Overview

If you've been struggling with elbow pain and wondering if it will go away on its own, you're not alone. Many people assume that tennis elbow is just a temporary discomfort, but leaving it untreated can lead to chronic pain, limited mobility, and even long-term disability. 

At first, the pain may seem mild, an occasional soreness after activity. However, as the condition progresses, even simple actions like shaking hands, opening a jar, or holding a coffee cup can become painful. 

Without proper care, tennis elbow can limit not only your ability to work but also your ability to enjoy hobbies and daily routines. If left untreated, some cases can persist for several months or even years, making treatment more difficult and recovery much longer.

Understanding the risks of ignoring tennis elbow is the first step toward preventing chronic pain and permanent damage. The good news? There are effective ways to manage and treat this condition before it significantly impacts your life.

Tennis elbow

Tennis elbow, or lateral epicondylitis, occurs when the tendons in your elbow become strained due to repetitive motion. It’s most commonly seen in athletes and people with physically demanding jobs, but it can affect anyone, even those who work at a desk for long hours. It is a degenerative condition, meaning it worsens over time if not managed properly.¹

Despite its name, you don’t have to play tennis to develop this condition. It results from overuse or repetitive stress on the tendons that attach your arm muscles to the lateral epicondyle, the bony bump on the outside of the elbow.

The condition typically develops over time due to small tears in the tendons. These tears cause inflammation, weakening, and pain. Without proper management, the damage can become chronic (long-term), leading to long-term discomfort and reduced mobility. Activities that require gripping, lifting, or twisting motions, such as typing, using hand tools, or playing certain sports, can contribute to the development of tennis elbow.

While tennis elbow can sometimes heal on its own, many cases persist for months or even years without appropriate treatment. The pain can spread down the forearm, making everyday tasks like opening a jar or shaking hands painful. Recognising the early signs and seeking treatment can prevent the condition from worsening and improve recovery outcomes.

Causes of tennis elbow

Tennis elbow develops due to repetitive stress and overuse of the forearm muscles and tendons. Common causes include:²

• Repetitive arm movements: Activities that require continuous use of the forearm muscles, such as painting, typing, or using tools, can strain the tendons
• Participation in sports: Engaging in racket sports like tennis, especially without proper technique, can lead to overloading of the elbow tendons
• Occupational hazards: Jobs that involve repetitive motions, such as carpentry or plumbing, heighten the risk of developing tennis elbow
• Sudden overload of the tendon: Abrupt increases in activity, such as starting a new sport or heavy lifting, can overload the forearm and trigger tennis elbow
• Atrophied tendons from sedentary lifestyles: If you've been inactive for a long time and suddenly begin vigorous activity, your tendons may not be adequately prepared for the increased strain

Symptoms of tennis elbow

The primary symptom of tennis elbow is pain on the outside of the elbow, which may extend into the forearm and wrist. Other symptoms include:²

• Weak grip strength: You might find it difficult to grip objects or shake hands because of pain and weakness
• Pain during activities: Activities such as lifting, bending your arm, or turning a doorknob can trigger discomfort
• Morning stiffness: Your elbow might feel stiff, especially when you first wake up
• Tenderness: The outer elbow is often sensitive to touch
• Pain on resisted finger extension: Extending (straightening) your third finger against resistance can notably increase the pain
• Pain that radiates down the forearm: In some cases, the discomfort spreads from the elbow to the wrist
• Burning sensation around the elbow: Some individuals report a burning pain along the outside of the elbow

Outcomes of untreated tennis elbow

Ignoring tennis elbow might seem harmless at first, but the consequences can build up over time. What starts as mild discomfort can develop into persistent pain that affects daily tasks, work, and even sleep. Without intervention, the tendons in your elbow may continue to weaken, making recovery much harder. The following is may happen if tennis elbow is left untreated:^2,5,6

• Chronic pain and weakness: The pain may subside briefly but often recurs, becoming a persistent issue
• Reduced range of motion: Inflammation and scar tissue can gradually restrict your elbow and wrist movement
• Tendon degeneration: Small tears in the tendons can worsen over time, leading to long-term weakening and an increased risk of rupture (complete tearing)
• Compensation injuries: To avoid pain, you might unknowingly change your movement patterns, placing extra stress on your shoulder, wrist, or even the opposite arm instead
• Delayed recovery & permanent damage: The longer the condition is ignored, the more challenging it becomes to fully recover; some individuals may experience lifelong discomfort or disability

Why some people avoid treatment

Many people delay treatment for tennis elbow because they believe the condition will resolve on its own. While some cases do improve naturally within a year, research shows that up to 20% of cases persist beyond 12 months.² Common reasons for postponing treatment include:

• “It’s just a minor strain; it’ll heal on its own”
• “I don’t play tennis, so it can’t be tennis elbow”
• Fear of medical costs or invasive procedures
• Belief that resting the arm is sufficient (which isn’t always true)

The reality is that ignoring the pain and continuing your usual activities can worsen the condition, leading to chronic pain and progressive tendon damage.²

The road to recovery: treatment options

The good news is that early intervention can significantly improve recovery outcomes.⁴ Effective treatments include:

• Rest & activity modification: Reducing or modifying activities that strain the elbow can prevent further damage
• Physical therapy & strengthening exercises: A tailored therapy program can restore function and build resilience in the affected tendons⁴
• Braces & supports: Using an elbow brace can help reduce tendon stress and lessen the pain
• Shockwave therapy: Extracorporeal shockwave therapy (ESWT) has been shown to reduce pain, especially in early-stage cases of tennis elbow⁹
• Hyaluronic acid injections: Injections of hyaluronic acid have demonstrated promise in reducing pain and improving function in some chronic cases⁸
• Surgery: Reserved for severe cases where non-invasive treatments have failed; less than 10% of patients require surgery⁶

Preventing long-term damage

To avoid the long-term complications of untreated tennis elbow, prevention is key. Here’s how you can keep yourself from over-straining your tendons:

• Practice proper technique in sports and daily activities
• Incorporate strength training and flexibility exercises to build a resilient forearm
• Make ergonomic adjustments at work (such as using wrist supports or adjusting your desk setup)
• Listen to your body and don’t ignore persistent pain

FAQs

Can tennis elbow heal on its own?

Yes, some cases resolve naturally within 6 to 24 months, but many persist without proper management.⁵

How long does recovery take with treatment?

With appropriate therapy, most people experience improvement within 6-12 weeks, though severe cases might take longer.⁴

Can I still use my arm if I have tennis elbow?

Yes, but you should modify your activities to avoid further strain on your tendons.²

What happens if I ignore the pain?

Untreated tennis elbow can lead to chronic pain, tendon degeneration, and reduced function.²

Is surgery the only solution for severe cases?

No, surgery is considered a last resort. Many people recover with non-invasive treatments.⁶

Summary

• Tennis elbow is a degenerative condition that can worsen if left untreated
• Ignoring it can lead to chronic pain, tendon weakening, and long-term disability
• Up to 20% of cases may persist beyond a year, making early treatment essential
• Effective treatments include physical therapy, bracing, and activity modification
• Newer options, such as hyaluronic acid injections, show promise for chronic cases
• Surgery is rarely needed but might be required in severe, persistent cases

If you’re experiencing persistent elbow pain, don’t wait. Taking action now can prevent years of discomfort and potential disability.