Physio Bangkok/Conditions
Tennis and Golfer’s Elbow Physiotherapy in Bangkok
Tennis elbow and golfer’s elbow are overuse problems in the tendons that attach your forearm muscles to the outside or inside of your elbow. At Aspire Physio Bangkok, near Asok, our physiotherapists settle the pain, then rebuild your tendon’s tolerance with progressive loading on the gym floor, the exercise-led approach guidelines recommend for tennis elbow. The clinic is on the 2nd floor of Jasmine Building, Sukhumvit Soi 23, a short walk from Asok BTS and Sukhumvit MRT, and your first consultation is free. Book through our contact page or call 082-281-8009.
- Free first consultation
- Licensed physiotherapists
- English and Thai
- Sukhumvit 23, near Asok BTS
Your physio team
Licensed physiotherapists who assess and treat you themselves, in English or Thai, from treatment through to the gym floor.
At a glance
| Also called | Lateral elbow tendinopathy (tennis elbow) and medial elbow tendinopathy (golfer’s elbow) |
|---|---|
| How common | In a Finnish population study, 1.3% of adults aged 30 to 64 had tennis elbow and 0.4% had golfer’s elbow |
| Typical recovery | Often 6 to 24 months to settle; about eight in ten people are significantly better after a year |
| Core treatment | Progressive resistance exercise for the forearm muscles, recommended (grade B) in the 2022 JOSPT guideline |
| Steroid injection | Faster relief at 6 weeks, but worse results at one year than physio or wait and see in trials |
| Scan needed? | Rarely, unless there’s been a fall or injury, or good rehab hasn’t helped |
What tennis elbow and golfer’s elbow are
Tennis elbow is pain where the tendons that lift your wrist and fingers attach to the bony point on the outside of your elbow, the lateral epicondyle. Most of the change happens in this common extensor tendon, especially the part belonging to a muscle called extensor carpi radialis brevis [1]. Golfer’s elbow is the same kind of problem on the inside, where the muscles that bend your wrist and turn your forearm palm down attach [7]. Clinicians call them lateral and medial elbow tendinopathy.
The old name, tendinitis, suggests ongoing inflammation. Research now points to a mix of changes in the tendon’s structure and in how your nervous system processes pain, and by the time people seek care, the inflammation has often settled while the pain remains [1]. That’s why treatment centres on rebuilding the tendon’s tolerance to load. With the right advice, most cases of tennis elbow settle within about a year [2][5].
Who gets it
In a Finnish population study of adults aged 30 to 64, 1.3% had tennis elbow and 0.4% had golfer’s elbow when they were examined, with rates highest between 45 and 54 [6]. Despite the name, most people with tennis elbow don’t play tennis [12], and one NHS service estimates that only around 5% of cases come from racquet sports [13].
Common causes and risk factors
Both are overuse problems. Common triggers include:
- Repeated gripping and wrist movement, such as typing and using a computer mouse [13]. Repetitive hand and wrist work for over two hours a day raises the risk [1].
- Manual work: forceful, repetitive tasks, handling heavy tools or loads, and repeated forearm twisting or screwing movements [1][6].
- A sudden jump in activity, such as a weekend of gardening, spring cleaning or DIY [13].
- Sport: racquet sports for tennis elbow [1], and golf, throwing, weightlifting and swimming for golfer’s elbow [7].
Smoking is linked to both conditions, and obesity to golfer’s elbow [6].
Symptoms
The main symptom is pain on the outside of your elbow with tennis elbow, or the inside with golfer’s elbow [11][14]. Tennis elbow pain can spread down the forearm [13]. Common patterns:
- Pain when you grip, twist or lift, such as turning a door handle or lifting a full kettle [12][15].
- Pain when you shake hands, unscrew a jar lid or carry shopping [15][13].
- Tenderness when you press on or just below the bony point of the elbow [12][7].
- A grip that feels weak [12].
- Stiffness bending or straightening the elbow, often worst first thing in the morning [13].
- Pain that disturbs your sleep when it’s severe [12].
Elbow movement is usually full, and losing movement can point to a different problem [1][7]. Your physio confirms the diagnosis from your history and by checking which movements reproduce your pain, such as resisted wrist or middle finger extension for tennis elbow [1], or resisted wrist bending and forearm turning for golfer’s elbow [7].
With golfer’s elbow, also tell your physio about any tingling in your hand. About 20% of people with golfer’s elbow also have irritation of the ulnar nerve, which runs behind the inner elbow [7].
When to see a doctor first
See a doctor first, or go to an emergency department, if any of these apply:
- An injury with swelling or a change in shape, or an arm you can’t move at all after a fall. These can mean a fracture or dislocation [7][8][13].
- A hot, swollen, tender elbow, especially if you feel feverish or unwell. This needs urgent medical review [8][13].
- Locking or painful catching, where the elbow sticks or clicks, especially with stiffness or loss of straightening. This points to a problem inside the joint, such as osteoarthritis [8].
- Pins and needles, numbness or weakness in your hand or arm. A nerve may be involved, from your neck or around the elbow [1][7][13].
- A lump that’s growing quickly, unexplained weight loss or night sweats [8][13].
- Extreme pain [13].
- A child or teenager with elbow pain after a fall or from throwing sports. Growing elbows have their own injuries, including fractures of the bone on the inner elbow [7].
Our physiotherapists screen for these at your first visit and will tell you if you need to see a doctor. We can recommend clinics nearby.
Your first consultation is free. A physiotherapist will assess you properly and explain what’s going on, with no pressure to book more.
The phases of tennis elbow rehab
Rehab follows a loading progression. The 2022 guideline for tennis elbow recommends progressing from isometric (holding) to isotonic (lifting and lowering) to eccentric (controlled lowering) exercise as your symptoms allow [1]. Golfer’s elbow has much less research, so we apply the same staged approach to the muscles on the inside of the forearm [14]. The timeframes are typical ranges. The right-hand column decides when you move on.
| Phase | Typical timeframe | What you notice | What rehab focuses on | We move on when you can… |
|---|---|---|---|---|
| 1. Calm and modify load | Typically the first 1 to 2 weeks of a new episode or flare-up [1] | Pain gripping, lifting and twisting. Everyday tasks hurt, and severe pain can disturb sleep. | Changing how you do the tasks that flare it, such as lifting palm up and gripping more lightly [12]. Short-term pain relief from elbow joint mobilisation, taping or a brace during aggravating tasks [1]. Gentle holds if they’re comfortable. | Get through daily tasks with only mild pain (about 3 out of 10 or less) [1], and do gentle holds without your elbow getting worse over the next 48 hours [13]. |
| 2. Isometric and isotonic loading | Typically weeks 1 to 6. It often takes 6 to 8 weeks of specific exercise to notice a clear difference [13] | Pain becomes more predictable. Your grip starts to feel stronger. | Wrist extensor work for tennis elbow, or wrist flexor and forearm-turning work for golfer’s elbow [7]. Holds first, then slow lifting and lowering against light resistance, about 20% to 40% of your maximum effort [1]. | Complete your sets with pain that stays mild during and for 48 hours after [13], with your pain-free grip strength improving on retesting [1]. |
| 3. Heavy slow and eccentric loading | Typically weeks 6 to 12. Exercise programmes in the guideline and trials run 6 to 12 weeks [1][9] | Less pain day to day. Heavier tasks start to feel manageable. | Gradually heavier loads, above about 40% of maximum effort, lifted and lowered slowly with emphasis on the lowering (eccentric) phase [1]. Load goes up only as fast as your elbow tolerates it [1][10]. | Handle heavier loads through full range without a flare that lasts beyond 48 hours [13], and grip for longer without pain building. |
| 4. Grip, whole-arm strength and return to sport or work | Typically from about weeks 8 to 12 onwards. It can take a further couple of months to feel fully better [13] | Pain is mild or gone in daily life. You want your full work or sport back. | Grip strength and endurance, shoulder and shoulder blade strength where it’s lacking, longer lever arms and weight-bearing through the arm, then faster sport and job-specific drills [1]. | Do your full work or sport, including repeated gripping and longer sessions, without symptoms building up afterwards. |
The phases overlap, and progress isn’t a straight line. A flare after a heavy week at work or a long session on court is common, and we step back until it settles [1]. Heavy loading needs to be earned. In a Norwegian trial of a heavy slow resistance programme, only 6 of 19 people kept it up, mostly because it increased their pain [10]. In a Danish trial, 12 weeks of heavy slow resistance with elastic bands at home improved symptoms in both the short and long term [9].
So heavier loading can help, once your elbow has shown it can cope. We move on when you meet the criteria, whatever the calendar says.
How we treat tennis elbow and golfer’s elbow
Find the cause
Your first session is with a licensed physiotherapist who takes a full history, screens for red flags and checks your neck, shoulder and wrist, since nerve problems from the neck and around the elbow can mimic tendon pain [1][7]. We test which movements reproduce your pain, check your pain-free grip strength as a baseline [1], and look at what your elbow has to handle: your desk set-up, tools, racquet or club, and training load. Most people don’t need a scan. Imaging is rarely needed unless you’ve had a fall or injury [12], and it’s mainly useful when good non-surgical care hasn’t worked [1]. We don’t do scans at the clinic, but we can recommend clinics nearby if you need one.
Settle the pain
Early on, we reduce the load that’s irritating the tendon while you keep using your arm. Hands-on treatment can help short term. The 2022 guideline supports elbow joint mobilisation to reduce pain and improve pain-free grip, and recommends combining strengthening with other treatments such as manual therapy [1]. It also supports dry needling, with the clearest benefit for pain in the short term, and rigid taping for short-term relief in an irritable elbow [1]. We use these to make loading more comfortable. Exercise drives the long-term result.
Build the strength
Progressive resistance exercise for the forearm muscles is the core of treatment. The guideline recommends isometric, isotonic and eccentric wrist extensor exercise for tennis elbow, and a phased return to heavier loads for people with demanding jobs, hobbies or sports [1]. You’ll move from the treatment room to the gym floor in the same building, often in the same session, where your physio sets and progresses your loads. Two of our physiotherapists are also qualified strength and conditioning specialists. Where your shoulder or shoulder blade muscles are weak, we train those too, as the guideline suggests [1].
Change the daily load
Rehab holds better when the daily load on the tendon changes too. For desk workers that means mouse, keyboard and breaks (see the home section below). For manual work and sport, we look at grip and equipment: a bigger grip on tools or a golf club, and lighter tools where possible, can ease the pain [12].
What about steroid injections?
Steroid injections are a medical treatment, so that decision sits with your doctor. We don’t give injections, but here’s what the research shows.
In an Australian trial of 198 people with tennis elbow, an injection had the highest success rate at 6 weeks: 78%, against 65% with physiotherapy and 27% with wait and see. By one year the order had reversed. Only 68% of the injection group reported success, against 94% with physiotherapy and 90% with wait and see, and many people who improved after the injection relapsed [2]. A later trial compared a steroid injection with a placebo injection. At one year, fewer people in the steroid group had recovered or were much improved (83% against 96%), and more had a recurrence (54% against 12%) [3]. A Lancet review found the same pattern across trials: a large drop in pain in the first weeks that reversed over the following 6 to 12 months [4]. For golfer’s elbow the evidence is thinner, and outcomes after injection may not differ much from natural recovery [7].
How long it takes and how many sessions
It varies with how long and how irritable your symptoms are, and with what your work or sport demands [1]. NHS guidance says tennis elbow can take 6 to 24 months to settle, and that eight out of ten people are significantly better after a year whether they have treatment or not [12]. Golfer’s elbow has a similar timescale [14], and conservative care may improve symptoms in about nine in ten people [7].
So what does physio add? In trials, physiotherapy brought faster improvement than waiting in the first 4 to 6 weeks [2][3], and people who had physio needed less extra treatment, such as anti-inflammatory tablets [2]. By one year, 83% to 90% of people in the wait-and-see groups also reported success [2][5]. Recovery isn’t always complete. Between 20% and 38% of people still have symptoms, or have them come back, 6 to 12 months after non-surgical care, and a repetitive or manual job makes slower recovery more likely [1]. Rehab aims to get you comfortable sooner and build capacity for your work and sport.
Physio programmes in the research have typically used around 8 sessions over 4 to 6 weeks, with home exercises in between [1][2], and exercise programmes usually run 6 to 12 weeks [1]. NHS guidance reserves surgery for people who still have symptoms after 6 to 12 months [11]. If you’re not improving with good rehab, we’ll tell you and recommend a doctor. After your first session, your physio gives you a plan with an estimated number of sessions and how we’ll measure progress.
What you can do at home
- Keep using your arm, and ease off what flares it. Using your arm won’t cause long-term damage [12]. Cut back the specific gripping, lifting and twisting that set your pain off [13].
- Change how you lift and grip. Lift with your palm facing up where you can, use the least grip force you need, and choose bigger handles or lighter tools [12].
- Sort out your desk. Keep your workstation close to your body, try a different style of mouse, such as a thumb mouse, and take regular short breaks from typing [12][13]. Workstation changes are standard care, though research specific to tennis elbow is limited [1]. If your neck and shoulders also ache at the desk, see our page on office syndrome.
- Use the 48-hour rule. Keep pain mild during activity or exercise and over the following 48 hours. If it climbs higher, you’re pushing too hard [13].
- Try heat or cold for comfort. A hot or cold pack for up to 20 minutes every 2 to 3 hours can take the edge off [11].
- A brace is optional. A forearm strap worn during the tasks that hurt can ease pain in the moment for some people, but it does less on its own than other treatments [1][12].
Your physio sets your specific exercises and loads after the assessment.
Cost and insurance
Your first consultation is free. Treatment sessions start from ฿1,600. If you have health insurance, you can claim with your insurer, and we’ll supply the documents your provider asks for. It’s worth checking your policy’s physiotherapy cover before you start. See our insurance claims page for how claiming works.
Your physiotherapists
Your knee is treated by one of our licensed physiotherapists: Boom Namsak, who is both a physiotherapist and a strength coach, Gino Udomthanakij, or Som Benjaprasertsri. They all work in English and Thai, and they all coach the gym-floor part of your rehab themselves.
Common questions
What’s the difference between tennis elbow and golfer’s elbow?
The difference is which side of the elbow hurts. Tennis elbow affects the tendons on the outside, which lift your wrist and fingers. Golfer’s elbow affects the tendons on the inside, which bend your wrist and turn your forearm. Golfer’s elbow is about a third as common. Both are overuse tendon problems, and rehab for both uses staged loading, though with golfer’s elbow your physio also checks the ulnar nerve on the inner elbow.
Can I get tennis elbow if I don’t play tennis?
Yes. Most people with tennis elbow don’t play tennis. It usually comes from repeated gripping and wrist movement at work or home, such as typing, mouse use, manual work with tools, or a sudden burst of DIY or gardening. Racquet sports are only one cause. Golfer’s elbow is similar: golf can trigger it, but so can lifting, throwing and many manual jobs.
Will tennis elbow go away on its own?
Often, yes, but it can take a while. NHS guidance says it can take 6 to 24 months to settle, and eight out of ten people are significantly better after a year. In trials, physiotherapy brought faster improvement than waiting over the first 4 to 6 weeks. Symptoms don’t always clear completely and can come back, especially with a repetitive or manual job, which is why building your forearm’s capacity matters.
Should I get a steroid injection for tennis elbow?
That’s a decision for your doctor, and we don’t give injections. Trials show steroid injections relieve pain faster over the first few weeks, but results at one year were worse than with physiotherapy, wait and see, or a placebo injection, with more relapses. If you’re considering one, discuss these trade-offs with your doctor so you can weigh short-term relief against the longer-term outlook.
Do I need an X-ray or MRI for tennis elbow?
Usually not. Tennis elbow is diagnosed from your history and a physical examination, and scans are rarely needed unless you’ve had a fall or injury. Imaging becomes more useful if good non-surgical care hasn’t helped, or if your physio suspects a different problem. We don’t do scans at the clinic, but we can recommend clinics nearby if you need one.
Does a tennis elbow strap or brace help?
It can help some people in the moment. Low-quality research suggests a forearm counterforce strap can reduce pain and improve grip strength while you wear it, but the evidence for longer-term benefit is conflicting, and on its own it does less than other physiotherapy treatments. If it makes your work or sport more comfortable, wear it during those tasks while you do your rehab.
Should I rest my arm completely?
No. Continuing to use your arm won’t cause long-term damage, and the tendon needs gradual loading to recover. Cut back on the specific gripping, lifting and twisting that flare your pain, change how you do them, and keep the rest of your arm active. Your physio then adds loading exercises at a level your elbow can handle and progresses them as it improves.
How much does tennis elbow physiotherapy cost, and can I claim on insurance?
Your first consultation at Aspire Physio Bangkok is free, and treatment sessions start from ฿1,600. We don’t bill insurers directly. You pay at the clinic and claim back using the dated receipts, consultation report and treatment plan we provide. Some insurers require a doctor’s referral first, and we can recommend clinics nearby if you need one.
References
Show 15 references
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- Bisset L, Beller E, Jull G, Brooks P, Darnell R, Vicenzino B. Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial. BMJ. 2006;333(7575):939. doi.org/10.1136/bmj.38961.584653.AE
- Coombes BK, Bisset L, Brooks P, Khan A, Vicenzino B. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309(5):461-469. doi.org/10.1001/jama.2013.129
- Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010;376(9754):1751-1767. doi.org/10.1016/S0140-6736(10)61160-9
- Smidt N, van der Windt DA, Assendelft WJ, Devillé WL, Korthals-de Bos IB, Bouter LM. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. Lancet. 2002;359(9307):657-662. doi.org/10.1016/S0140-6736(02)07811-X
- Shiri R, Viikari-Juntura E, Varonen H, Heliövaara M. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11):1065-1074. doi.org/10.1093/aje/kwj325
- Barco R, Antuña SA. Medial elbow pain. EFORT Open Rev. 2017;2(8):362-371. doi.org/10.1302/2058-5241.2.160006
- Javed M, Mustafa S, Boyle S, Scott F. Elbow pain: a guide to assessment and management in primary care. Br J Gen Pract. 2015;65(640):610-612. doi.org/10.3399/bjgp15X687625
- Couppé C, Døssing S, Bülow PM, et al. Effects of heavy slow resistance training combined with corticosteroid injections or tendon needling in patients with lateral elbow tendinopathy: a 3-arm randomized double-blinded placebo-controlled study. Am J Sports Med. 2022;50(10):2787-2796. doi.org/10.1177/03635465221110214
- Sveinall H, Brox JI, Engebretsen KB, Hoksrud AF, Røe C, Johnsen MB. Heavy slow resistance training, radial extracorporeal shock wave therapy or advice for patients with tennis elbow in the Norwegian secondary care: a randomised controlled feasibility trial. BMJ Open. 2024;14(12):e085916. doi.org/10.1136/bmjopen-2024-085916
- NHS. Tennis elbow. nhs.uk. Page last reviewed 31 May 2024. www.nhs.uk/conditions/tennis-elbow/
- NHS Lothian. Tennis elbow: information for patients. Version 3.0. 2026. policyonline.nhslothian.scot/wp-content/uploads/2023/03/Tennis_Elbow.p
- NHS Lanarkshire. Tennis elbow. Musculoskeletal (MSK) physiotherapy patient information. Updated 2023. www.nhslanarkshire.scot.nhs.uk/services/physiotherapy-msk/tennis-elbow
- NHS Lanarkshire. Golfer’s elbow. Musculoskeletal (MSK) physiotherapy patient information. Updated 2023. www.nhslanarkshire.scot.nhs.uk/services/physiotherapy-msk/golfers-elbo
- Mersey Care NHS Foundation Trust. Golfer’s elbow. Patient information web page. Undated (accessed October 2026). www.merseycare.nhs.uk/golfers-elbow
Free first consultation
Book a knee assessment
Aspire Physio Bangkok is at Jasmine Building, 2nd Floor, Sukhumvit Road, Soi 23, a short walk from Asok BTS and Sukhumvit MRT. We’re open Monday to Friday 7am to 8pm, and Saturday and Sunday 8am to 4pm. Bookings are required in advance. Book your free first consultation through our contact page or call 082-281-8009.