Lateral Epicondylitis Treatment in NYC: What the Evidence Says

Quick Answer

Lateral epicondylitis is the medical name for tennis elbow, a wear-related problem in the forearm tendon at the outside of the elbow. About 9 in 10 people improve within a year, steroid injections help early but do worse later, surgery is uncommon, and embolization is an early-stage option for pain that persists.

If your chart, a referral or an insurance form says "lateral epicondylitis," you have been given the medical name for tennis elbow. This page explains what the diagnosis describes, how often it settles without treatment, what each standard treatment does and does not do according to the research, and where newer options fit for the smaller group whose pain does not go away.

What "lateral epicondylitis" means

The lateral epicondyle is the bony bump on the outside of your elbow. The muscles that lift your wrist and fingers attach there through a shared tendon. MedlinePlus, the patient site of the U.S. National Library of Medicine, lists lateral epicondylitis as another name for tennis elbow: soreness or pain on the outside of the upper arm near the elbow.

If you are reading your own records, you may also see a code. In the ICD-10 system used on U.S. medical records and insurance claims, lateral epicondylitis sits in category M77.1. The full code adds a digit for the side: M77.11 for the right elbow, M77.12 for the left, and M77.10 when the side is not specified. The code is a billing label. It says nothing about how severe your case is.

For a closer look at symptoms, exam tests and look-alike conditions, see our guide to tennis elbow causes, symptoms and diagnosis.

What is actually wrong with the tendon

The ending "-itis" suggests inflammation, but that is not the main finding. A 2016 orthopedic review describes lateral epicondylitis as a chronic, symptomatic degeneration of the wrist extensor tendons where they attach to the bone.

Repeated small tears lead to degenerative changes inside the tendon, a state doctors call tendinosis. MedlinePlus puts it simply: repeated use causes small tears, and over time the tendon cannot heal, which leads to irritation and pain at the attachment.

One more detail from that review matters later on this page. Ultrasound with color Doppler can show new, abnormal small vessels in the painful area. Those vessels are what embolization is aimed at.

How common it is, and how often it settles

Lateral epicondylitis is common. The 2016 review estimates that it affects between 1% and 3% of the population, mostly in middle age, with no difference between men and women. It shows up most often in the 30s to 50s.

The most important fact about this diagnosis is its natural course. A 2022 meta-analysis looked only at people in the placebo or no-treatment groups of 24 randomized trials, 1,085 people in all. About 89% reported being globally improved at one year.

Still, a year is a long time when your grip hurts every day, and roughly 1 in 10 people in those trial groups had not improved at a year. Every treatment below should be judged against that background.

Questions about your treatment options? Dr. Fox can help.

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This article is part of our Embolization Guide.

What each standard treatment does, and does not do

Treatment	What the evidence supports	What it has not been shown to do
Exercise and manual therapy	A slight reduction in pain and disability in the first three months (low-certainty evidence)	Benefits that last beyond that period
Counterforce brace	Less pain in the early weeks in a small placebo-controlled trial	Firm conclusions; older reviews could not draw any
Anti-inflammatory medicines	Topical gels may reduce pain for up to four weeks (low-quality evidence)	A clear benefit from pills; two trials disagreed
Steroid (cortisone) injection	Strong pain relief for the first several weeks	Lasting benefit; outcomes at 6 and 12 months are worse than no injection
PRP or blood injection	Less pain than steroid at 3 and 6 months in pooled trials (low-quality evidence)	A meaningful benefit over placebo injection
Shock wave therapy	Few side effects	Benefit over placebo in most pooled analyses

Rest, exercise and bracing

MedlinePlus suggests starting by resting the arm for two or three weeks and changing or avoiding the activity that triggers pain. A physical therapist can then teach stretching and strengthening exercises for the forearm.

The therapy research is modest. A 2024 Cochrane review of 23 randomized trials (1,612 participants) found that manual therapy, prescribed exercise or both reduced pain by about half a point on a 10-point scale compared with minimal or no treatment at four weeks to three months. The authors called the evidence low-certainty, said the difference may not be clinically worthwhile, and found the benefits were not sustained. No serious adverse events were reported, so therapy remains a low-risk first step.

A counterforce brace wraps around the upper forearm and takes some pressure off the muscles. A small randomized trial in recent-onset tennis elbow (17 people with a real brace, 14 with a placebo brace) found less pain at 2 to 12 weeks. An older Cochrane review of five small trials could not reach definitive conclusions.

For anti-inflammatory medicines, a 2013 Cochrane review of 15 trials (759 participants) could not draw firm conclusions, and the typical trial lasted only two weeks.

Steroid injections: better early, worse later

This is the finding patients are least often told. A 2010 systematic review in The Lancet covering 41 trials of injections for tendon problems found that for lateral elbow pain, a steroid injection had a large effect on pain in the short term, around four weeks. At about 26 weeks and 52 weeks, the results favored no injection at all.

A 2013 randomized trial in JAMA with 165 patients showed the same pattern against a placebo injection. At one year, 83% of the steroid group were completely recovered or much improved, compared with 96% of the placebo group. Recurrence was 54% after steroid and 12% after placebo.

The 2016 review advises avoiding steroid unless a short-term result is specifically needed. If you choose an injection, choose it knowing the trade. Our article on embolization vs. cortisone and PRP injections goes deeper.

PRP and shock wave therapy

Platelet-rich plasma (PRP) is made from your own blood and injected into the tendon. A 2023 meta-analysis of 13 randomized trials found steroid was ahead for pain at one month and PRP was ahead at three and six months, though the authors rated the evidence low quality and said it may not justify recommending one over the other. But beating steroid at six months is a low bar, because by about six months steroid does worse than no injection at all. When PRP and blood injections were compared with placebo injections in a 2021 Cochrane review of 32 studies (2,337 participants), they probably provided little or no clinically important benefit at three months, and no benefit at 6 and 12 months.

For shock wave therapy, a Cochrane review of nine placebo-controlled trials (1,006 participants) found no significant benefit over placebo in 11 of 13 pooled analyses.

When surgery is considered, and how rarely

Surgery is reserved for persistent pain and disability after a well-performed course of non-surgical care. The American Academy of Orthopaedic Surgeons (AAOS) patient guidance puts that point at 6 to 12 months without improvement. The operation removes the degenerated part of the tendon.

Few people get that far. In a U.S. insurance database study covering 2007 to 2014, 1,694 of 85,318 people diagnosed with lateral epicondylitis had surgery. That is 2%.

AAOS describes surgery as successful in 80 to 90% of patients and says return to athletic activity usually takes four to six months. The research behind surgery is thinner than those figures suggest, though. A Cochrane review found only five small trials (191 participants) and judged the evidence insufficient to support or refute surgery. A small randomized trial comparing tendon removal with a sham skin incision (13 patients in each group) found no difference at six months or at two and a half years. We compare the two paths in tennis elbow embolization vs. surgery.

Where embolization fits for pain that persists

In embolization, a doctor guides a thin catheter through an artery to the small branches around the painful tendon and injects tiny particles to reduce flow through the abnormal vessels described earlier. Our tennis elbow embolization page explains the procedure, and the embolization guide covers how it is used in other joints.

The evidence is early, and you should weigh it that way:

The main peer-reviewed study is a 2017 uncontrolled pilot study from Japan with 24 patients who had symptoms for more than six months and had not improved after at least three months of conservative care. In the 22 patients followed for two years, the average disability score (QuickDASH, 0 to 100, lower is better) went from 50.8 before treatment to 2.7 at two years. No major adverse events were reported.
According to a later systematic review, 36% of the patients in that study needed a second embolization after six months.
A 2022 systematic review found only cohort studies and case series, with no placebo-controlled study. We found no randomized or sham-controlled trial of elbow embolization as of October 2026.
A U.S. study at UCLA is testing the procedure under an FDA investigational device exemption. It is a single-group study of about 13 participants, with primary data collection estimated to finish at the end of 2027.

With a condition that improves on its own in most people, a before-and-after study with no comparison group can make any treatment look good. The early embolization numbers are encouraging. They are not proof.

In a 2025 safety study of 431 patients treated in various joints, pain at the treated site lasting more than a week occurred in 5.8% to 22.1% of patients depending on the particle used, and it was more common in the elbow. The UCLA trial excludes people with poor kidney function, a contrast allergy that does not respond to steroids, active infection or cancer, an uncorrectable bleeding disorder, or prior surgery on that elbow. Those are trial exclusion criteria, not a complete list.

On insurance: we did not find a major insurer policy that lists elbow embolization as covered, and Aetna classifies the better-studied knee version as experimental, investigational or unproven. Our Manhattan office verifies your benefits before any treatment.

Embolization is reasonable to discuss after months of well-done conservative care, once the diagnosis is solid. The study-by-study details are in tennis elbow embolization research and success rates.

When the diagnosis itself should be rechecked

The diagnosis rests on your history and an exam: tenderness where the tendon attaches, and pain when you bend the wrist back against resistance. A 2018 review found that elbow exam tests have been poorly studied for accuracy, so ask your doctor to revisit the diagnosis if:

You cannot fully bend or straighten the elbow. Range of motion is usually normal in this condition, and limited motion points to something else.
Resisted wrist extension does not reproduce your pain. Nerve entrapment near the elbow can behave this way.
Your pain has not followed the usual course after many months. Cartilage problems in the nearby joint can sit behind stubborn outer elbow pain.

Frequently Asked Questions

Is lateral epicondylitis the same as tennis elbow?

Yes. Lateral epicondylitis is the medical term and tennis elbow is the everyday name for the same condition. It is also seen in people who do repetitive wrist-twisting work, such as painters, plumbers, cooks and butchers, and sometimes there is no known cause.

What is the ICD-10 code for lateral epicondylitis?

It falls in ICD-10 category M77.1. The full codes are M77.11 for the right elbow, M77.12 for the left elbow and M77.10 when the side is not specified.

Will lateral epicondylitis go away on its own?

Usually. In a 2022 analysis of people in the placebo or no-treatment groups of 24 trials, about 89% were improved at one year. A minority have pain that persists.

Should I get a cortisone shot for lateral epicondylitis?

A steroid injection often gives strong relief for the first several weeks. In pooled trials, people who had one did worse at about 6 and 12 months than people who had no injection, and in one trial they did worse at one year than people given a placebo injection, so it is worth discussing that trade-off with your doctor first.

Is embolization a proven treatment for lateral epicondylitis?

Not yet. The main evidence is a 24-patient uncontrolled pilot study with two years of follow-up, and no randomized or sham-controlled trial has been published. It is considered for people whose pain persists after months of standard care.

Keep Reading

Sources

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.

Lateral Epicondylitis: The Diagnosis and Its Treatments, Explained