A week-by-week guide to recovery. Individual timelines vary, always follow your surgical team.
Consent information
Purpose and intended benefits
The aim of surgery is to excise the degenerative tissue at the common extensor origin and stimulate a healing response, relieving the chronic pain that has not responded to non-operative treatment.
What the procedure involves
The procedure can be performed open or arthroscopically. Open approach: a small incision is made over the lateral epicondyle. The degenerate tissue of the ECRB tendon origin is identified and excised. The remaining extensor origin is repaired and the bone may be lightly drilled to stimulate a healing response. Arthroscopic approach: the degenerative tissue is identified and excised from within the elbow joint. Both take approximately 30-45 minutes under general or regional anaesthetic.
Alternative treatments
Continued physiotherapy and load management
Eccentric and isometric loading exercises under physiotherapy guidance. The mainstay of treatment and effective in the majority of patients given adequate time (6-18 months).
Extracorporeal shockwave therapy
3-6 sessions of shockwave therapy to stimulate healing. Preferred non-invasive intervention before surgery.
Platelet-rich plasma (PRP) injection
Injection of growth factors into the degenerative tendon. Growing evidence base; may be tried before surgical referral.
No treatment
Tennis elbow resolves spontaneously in the majority of patients within 12-18 months. Watchful waiting is reasonable.
Risks of the procedure
The posterior interosseous nerve (deep branch of the radial nerve) runs close to the surgical site. Injury causes weakness of wrist and finger extension. Most injuries are temporary neurapraxias.
If the lateral collateral ligament complex is inadvertently damaged during surgery.
Wound infection. Usually treated with antibiotics.
Surgery does not guarantee resolution of symptoms. Some patients continue to have pain despite technically successful surgery.
Symptoms may recur, particularly if provocative activities are resumed too early.
Expected and managed with regular analgesia.
Normal after elbow surgery. Settles within 2-3 weeks.
Expected during the recovery period. Grip strength returns over 3-6 months.
The lateral elbow scar may be tender for several months. Scar massage helps.
If you choose not to have surgery
Tennis elbow resolves spontaneously in approximately 80-90% of patients within 12-18 months with non-operative management. Surgery is generally only considered after at least 6-12 months of structured non-operative treatment has failed. There is no significant risk of harm from delaying surgery.
Your questions, answered
Plain-English answers to the things people most often ask, drawn from real patient questions and grounded in published guidance. Tap a question to open it.
About thisWhat is tennis elbow?
It is pain on the outer side of the elbow from overload of the tendons that straighten the wrist. Most cases are not caused by tennis, but by repetitive gripping or lifting.
Your choiceHow is it treated, and will it settle?
Most cases improve with time. First-line care is adjusting the activities that aggravate it and a progressive tendon-loading exercise programme. The large majority recover without surgery, although it can take many months.
InjectionsDo steroid injections help?
A steroid injection can reduce pain in the short term, but the evidence shows worse longer-term outcomes and higher recurrence compared with exercise or simply waiting. Many clinicians now avoid routine steroid injections and favour exercise.
Self-careWhat can I do day to day?
Adjust gripping and lifting, check your technique and equipment, consider a forearm brace for aggravating activities, and follow a graded strengthening programme. Simple pain relief can help.
Getting backHow long does it take?
Often several months. Continuing gentle use within comfort, rather than resting completely, tends to recover better.
UrgentWhen should I seek review?
Pain that followed a clear injury, significant weakness, locking of the elbow, or numbness and tingling into the hand, which may point to nerve involvement rather than tennis elbow.
WellbeingIt is frustrating that it is taking so long.
Tendon problems are slow to settle, which is normal. Consistency with the exercises and realistic expectations make a big difference.
- British Elbow & Shoulder Society: tennis elbow
- NICE CKS: Tennis elbow (clinical knowledge summary)
- Versus Arthritis: elbow pain
- British Elbow & Shoulder Society: exercises for elbow stiffness
These links are to UK clinical guidance and patient information from recognised organisations. This page is for general information and does not replace personalised advice from your own clinical team.