Elbow surgery
A group of operations on the elbow to treat stubborn tennis or golfer's elbow, a trapped nerve, a stiff or arthritic joint, or loose fragments, usually only after non-surgical treatment has been tried.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Elbow surgery covers several different operations — for tennis or golfer's elbow, a trapped nerve, stiffness, arthritis or loose fragments — each with its own outlook.
- Most elbow problems are treated without surgery first; many, such as tennis elbow, settle with time, physiotherapy or injections.
- Nerves run close to the elbow, so temporary or, less often, lasting nerve symptoms are a recognised risk, especially around keyhole surgery and nerve operations.
- Recovery and results vary widely by procedure, so be clear on your diagnosis and what your specific operation can realistically achieve.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Can reduce stubborn outer or inner elbow pain when other treatments have failed
Symptoms are mild or improving and likely to settle with time and non-surgical treatment.
The arm is often in a sling or splint. Pain relief is given, and you keep the hand moving. Keep the wound clean and dry, and elevate the arm to reduce...
A clear, procedure-specific physiotherapy and rehabilitation plan.
The arm is often in a sling or splint. Pain relief is given, and you keep the hand moving. Keep the wound clean...
Stitches are checked or removed. Many people begin gentle movement or physiotherapy. Light activity returns...
Movement and strength build up with physiotherapy. Desk work often resumes within this window; heavier or...
Pain settles and function improves for most procedures. Stiffness releases and arthritis surgery may still be...
What is elbow surgery?
Elbow surgery is not a single operation but a family of procedures, chosen according to the problem. Common reasons include long-standing tennis elbow (pain on the outer side) or golfer's elbow (pain on the inner side) that has not settled, a trapped ulnar nerve at the elbow (cubital tunnel syndrome), a stiff elbow that will not straighten or bend, arthritis, or loose pieces of bone or cartilage catching in the joint.
The operation may be done as keyhole surgery (arthroscopy), through a small open cut, or a combination, depending on what needs doing. For tennis or golfer's elbow, the worn part of the tendon is cleaned up or released. For a trapped nerve, the nerve is freed and sometimes moved. For stiffness, tight tissue and bone spurs are released. For loose fragments, these are removed.
The most important thing to understand is that most elbow problems are treated without surgery first. Rest, activity changes, physiotherapy, splints and sometimes injections help many people, and conditions such as tennis elbow often settle with time. Surgery is generally considered only when these have been given a fair trial and symptoms remain limiting.
Results depend heavily on which operation you are having and why, so it is important to be clear about your specific diagnosis and what that particular operation can realistically achieve.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Keyhole vs open elbow surgery
| Point | Keyhole (arthroscopy) | Open surgery |
|---|---|---|
| Cuts | Several small | One larger |
| Best for | Loose bodies, some releases | Nerve moves, complex work |
| Nerve proximity | Close — needs care | Nerve can be seen directly |
| Recovery | Often quicker | Varies by procedure |
The best approach depends on your diagnosis and anatomy, including where your nerves run. Your surgeon will explain why one is chosen.
Preparing for your surgery
- Be clear on your exact diagnosis and which operation is planned, as elbow surgery covers very different procedures.
- Ask whether non-surgical treatment — physiotherapy, activity changes, splints or injections — has been fully tried, as many elbow problems settle without surgery.
- Tell your surgeon about any previous elbow surgery or injury, and any tingling or numbness in the hand, which matters for nerve safety.
- Mention all medicines, especially blood thinners, and any diabetes or smoking, which can affect healing and nerve recovery.
- Arrange a lift home after a day-case anaesthetic and help at home, as you may have your arm in a sling or splint at first.
- Plan time off work to suit your job and whether it is your dominant arm.
- Sort out a physiotherapy plan in advance, as rehab is central to a good result for many elbow operations.
What happens
Most elbow operations are done under a general anaesthetic, often combined with a regional nerve block that numbs the arm and helps with pain afterwards; sometimes a regional block is used alone.
What happens next depends on the procedure. For keyhole surgery, the joint is filled with fluid and a small camera and instruments are passed through tiny cuts to remove loose fragments, trim bone or release tissue. For tendon or nerve surgery, a small open cut is used to reach and treat the affected structure, and for a trapped nerve the surgeon may free it and sometimes reposition it. The surgeon takes particular care to protect the nerves that run close to the elbow.
The wounds are closed with stitches and a dressing, sling or splint applied. Most people go home the same day, with arrangements for follow-up and physiotherapy.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Symptoms are mild or improving and likely to settle with time and non-surgical treatment.
- Non-surgical options such as physiotherapy, activity changes, splints or injections have not been fairly tried.
- The pain does not clearly come from the structure the operation targets, so surgery may not help.
- There is an active infection, or general health that makes anaesthetic too risky until optimised.
- Expectations are for a perfect, pain-free elbow, which surgery cannot guarantee.
Delay surgery if…
- You have an active infection in the arm or elsewhere.
- You are taking blood thinners that need a managed plan.
- Your diagnosis is unclear and further imaging or nerve studies are needed.
- A reasonable course of non-surgical treatment is still ongoing.
- You cannot arrange help at home or commit to the physiotherapy the operation needs.
Alternatives to discuss
- Physiotherapy, a graded exercise programme and activity or technique changes.
- Splints or braces, and ergonomic changes at work.
- Steroid or other injections in selected conditions, with their own limits and risks.
- Watchful waiting, as conditions such as tennis elbow often improve over time.
- A second opinion if surgery is being recommended but the benefit is uncertain.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Can reduce stubborn outer or inner elbow pain when other treatments have failed
- Can relieve tingling, numbness or weakness from a trapped nerve
- Can improve how far a stiff elbow bends and straightens
- Can remove loose fragments that catch, lock or grind the joint
- Can improve the use of the arm for daily tasks and work
- Allows the joint to be inspected and treated directly during keyhole surgery
Risks & complications
- Pain, swelling and bruising around the elbow for a few weeks
- Stiffness that needs physiotherapy to overcome
- Temporary numbness or tingling in the hand or around the wound
- A scar or small scars that fade over months
- Wound infection needing antibiotics
- Slow or incomplete improvement in pain or movement
- Persistent numbness or altered sensation from a stretched or bruised nerve
- A blood collection or wound-healing problem
- Lasting nerve injury causing weakness or numbness in the hand
- Damage to a blood vessel near the elbow
- Complex regional pain syndrome (persistent pain, swelling and stiffness)
- Blood clots in the arm, or anaesthetic complications
- The need for further surgery
Because important nerves run close to the elbow, nerve symptoms are the key risk to understand — most are temporary, but a small number are lasting, and the risk is higher with keyhole surgery, nerve operations and after previous surgery. Results also vary a lot by procedure: for example, tennis elbow surgery helps many but not all, and a stiff elbow needs committed physiotherapy. Ask your surgeon for their own results for your specific operation.
Published figures to discuss
Reported rates vary by the specific operation, the surgical approach, and patient factors such as previous surgery, diabetes and smoking. Figures below come mainly from elbow arthroscopy reviews and should be read as cautious ranges; your surgeon can give figures for your particular procedure.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Nerve injury after elbow arthroscopy | Reported roughly 1–7.5% across reviews, mostly temporary sensory symptoms | Higher with previous surgery and certain anatomy; lasting major nerve injury is much less common. | A systematic review of elbow arthroscopy complications — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
| Overall complications of elbow arthroscopy | Reported around 1.5–11% across studies | Includes minor wound and stiffness problems as well as nerve issues; definitions vary. | A systematic review of elbow arthroscopy complications — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
| Tennis elbow surgery not helping | UK patient information reports about 25% are not improved by surgery, and roughly 1–2% may be worse afterwards | Only a small minority of tennis elbow cases need surgery at all, usually after many months of failed non-surgical care. | A systematic review of elbow arthroscopy complications — PubMedpubmed.ncbi.nlm.nih.govPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery depends heavily on which operation you have had. Some, such as loose-body removal, recover quickly; others, such as a stiffness release or arthritis surgery, need weeks to months and a structured physiotherapy programme.
- Soreness, swelling and bruising around the elbow for a few weeks
- Stiffness that gradually improves with physiotherapy
- Temporary numbness or tingling in the hand that usually settles
- Tiredness in the arm as strength rebuilds
- Gradual, sometimes slow, improvement rather than an instant fix
Aftercare
- Wear the sling or splint as advised and keep the hand and fingers moving.
- Elevate the arm and use ice (wrapped, not directly on skin) to ease early swelling.
- Keep the wound clean and dry and follow advice on dressings and stitches.
- Take pain relief as prescribed so you can do your exercises.
- Follow your physiotherapy programme closely — for many elbow operations this is what determines the result.
- Avoid heavy lifting, gripping or sport until your surgeon and physiotherapist agree.
- Only drive when you can safely control the car and do an emergency stop.
- Keep follow-up appointments so progress and nerve recovery can be checked.
- Lift home arranged after a day-case anaesthetic
- Sling or splint and loose clothing ready
- Pain relief understood and collected
- Physiotherapy appointments arranged
- Help at home for the first few days, especially if it is your dominant arm
- Time off work planned to suit your job
- Clinic contact number saved for concerns
Scars and how they heal
Keyhole surgery leaves a few small scars, while open surgery leaves one larger scar over the part of the elbow treated. Scars are firm and pink at first and usually fade over months. Protecting the wound from strong sun while healing helps it settle. Numbness around a scar is common early on and usually improves.
⚠ Get urgent help if…
- New or worsening weakness or numbness in the hand or fingers
- Increasing redness, swelling, heat or discharge from the wound (signs of infection)
- Severe or escalating pain not controlled by your usual pain relief
- Fever or feeling generally unwell
- A cold, pale or very swollen hand or forearm
- Calf pain or swelling, or sudden breathlessness or chest pain (possible clot)
- Spreading, burning pain with marked swelling and stiffness of the hand (possible complex regional pain syndrome)
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result depends on the operation. Freeing a trapped nerve often eases tingling and can stop further weakness; releasing a stiff elbow can improve movement; removing loose fragments can stop catching and locking; and tennis or golfer's elbow surgery relieves pain for many people who have not improved with other treatments.
It is realistic to expect improvement rather than a perfect, pain-free elbow. Some pain, stiffness or altered sensation can remain, nerve recovery can be slow or incomplete, and a minority of people need further treatment. Because outcomes vary so much by procedure and diagnosis, your surgeon should explain what your specific operation can and cannot achieve.
How long the benefit lasts depends on the condition. Tendon and nerve releases often give lasting relief, though symptoms can occasionally return. Surgery for arthritis manages a progressive condition rather than curing it, and a stiff elbow can tighten again, particularly without ongoing exercises. Keeping up your rehabilitation helps protect the result.
Combining with other procedures
Sometimes more than one problem is addressed at the same operation — for example removing loose bodies while releasing stiffness, or treating a tendon and an adjacent nerve. Your surgeon will discuss whether combining procedures makes sense for you or whether it is better to do them separately.
Follow-up & long-term care
You will usually be reviewed after surgery to check the wound, movement and nerve recovery, with physiotherapy support for many procedures. Report any new or worsening weakness or numbness in the hand, or signs of infection, straight away rather than waiting.
- Keep up the strengthening and movement exercises your physiotherapist recommends.
- Modify activities or technique that triggered the original problem where possible.
- Report any return of pain, stiffness or nerve symptoms for review.
- For arthritis, attend follow-up as the joint may change over time.
Revision and secondary surgery reality
- Some people need further surgery if symptoms persist or recur.
- A released stiff elbow can tighten again, especially without ongoing exercises.
- Surgery for arthritis manages a progressive condition rather than curing it.
- Nerve recovery can be slow and is not always complete after a nerve operation.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A clear, procedure-specific physiotherapy and rehabilitation plan.
- A named contact and instructions to report new weakness or numbness in the hand promptly.
- Planned follow-up to check the wound, movement and nerve recovery.
- Guidance on returning to work, driving, lifting and sport.
- An honest plan if symptoms do not improve or recur.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Surgeon's fee and which elbow operation is being done
- Anaesthetic fee and whether a regional nerve block is used
- Hospital or theatre facility fee and whether it is a day case
- Keyhole equipment or implants where relevant (for example for joint surgery)
- Pre-operative imaging such as X-ray, ultrasound, MRI or nerve studies
- Physiotherapy and rehabilitation, which can be a substantial part of the cost
- Follow-up appointments and policy on further treatment
- Surgeon's fee and exactly which procedure is included
- Anaesthetist's fee
- Hospital or facility fee and expected length of stay
- Cost of pre-operative imaging or nerve studies
- How many physiotherapy sessions are included
- Follow-up appointments included or extra
- What happens, and what it costs, if a complication or further surgery is needed
On the NHS? Elbow surgery is available on the NHS when symptoms are significant and non-surgical treatment has not helped; private care is sometimes chosen for a shorter wait or a particular surgeon.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not making clear which specific operation is planned and what it can and cannot achieve.
- Recommending surgery before non-surgical treatment has been fairly tried.
- Underplaying the risk of nerve symptoms, particularly with keyhole and nerve surgery.
- Not explaining how central physiotherapy is to the result.
- Promising a perfect, pain-free, fully mobile elbow.
Marketing red flags
- Presenting keyhole elbow surgery as without risks or suitable for every problem.
- Pushing surgery for tennis elbow before time and non-surgical care have been given a chance.
- Guaranteeing full movement and complete pain relief.
- Glossing over the nerves that lie close to the elbow.
- Not mentioning the physiotherapy commitment needed for a good outcome.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- What exactly is my diagnosis, and which operation are you recommending?
- Have all the non-surgical options been fully tried for my problem?
- What is my personal risk of nerve symptoms, and are they likely to be temporary?
- What can this specific operation realistically achieve for me, and what will it not fix?
- What does recovery and physiotherapy involve, and how long until I can work and lift again?
- What are your own results and complication rates for this procedure?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Do I really need surgery, or will my elbow settle on its own?
Will I get full movement and strength back?
How risky is the nerve damage I have heard about?
How long will I be off work?
Can it be done by keyhole surgery?
Is elbow surgery available on the NHS?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Tennis elbow Royal Berkshire NHS FT — Tennis elbow (lateral epicondylitis) patient leaflet (PDF) A systematic review of elbow arthroscopy complications — PubMed Peripheral nerve injury after elbow arthroscopy: risk factors — PubMed Avoiding neurological complications of elbow arthroscopy (PMC)
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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