Tennis elbow · Golfer's elbow · Vienna
A tennis elbow (or golfer's elbow) can be surprisingly stubborn – and a lot of common advice makes it worse rather than better. As an English-speaking specialist in Vienna, I treat elbow tendon pain with what the evidence actually supports: the right loading, shockwave therapy, and surgery only in the rare cases that truly need it.
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The tennis elbow (lateral epicondylitis) is an overload of the tendon attachments on the outer side of the elbow – the muscles that extend the wrist. Despite the name, most patients never played tennis: it comes from computer work, repetitive gripping, DIY or lifting.
Typical: pain when gripping, shaking hands, lifting a coffee cup or turning a door handle, often radiating down the forearm.
The golfer's elbow (medial epicondylitis) is the mirror image on the inner side – the tendons that flex the wrist. It is less common than tennis elbow but follows the same principle: an overloaded tendon origin that has not been given the right kind of load to recover.
The good news: both respond to the same evidence-based approach, and both very rarely need surgery.
The single most important message: this is a loading problem, not something to simply rest away. Controlled load is the treatment.
Identifying and modifying the trigger (mouse and desk setup, tools, sport technique), combined with a structured programme of eccentric strengthening – the best-evidenced treatment there is.
For stubborn cases, shockwave therapy stimulates the tendon's healing response – a well-tolerated, non-surgical option with good evidence for chronic tendon pain.
If 6–12 months of consistent conservative treatment genuinely fail and the elbow remains disabling, a small procedure to release and clean up the affected tendon origin can help. This is the exception, not the rule – and I will tell you honestly if you don't need it.
Two common instincts backfire: complete rest, which deconditions the tendon further, and repeated cortisone injections, which relieve pain briefly but are associated with worse results at 6–12 months and can weaken the tendon.
The path that works is less dramatic but more reliable: the right load, patience, and dealing with the underlying cause.
Why patients with elbow pain come to me
The best-evidenced treatments are eccentric strengthening of the forearm muscles and shockwave therapy – pure rest or repeated cortisone injections tend to worsen the long-term outlook. It is also important to change the triggering loads (mouse, tools, sport technique). Only when 6–12 months of consistent conservative treatment have failed does surgery become a topic.
Tennis elbow (lateral epicondylitis) causes pain on the outer side of the elbow, typically when gripping and extending the wrist. Golfer's elbow (medial epicondylitis) causes pain on the inner side, when flexing the wrist and gripping. Both are overload conditions of the tendon attachments and are treated along similar lines.
Rarely. The great majority of tennis elbows settle with conservative treatment – load management, eccentric exercises and shockwave therapy – even if it takes patience. Surgery (a release of the affected tendon origin) is reserved for the few cases that remain genuinely disabling after many months of proper treatment.
A cortisone injection can relieve pain in the short term, but studies show worse results at 6–12 months compared with exercise or shockwave therapy – and repeated injections can weaken the tendon. I therefore use them sparingly, if at all, and focus on treatments that improve the long-term outcome.
It requires patience: with consistent treatment most people improve over a few months, but a stubborn tennis elbow can take 6–12 months to settle fully. The key is to keep loading the tendon in a controlled way rather than avoiding all use – and to address the underlying trigger.
Let's find out what's driving it and build a plan that actually works – in English, without a quick-fix injection you'll regret.
1040 Vienna: +43 1 585 62 60 · 1020 Vienna: +43 1 890 45 20
By prior appointment only · 1040 Vienna-Wieden (Große Neugasse 28/2) · 1020 Vienna-Leopoldstadt (Vorgartenstrasse 206c)