Shockwave therapy for golfer's elbow

The main symptom is pain on the inner side of the elbow, over the bony point where the tendons that bend the wrist and fingers attach. It is usually brought on by gripping, lifting, turning the forearm or bending the wrist against resistance, and it can spread a little way down the inner forearm.

Tingling or numbness into the ring and little fingers is a different signal. The ulnar nerve runs just behind the inner elbow, and nerve irritation there needs examining before any tendon treatment is considered. If the pain is on the outer side of the elbow instead, the tennis elbow page is the one to read.

They are mirror images. Tennis elbow affects the tendons on the outer side of the elbow that extend the wrist; golfer's elbow affects the tendons on the inner side that flex it. Both are load problems of a tendon attachment, both are provoked by gripping, and despite the names neither needs a racket or a golf club.

The difference that matters here is the evidence. NICE has assessed extracorporeal shockwave therapy for refractory tennis elbow and found no major safety concerns while the efficacy evidence is inconsistent. It has published nothing on the inner side, and the research there is smaller and more mixed, as the section below sets out.

A 2022 clinical review describes the cause as small repeated strains combined with wear at the common flexor tendon where it attaches to the inner elbow, and notes that it affects men and women alike. In practice that load comes from:

• repeated gripping, lifting and wrist bending at work or in the gym
• racket sports, golf, climbing and throwing
• a sudden rise in training or manual workload
• grip and forearm strength that has not kept up with the work

Because the cause is load on a tendon, the first treatment is changing that load and then rebuilding the forearm, which is the part a machine cannot do.

The evidence is thin and it points both ways. A 2012 Korean study of newly diagnosed inner and outer elbow pain found that "the ESWT group improved as much as the local steroid injection group". A 2007 report was titled plainly "Extracorporeal shock wave therapy unsuccessful for chronic medial epicondylitis". A 2023 review in Die Orthopädie summed it up: shockwave is widely used for the outer elbow, "although it is questionable for medial epicondylopathy".

NICE has published no guidance on shockwave for the inner elbow. So if it is offered for golfer's elbow, it should be offered as an adjunct to loading, for pain that has lasted months, by a clinician who tells you the evidence is weaker than for the outer side.

The first treatment is reducing the gripping and lifting that provokes the pain, then a progressive forearm strengthening programme, usually with a physiotherapist. A steroid injection is sometimes offered for short-term pain relief. It does not rebuild the tendon, so the loading work still has to follow, as it does for tennis elbow on the outer side.

For inner elbow pain that has lasted despite that, London Shockwave Therapy arranges an assessment at one of four UNTIL clubs, where a registered clinician examines the tendon and the nerve and discusses whether a course is worth adding. Published London prices checked on 29 September 2026 ran from £85 to £150 a session and £348 to £400 for a course of three, set out on the shockwave therapy prices page. To start, ask about your case.

The NHS has no separate page for golfer's elbow, and its tennis elbow advice is a reasonable starting point for either side: avoid or reduce the activities that make the pain worse, use pain relief tablets or an anti-inflammatory gel, apply a hot or cold pack for up to 20 minutes every 2 to 3 hours, try simple arm exercises, and consider a forearm strap.

Over the following weeks, the work shifts to strengthening the wrist and finger flexors and grip, starting light and progressing as the elbow tolerates it. The shoulder is worth including too, because it shares the load when you lift and carry.

No UK guideline sets a recovery time for golfer's elbow. For the outer-side equivalent, the NHS says tennis elbow usually gets better with rest over a few weeks but can sometimes last over a year, and it advises seeing a GP if the pain has not eased after 2 weeks of self-care, with physiotherapy worth considering if symptoms have not improved after 6 weeks.

Shockwave belongs, if at all, after that stage: when inner elbow pain has lasted months despite a proper loading programme. Where a course is used, the review point sits 6 to 12 weeks after the last session.

If inner elbow pain is limiting your grip at work or in sport, an assessment is the next step. London Shockwave Therapy arranges assessments at four UNTIL clubs, with walking times from the TfL journey planner: 280 Bishopsgate, about 7 minutes from Liverpool Street station; 111 Charing Cross Road, about 5 minutes from Leicester Square; 1 Orchard Street, about 8 minutes from Marble Arch; and 30 South Colonnade, about 2 minutes from Canary Wharf.

Every club opens at 06:00 on weekdays, so an appointment can fit before a working day of keyboards and carrying, and every club has a gym floor where the forearm strengthening that goes alongside any course can carry on.