Part of Tennis elbow

How long does tennis elbow last?

How long does tennis elbow last? Give it months rather than weeks, and expect most of the improvement to arrive slowly. The NHS says it usually gets better after you rest the arm, and that it can sometimes last over a year. The most useful numbers come from a Brisbane trial that followed people for a full year: at 52 weeks, 56 of the 62 people in the wait and see group, about 90 percent, counted themselves completely recovered or much improved, and so did 59 of 63 in the physiotherapy group (Bisset and colleagues, 2006). The gap between the groups was in how fast they got there, not in where they ended up. At 6 weeks, 65 percent of the physiotherapy group reported success against 27 percent of those waiting. So the honest answer has two halves: the odds of being much better in a year are good whatever you do, and treatment is mostly about shortening the bad part and keeping your grip strength while you wait. What catches people out is that the pain goes before the grip does, and that much improved is not the same as pain free. This page is education, not advice about your own elbow.

Warning signs, and when to get help

The short answer, and why the range is so wide

How long does tennis elbow last? Plan for months. The NHS says tennis elbow usually gets better after you rest the arm and that it can sometimes last over a year, which is a wide range to be told when you want a date. The reason the range is wide is that the tendon on the outer side of your elbow does not heal to a schedule. It rebuilds tolerance in response to how much you ask of it, so two people with the same elbow and different jobs get different answers.

The best figures we have come from a trial in Brisbane that put 198 people with tennis elbow into three groups, physiotherapy, a steroid injection or wait and see, followed them for a full year, and counted success as being completely recovered or much improved. At 52 weeks, the physiotherapy group was at 59 of 63 and the wait and see group at 56 of 62, which is about 90 percent either way, while the group given a steroid injection sat lower at 44 of 65 (Bisset and colleagues, 2006). Hold on to the shape of that rather than the decimal points. A year out, most people are much better; the treatments differ mainly in how much of that year you spend sore.

One caution before you lean on those numbers. This is one trial, in one city, in people whose elbow was diagnosed on clinical signs: tenderness over the bony point, pain on gripping, and pain when the wrist or fingers were lifted against resistance. It was not a survey of everyone who has ever had a sore elbow, and it cannot tell you where in the spread you personally sit.

What the first six weeks usually look like

The early weeks are where the difference between doing something and doing nothing is real. In the same trial, at 6 weeks, 41 of 63 in the physiotherapy group reported success, against 16 of 60 of those waiting (Bisset and colleagues, 2006). A second trial from the same group found the same pattern on a shorter clock: adding physiotherapy to a dummy injection took the proportion completely recovered or much improved at 4 weeks from 10 percent to 39 percent, and by 26 weeks and a year that advantage had gone (Coombes and colleagues, 2013).

Read those two together and you get the practical point of treatment. It buys you the early months. In clinic, the first fortnight is usually when the elbow stops shouting at rest and at night. Somewhere in weeks three to six, the ordinary jobs that set it off, carrying a laptop bag or turning a key, stop producing the sharp catch. The bony point stays tender to press for a good while after that, which worries people more than it should.

Progress in this period shows up as more tolerance before soreness rather than less pain at a given moment. If you can do today what left you aching a fortnight ago, you are moving, even if the number you would give the pain has not changed.

Does tennis elbow go away on its own?

Often, eventually, and that is a weaker promise than it sounds. The 90 percent figure above comes from the wait and see arm of one trial at the 52 week mark, so it describes a year of waiting, not a few weeks of it, and it was not a year of doing nothing either: every participant was given advice on managing the elbow, and 34 of the 62 people in that arm sought some other treatment before the year was out. The guideline for lateral elbow pain describes the condition as often self-limiting while pointing to high recurrence rates and long spells of work absence as the reason to treat it properly instead of waiting it out (Lucado and colleagues, 2022).

There is also the question of what much improved means. An elbow can be counted as much improved and still object to a full kettle. Nor does a good result always hold: in the Brisbane trial, 47 of the 65 people in the injection group had a good result that later regressed (Bisset and colleagues, 2006). If you wait the year out, you are also likely to spend it using the arm less, and an arm that has been spared for twelve months is weaker than the one you started with.

Who was counted matters as well. The Brisbane trial recruited volunteers who answered advertisements and had had no treatment for the elbow in the previous six months, which is a different group from people who turn up at a clinic because the elbow has beaten them. The longest follow-up of clinic patients we can read is old but sobering: 125 people treated for tennis elbow in a rheumatology clinic were reviewed between 1 and 5 years after they first came in, and over 40 percent had prolonged minor discomfort that affected some activities, while 26 percent had had a recurrence of their symptoms (Binder and Hazleman, 1983).

A larger and more recent study points the same way. Nilsson and colleagues (2012) followed 297 people in Sweden whose doctor had given them the diagnosis and who were then treated in various ways, and at two years 54 percent still had pain and 55 percent still had some loss of function. Read the 90 percent as a good reason for optimism rather than as a promise, and note what it is measured against: the question asked is whether you count yourself completely recovered or much improved, not whether the elbow has stopped bothering you.

What makes it last longer

Four things come up repeatedly, and only one of them is bad luck.

Carrying on with the load unchanged is the commonest. The guideline's own list of changeable risk factors includes handling heavy tools, bending and straightening the elbow or wrist repeatedly for more than 2 hours a day, and repeated twisting, rotating or screwing movements of the forearm, along with low control and low support at work (Lucado and colleagues, 2022). If those describe your day and nothing about your day changes, the calendar will not rescue you. Tennis elbow from computer use and desk work covers the desk version and lifting weights with tennis elbow the gym version.

Complete rest is the second, and it is the one people choose on purpose. It takes the pull off the tendon and also removes the only thing shown to rebuild it. Across 30 trials in 2,123 people, exercise did better than passive treatments, with the reviewers noting the effect was small and the certainty of the evidence low (Karanasios and colleagues, 2021).

Third, the problem may not be only the tendon. Coombes and colleagues (2015) suggest shaping treatment around factors such as neck pain alongside the elbow, tears in the tendon itself, and signs of widespread pain sensitivity, and they are plain that a subgroup has long-lasting pain whatever is done. An elbow that has not budged in months deserves a fresh look rather than more of the same program.

Fourth, a steroid injection earlier in the story changes the curve. Both Brisbane trials found better pain in the short term and more relapses later in the people who had one, which is the pattern behind the 44 of 65 figure at a year.

What shortens it

Loading the tendon, in steps it tolerates, is the part with evidence behind it. The guideline recommends resisted exercise for the wrist extensors, held, lifted or lowered slowly, for symptoms that have lasted a few weeks or longer (grade B, moderate evidence), and suggests 3 sets of 15 over 6 to 12 weeks at a load that does not flare the symptoms (Lucado and colleagues, 2022). Many programs use 2 to 3 sets of 10 to 15 slow repetitions for the strength exercises, once a day or every second day, with a weight light enough that the last few repetitions still look controlled. Your physio will adjust the exercises and the numbers to your elbow and to what you need to get back to. If you have high blood pressure, breathe steadily through every hold and never hold your breath.

Starting is worth more than starting perfectly. Isometric wrist extension asks nothing of the elbow except a steady push, which is why it tends to be the first thing in, and wrist extension with a weight is the exercise most of the trial programs are built around. The staging, the sets and the order live on the tennis elbow program.

Cutting the daily total matters as much as adding the exercises, and it is the half people skip. Fewer loads, lighter loads, shared between both hands where you can. A strap gets asked about constantly here, and the honest answer is in tennis elbow braces and straps: it may make a task easier today, and nobody can tell you it shortens anything.

The milestones worth judging by instead of the calendar

Dates are a poor measure because the elbow improves in an order rather than at a rate. Use the order.

The first thing to go is pain when you are doing nothing, including at night. Next is pain during ordinary one-handed jobs at moderate effort. Last, and well after you feel better, is grip under load: the full kettle, the stiff jar, the heavy bag by the handle. That ordering is why we keep coming back to grip. The 2006 Brisbane trial made pain-free grip force one of its main outcome measures (Bisset and colleagues, 2006), and the guideline asks clinicians to record pain-free grip and maximum grip at the start and again later (grade B, Lucado and colleagues, 2022), which gives you a measure that moves later and more honestly than a pain score.

So pick a test, not a date. One repeatable gripping task, done on both arms, checked weekly rather than hourly. Base progression on pain-free grip and the 24-hour response rather than a fixed sheet. The pain monitoring model explains why the morning after a session tells you more than the session did.

Can it come back?

Yes, and the guideline names high recurrence rates as one of the reasons not to treat this casually (Lucado and colleagues, 2022). The usual story we hear is not a relapse out of nowhere. It is a return to full load a few weeks after the pain stopped, with the loading exercises dropped at the same time, which removes the thing that was building tolerance just as the demand goes back up.

Two habits keep it away. Keep the strength work going for a while after the pain has gone, at a lower frequency if you like, and add demand back one change at a time so you can tell what your elbow objected to. Exercise progression sets out how to do that without guessing.

When a slow recovery is a reason to get it looked at

The NHS advises seeing a GP if elbow pain is still there after at least 2 weeks of looking after it yourself. Get seen sooner if it is stopping you working or sleeping. If you already have a program and it is not helping after several weeks, a physio can check the diagnosis and change the load. The warning signs below need prompt medical attention.

Getting the diagnosis confirmed matters more the longer this goes on, because pain on the outer elbow can come from the neck, from a trapped nerve in the forearm or from the joint itself, and none of those improves on a wrist extensor program. If the pain sits on the inner side instead, golfer's elbow is the page you want. In the United States that assessment usually comes from a physical therapist or a PT; elsewhere from a physio or physiotherapist.

If things are still not improving after 6 to 12 months, the NHS says surgery may be an option, and a specialist can talk that through with you. If you have had surgery on the elbow, follow the program your surgeon or physio gives you rather than this one.

Related exercise programs

Tennis elbow

Warning signs

Get emergency help now

Emergency: any sign of a stroke, even if it goes away. That means a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, sudden dizziness with unsteadiness or falling over, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack). Call emergency services straight away.
Chest pain or tightness, which may spread to your arm, neck or jaw, or shoulder or arm pain that comes with shortness of breath, sweating or feeling sick. This can be a heart attack. Call emergency services straight away.
Emergency: after a fall or a blow to the elbow, the arm has changed shape or sits at an odd angle, a bone is showing through the skin, a cut is bleeding heavily, or the hand has gone numb or tingly or turns cold, pale or blue. Go to an emergency department or call emergency services straight away, and do not drive yourself.
Your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
The pain started with a fall or a blow to the elbow, and the pain is severe, you heard a snap, the elbow is swollen or bruised, or you cannot bend or straighten the arm. Go to an urgent care center or emergency department the same day.
A sudden pop or snap at the front of your elbow, sudden sharp pain there, or the muscle at the front of your upper arm bunches up or changes shape. Stop and go to an urgent care center or emergency department the same day, even if you can still bend the elbow, as this can be a torn biceps tendon.

Get help today

Your wrist or fingers will not lift properly (the fingers may droop at the knuckles), or your hand keeps getting weaker, not just sore. Get medical advice the same day, as this can be a problem with a nerve rather than the tendon. If the weakness is getting worse by the hour, go to an emergency department.
You have numbness, tingling or pins and needles in the hand or fingers, or pain that spreads from your neck down the arm. Stop any exercise that brings it on and see a physio or doctor, because this points to a nerve or to your neck rather than the tendon. If the pins and needles do not go away after you stop, or part of your arm or hand goes numb, get medical advice the same day. If one side of your face or body suddenly goes numb or weak, or your speech becomes slurred or muddled, call emergency services, even if it goes away.
The elbow is hot, red and swollen, or you have elbow pain with a high temperature or feel hot, cold or shivery. Get medical advice the same day, and go to an emergency department if you feel very unwell. This can be a sign of infection in the joint, which needs treatment quickly.
The pain is there at night or at rest and keeps getting worse. If you are being treated for cancer now, contact your cancer team the same day.

Book an appointment

The elbow locks, catches, or feels unstable, as if it slips or gives way. Get it assessed before you start these exercises, and ask your doctor or physio for an appointment within a few days.
The pain is there at night or at rest and keeps getting worse. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse.
The pain is there at night or at rest and keeps getting worse. See your doctor within a few days.

Common questions

How long does mild tennis elbow take to heal?

Nobody has measured mild separately, so there is no figure to give you, and anyone offering one has made it up. What the trials can tell you is that the people who did best were the ones whose elbow was still being loaded in some form. If your elbow only complains at the end of a long day and your grip is close to normal, you are at the easy end of the range, and a few weeks of lighter gripping plus the static holds is often enough to turn it round. The thing that reliably turns a mild elbow into a six month one is going back to full load the week it stops hurting. Build up in steps instead, using the stages on the tennis elbow program.

Can tennis elbow heal in a week?

The pain can settle in a week. The tendon's tolerance does not. We see this often: someone has three quiet days, decides it has gone, plays a full match or does a heavy session, and is back where they started by the weekend. A tendon that has been sore for weeks has lost load tolerance, and rebuilding that takes the sort of time the guideline describes, with 6 to 12 weeks of resisted wrist extensor work as its suggested course (Lucado and colleagues, 2022). Your physio will adjust this. If your elbow genuinely settles inside a week, treat it as a warning you got cheaply rather than as a recovery.

How do you know when tennis elbow has healed?

Test it rather than feel it. The 2006 Brisbane trial used pain-free grip force as one of its main outcomes, which is a measured squeeze on a dynamometer rather than a pain score (Bisset and colleagues, 2006), and the guideline asks clinicians to record pain-free grip and maximum grip at the start and again later (grade B, Lucado and colleagues, 2022). You can borrow the idea without the equipment. Pick one gripping task you can repeat exactly, do it on both sides, and compare. You are there when the sore side matches the other one, the bony point is no longer tender to press, and a hard day of using the arm does not leave you sore the next morning.

How long does tennis elbow last without treatment?

In the trial that answers this most directly, the group assigned to wait and see, who had neither the physiotherapy program nor an injection, reached 56 of 62 completely recovered or much improved at 52 weeks (Bisset and colleagues, 2006). That is reassuring about the year and says nothing kind about the months in between: at 6 weeks only 16 of 60 in that group reported success. Read that arm carefully before you call it untreated. Everyone in the trial was given a booklet explaining the condition and practical advice on managing it. The waiting group were told how to change their daily activities and could use painkillers, heat, cold or a brace, and 34 of the 62 went and found some other treatment during the year anyway. The authors say plainly that this group's progress was not natural history alone. Untreated also means unmodified, and most people cannot leave the arm alone for a year because the aggravating load is their job or their sport. Coombes and colleagues (2015), in their review of the field, describe a spread of outcomes from symptoms that clear after simple advice to pain that persists whatever is tried, so waiting is a gamble rather than a plan.

References

Binder AI, Hazleman BL. Lateral humeral epicondylitis: a study of natural history and the effect of conservative therapy. British Journal of Rheumatology. 1983;22(2):73-76. https://doi.org/10.1093/rheumatology/22.2.73
Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333(7575):939. https://doi.org/10.1136/bmj.38961.584653.AE
Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309(5):461-469. https://doi.org/10.1001/jama.2013.129
Coombes BK, Bisset L, Vicenzino B. Management of lateral elbow tendinopathy: one size does not fit all. Journal of Orthopaedic and Sports Physical Therapy. 2015;45(11):938-949. https://doi.org/10.2519/jospt.2015.5841
Karanasios S, Korakakis V, Whiteley R, Vasilogeorgis I, Woodbridge S, Gioftsos G. Exercise interventions in lateral elbow tendinopathy have better outcomes than passive interventions, but the effects are small: a systematic review and meta-analysis of 2123 subjects in 30 trials. British Journal of Sports Medicine. 2021;55(9):477-485. https://doi.org/10.1136/bjsports-2020-102525
Lucado AM, Day JM, Vincent JI, MacDermid JC, Fedorczyk J, Grewal R, Martin RL. Lateral elbow pain and muscle function impairments: clinical practice guidelines. Journal of Orthopaedic and Sports Physical Therapy. 2022;52(12):CPG1-CPG111. https://doi.org/10.2519/jospt.2022.0302
Nilsson P, Baigi A, Swärd L, Möller M, Månsson J. Lateral epicondylalgia: a structured programme better than corticosteroids and NSAID. Scandinavian Journal of Occupational Therapy. 2012;19(5):404-410. https://doi.org/10.3109/11038128.2011.620983
NHS. Tennis elbow. Page last reviewed 31 May 2024. https://www.nhs.uk/conditions/tennis-elbow/
NHS. Elbow and arm pain. Page last reviewed 26 January 2024. https://www.nhs.uk/symptoms/elbow-and-arm-pain/
NHS. Septic arthritis. Page last reviewed 3 September 2026. https://www.nhs.uk/conditions/septic-arthritis/
NHS. Symptoms of a stroke. Page last reviewed 12 September 2024. https://www.nhs.uk/conditions/stroke/symptoms/

Written and checked by the PocketPhysio editorial team. Last updated 2026-10-24.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.