Tennis elbow is a tendon problem, not an inflammation
Lateral epicondylalgia — the clinical name for tennis elbow — is pain at the bony point on the outside of the elbow where the wrist-extensor tendons attach. Those tendons work every time you grip, and when the grip demand of your week jumps (a new job, a renovation, a run of overtime, a new pressing program at the gym) the tendon can be overloaded faster than it adapts. Under the microscope the tissue shows a failed healing response rather than true inflammation, which is why anti-inflammatory strategies have such a short-lived effect and why the condition responds to load.
It is not rare. A Finnish population study of 4,783 adults aged 30 to 64 found definite lateral epicondylitis in 1.3% of the population at any one time, with no difference between men and women and the highest rates in the 45-to-54 age group — exactly the working-age bracket we see most of in Logan. Smoking and repetitive forceful arm work were the standout risk factors.
What else it could be: pain referred from the neck (very common and often missed), a nerve entrapment around the elbow, or golfer’s elbow on the inside of the joint. Part of the first visit is testing the neck and the nerves so that we treat the right thing.
Two Brisbane trials that should change what you ask your GP for
The 2006 BMJ trial randomised 198 Brisbane adults with tennis elbow of at least six weeks’ duration to eight sessions of physiotherapy (elbow mobilisation with movement plus exercise), a corticosteroid injection, or wait-and-see. The injection was clearly the best option at six weeks — and then it reversed. Of the 65 people who improved after an injection, 47 relapsed, and at 52 weeks the injection group had significantly poorer outcomes than the physiotherapy group. Physiotherapy beat wait-and-see in the first six weeks; by a year most people in both of those groups had a good outcome, but the physiotherapy group had needed less additional treatment along the way.
The 2013 JAMA trial went further, randomising 165 Brisbane patients to a corticosteroid or a placebo injection, each with or without physiotherapy. At one year, 83% of the corticosteroid group had recovered or much improved compared with 96% of the placebo-injection group, and the recurrence rate after corticosteroid was 54% against 12% after placebo. Physiotherapy sped things up early — at four weeks, 39% of the placebo-plus-physio group had recovered or much improved versus 10% without physio — but by a year the physio and no-physio groups had converged. In other words: the injection actively harms your one-year odds, and physiotherapy gets you to the good outcome sooner.
Neither trial says an injection is never appropriate. For someone who cannot work and needs short-term relief to start rehab, it can be a deliberate trade-off. What the trials do say is that it should not be the first move, and that it works better as a bridge into a loading program than as a treatment on its own.
What tennis elbow physio involves at Daisy Hill
We start by finding the load that caused it and adjusting it — grip size on tools, the way a load is lifted, keyboard and mouse set-up, the pressing and pulling volume in a training week. Then we load the tendon: progressive wrist-extensor and grip strengthening, started at a level that produces only mild, settling discomfort and built up over weeks. The heavy-slow-resistance principles in our tendon pain guide apply directly here. Mobilisation with movement — the hands-on technique used in the 2006 trial — gives many people immediate pain-free grip in the room and is used to make the exercise possible.
A counterforce brace or taping can take the edge off at work while the tendon builds capacity. Dry needling is an option for short-term relief in some patients (see our dry needling page). We also assess and, where needed, treat the neck and shoulder — a weak or stiff shoulder loads the forearm more than most people realise, and our shoulder physio page explains that side of the picture. For gym-goers the return to pressing and pulling is planned in stages in our gym-based rehab space.
How long tennis elbow takes to settle
Honestly: months. Both trials followed people for a year because that is the natural timescale of the condition, and the good news inside those results is that most people do recover within it. What a well-run program changes is how quickly you get pain-free function back, how much you can keep working in the meantime, and — critically — whether it comes back. The pattern we look for is steady improvement in pain-free grip strength week on week, which we measure rather than guess, and a return to the tasks that started it with the load managed differently the second time around.
Tennis elbow at a glance
Pain on the outside of the elbow with gripping and lifting, usually after a jump in arm workload · A tendon overload problem, not an inflammation · Corticosteroid injection: best at six weeks, worst at one year (54% recurrence vs 12% for placebo in the JAMA trial) · Physiotherapy with progressive loading and mobilisation gets people better sooner and with less relapse · See a GP promptly for elbow pain with a hot swollen joint or fever, marked weakness or numbness in the hand, or pain after a fall with an inability to straighten the arm.
Paying for elbow physio in Logan
Private patients can claim on the spot through HICAPS — see our physiotherapy fees page. Tennis elbow that started at work is usually managed through your WorkCover claim — see our occupational health physio page. If it is managed under a GP chronic condition management plan, Medicare rebates item 10960 ($63.40 from 1 July 2026, up to five allied health visits a calendar year, pooled across professions) — details on our Medicare physiotherapy page. DVA card holders pay nothing for accepted conditions and NDIS participants can use their plan.
Book an elbow assessment in Daisy Hill
Daisy Hill Physio is at Unit 4, 11–13 Allamanda Drive, Daisy Hill QLD 4127 — in Logan City, Queensland, Australia (not Logan, Utah) — and sees elbow patients from Springwood, Shailer Park, Slacks Creek, Underwood, Rochedale South, Cornubia and Loganholme. Book online or call 07 3209 2000 and tell reception it is elbow pain. Principal physiotherapist Joshua Hopton reviewed this page; meet the whole team on our team page or read how to choose a physio in Logan.
Reviewed by Joshua Hopton, Physiotherapist, Daisy Hill Physio. Content current at 16 September 2026. This page is general information, not a diagnosis — see a physiotherapist or GP for advice about your own situation.
Sources: Bisset L et al. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ 2006;333:939 · Coombes BK et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA 2013;309:461–469 · Shiri R et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol 2006;164:1065–1074. Accessed 16 September 2026.
