Shockwave · Elbow pain

Shockwave for Tennis and Golfer's Elbow

Tennis elbow and golfer's elbow are overuse problems of the forearm tendons. Most cases settle with time and exercise. Here is where shockwave fits, and why the evidence is mixed.

Book a shockwave consultation (214) 233-3094

In short

Tennis elbow causes pain on the outside of the elbow; golfer's elbow causes pain on the inside. Both usually improve with rest from aggravating activities, a brace or strap, and stretching and strengthening exercises. For tennis elbow, shockwave research is mixed: a Cochrane review found little or no benefit over placebo, while some later reviews were more positive. For golfer's elbow there is very little shockwave research at all. Your provider decides whether it is worth considering.

Updated October 30, 2026 · Educational information, not medical advice. Results vary, and not everyone is a candidate.

What these conditions are

Your forearm muscles attach to two bony bumps at the elbow. The muscles that lift your wrist and fingers attach on the outside (the lateral epicondyle). The muscles that bend your wrist and turn your palm down attach on the inside (the medial epicondyle).

Tennis elbow (lateral epicondylitis, or lateral elbow tendinopathy) is irritation and wear of the tendons on the outside. Golfer's elbow (medial epicondylitis) is the same kind of problem on the inside. Golfer's elbow is much less common: a recent review put it at about 1 in 10 cases of epicondylitis. Despite the names, most people who get either one do not play tennis or golf.

Typical symptoms and common causes

Symptoms usually build up gradually over weeks or months, often with no single injury:

Tennis elbow: pain or burning on the outer elbow, weaker grip, pain when lifting, gripping or shaking hands, and sometimes pain at night
Golfer's elbow: a dull ache on the inner elbow that can spread into the forearm, worse with gripping, bending the wrist or turning the palm down
With golfer's elbow, some people also notice tingling toward the ring and little fingers, because the ulnar nerve runs close by

Both come from repeated gripping and wrist or forearm movements: computer work, using hand tools, manual jobs, racquet sports, throwing, golf, or playing an instrument. They are most common from middle age on.

First-line care: most cases settle

The good news is that most people get better without surgery. The American Academy of Orthopaedic Surgeons reports that the large majority of people with tennis elbow do well with nonsurgical treatment, and reviews of golfer's elbow describe the same stepwise, conservative approach. Recovery can take weeks to months, and occasionally longer than a year.

Rest from, or change, the activities that provoke the pain for several weeks
A forearm strap or wrist brace to take load off the tendon
Ice or heat for comfort, and over-the-counter pain relief if it suits you
Stretching, then gradually building strength in the wrist and forearm, often with a physical therapist
Checking technique and equipment at work or in sport, such as grip size or tool handles

If home care has not helped after a few weeks, physical therapy is the usual next step.

Where shockwave fits

Shockwave is not a first-line treatment for elbow pain. When it comes up, it is usually for tennis elbow that has lasted many months despite rest, a brace and a proper exercise program. NICE in the UK describes this group as refractory tennis elbow.

The American Academy of Orthopaedic Surgeons notes that many doctors consider shockwave for tennis elbow experimental, though some sources show it can be effective. That is a fair summary of where things stand. If it is used, it is generally alongside continued exercise, not instead of it.

What the research shows

For tennis elbow, the evidence is genuinely mixed:

A Cochrane review of nine placebo-controlled trials with about 1,000 participants concluded that shockwave provided little or no benefit for pain and function in lateral elbow pain. That review is from 2005, and newer trials have been published since.
A 2024 review of 18 randomized trials of shockwave for arm and shoulder tendon problems, including tennis elbow trials, found that shockwave relieved pain more than placebo on average. The authors used a broad mix of studies and devices.
NICE found no major safety concerns but describes the evidence on effectiveness as inconsistent.

For golfer's elbow, there is very little to go on. The Cochrane review covered only the outer elbow, and the 2024 review did not include any golfer's elbow trials. We could not find good-quality trials of shockwave for golfer's elbow specifically, so any use there is based on research in other tendons.

Side effects reported in trials were mostly minor and short-lived, such as temporary pain and skin redness. Results vary, and not everyone responds.

What a visit at Innovare Tx looks like

You start with an evaluation by a provider, Charles Ortega, PA-C, or Rowena Calleja, PT, a Texas-licensed physical therapist. They ask about your work, hobbies and what you have tried, examine the elbow, and check for other causes of elbow and forearm pain, such as a pinched nerve in the neck or nerve irritation at the elbow. If your elbow pain is recent, the provider is more likely to suggest exercise and load changes first.

If shockwave seems reasonable, the provider sets the plan, often combined with physical therapy. Trained medical staff perform the sessions: they locate the most tender area, apply gel and focus the waves there for about 15 to 30 minutes. Mild, temporary discomfort is common. Your provider may ask you to avoid anti-inflammatory medicines and heavy gripping during the course; do not stop a prescribed medicine without asking the prescriber.

Most insurance plans do not cover shockwave therapy, so the sessions are self-pay; your office visit may be billable to insurance. See what to expect.

When to get checked promptly

See someone soon, rather than waiting it out, if:

The pain started with a fall, a pop or a sudden injury
The elbow is badly swollen, looks misshapen, or you cannot bend or straighten it
You have numbness, tingling or weakness in your hand that does not go away
The elbow is red and hot, or you feel feverish or unwell
The pain is getting worse despite rest and home care

Frequently asked questions

Most cases do improve with time, rest from aggravating activities and exercise, although it can take months. Most people get better without surgery.

The research is mixed. A Cochrane review found little or no benefit over placebo, while a more recent review of arm and shoulder tendon trials found a modest average benefit. Results vary, and your provider can talk through whether it is worth trying in your case.

People with golfer's elbow sometimes ask about it, but there is very little research on shockwave for the inner elbow. Exercise and load changes remain the main approach, and your provider decides whether shockwave is appropriate.

Usually you cut back on whatever provokes the pain for a few weeks, then build back gradually. A physical therapist can help you work out what to change and when to return.

Sources

Keep reading

See everything in the shockwave guide

Wondering whether shockwave fits your pain?

Book a consultation at our Addison clinic. A provider examines the area, explains your options, and tells you plainly whether focused shockwave makes sense for you.

Book Your Visit (214) 233-3094