Cortisone Shots, PRP and Surgery for Tennis Elbow: What to Know

When are injections or surgery considered?

OrthoInfo reports that roughly 80 to 95% of people with tennis elbow do well with non-surgical treatment, such as rest, medicines, physical therapy and a brace. Cleveland Clinic lists injections and procedures as options if symptoms persist. A clinician may discuss them if:

• pain is severe and is stopping you from working or sleeping
• symptoms have not improved after several months of well-structured care
• the diagnosis needs to be confirmed or other causes ruled out

See our overview of tennis elbow treatment options for the full range of approaches.

Cortisone (steroid) shots

A cortisone shot is an injection of a corticosteroid medicine near the painful area on the outside of the elbow. MedlinePlus notes that a numbing medicine is often given along with it.

What people may notice

According to Cleveland Clinic, a cortisone shot can take up to a week to start working, and relief usually lasts somewhere between a few weeks and a few months.

Possible downsides

• Relief may be temporary. Cleveland Clinic notes that corticosteroid injections are less useful if symptoms have lasted more than six weeks.
• Use sparingly. OrthoInfo advises using steroid injections sparingly, because repeated injections can weaken the tendon over time.
• Side effects listed by Cleveland Clinic include pain and a temporary increase in swelling at the injection site, lightening of the skin near the site, and infection.
• Limits on repeat shots. Cleveland Clinic says most people shouldn't have more than three shots in a year, with at least three months between them.

Cortisone can temporarily raise blood sugar. Cleveland Clinic advises people with diabetes to check their blood sugar more often for about five days afterwards.

PRP injections

Platelet-rich plasma (PRP) uses a concentrated preparation of platelets from your own blood, which is injected near the tendon. OrthoInfo describes study results as mixed: some inconclusive, others promising. Ask about the expected benefits, the number of sessions, and the total cost and insurance coverage before deciding.

Other procedures

Depending on where you are treated, a clinician may also discuss:

• Shockwave therapy: sound waves used to stimulate healing. OrthoInfo notes that many doctors consider it experimental, though some sources report it can be effective.
• Ultrasound-guided tenotomy: a minimally invasive procedure, listed by Cleveland Clinic, that treats damaged tendon tissue using ultrasound guidance.

You may also hear about dry needling and other treatments. We couldn't find clear guidance on them for tennis elbow from the sources we use, so ask your clinician about the evidence for anything you're offered.

A note on unapproved injections

You may see online discussion about injecting peptides such as BPC-157 for tennis elbow. The FDA has said that compounded drugs containing BPC-157 may pose a risk of immune reactions for certain routes of administration, and that it has little or no safety information about them. In its words, the agency "lacks sufficient information to know whether the drug would cause harm when administered to humans." Injecting substances like this yourself carries real risks. Talk with a qualified clinician instead.

Surgery and what to expect afterwards

Cleveland Clinic describes surgery for tennis elbow as rare. OrthoInfo says it is considered if symptoms don't improve after 6 to 12 months of non-surgical treatment. Most procedures remove damaged tendon tissue and reattach healthy tendon to bone. They may be done through an incision on the outer elbow (open surgery, the most common approach) or arthroscopically, through small incisions. OrthoInfo lists risks including infection, nerve and blood vessel damage, prolonged rehabilitation, loss of strength or flexibility, and the need for further surgery.

What to expect after tennis elbow surgery

OrthoInfo describes a typical recovery like this:

• the arm is usually splinted at first, with the splint and stitches removed about a week later
• stretching exercises begin after the splint comes off
• light strengthening starts about 2 months after surgery
• return to sport is usually 4 to 6 months after surgery, as directed by the surgeon

OrthoInfo reports that surgery is considered successful in 80 to 90% of patients, although some loss of strength is not uncommon. Ask your surgeon for a plan that fits your job and activities. Our guide to tennis elbow recovery time gives broader context.

Questions to ask your clinician

• Why are you suggesting this option now, and what else could I try first?
• What benefits can I realistically expect, and for how long?
• What are the risks and side effects?
• How many sessions or injections might I need, and what will it cost?
• What should I do, and avoid, in the days and weeks afterwards?

Frequently asked questions

Sources

We checked this article against the following pages on October 22, 2026. Read how we write our guides.

1. Tennis Elbow (Lateral Epicondylitis) (opens in a new tab). Cleveland Clinic.
2. Tennis elbow (opens in a new tab). NHS.
3. Tennis elbow (opens in a new tab). MedlinePlus Medical Encyclopedia, U.S. National Library of Medicine.
4. Tennis Elbow (Lateral Epicondylitis) (opens in a new tab). OrthoInfo, American Academy of Orthopaedic Surgeons.
5. Cortisone Shots (Steroid Injections): Benefits & Side Effects (opens in a new tab). Cleveland Clinic.
6. Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks (opens in a new tab). U.S. Food and Drug Administration.