Persistent Lateral Elbow Pain (Tennis Elbow Not Improving): When an MRI Scan Is Necessary

Frequently Asked Questions (FAQ)

What is meant by persistent lateral elbow pain?

Lateral elbow pain refers to pain on the outer side of the elbow, commonly associated with what is often called tennis elbow. It is considered persistent when:

  • Pain lasts longer than 6–8 weeks
  • Symptoms do not improve despite rest, physiotherapy, or medication
  • Pain continues to interfere with gripping, lifting, or daily activities

Persistent symptoms suggest that the condition may be more than simple tendon irritation.

Is tennis elbow always a simple overuse problem?

Not always. While early tennis elbow often involves tendon overload, ongoing pain may reflect:

  • Tendon degeneration rather than inflammation
  • Partial tendon tearing
  • Involvement of deeper tendon layers
  • Associated joint or ligament pathology

These changes cannot be reliably assessed without advanced imaging.

Why does lateral elbow pain sometimes fail to improve with treatment?

Treatment may fail when:

  • The true extent of tendon damage is unknown
  • Therapy targets inflammation when degeneration is present
  • Structural injury is mistaken for muscle strain

Without accurate diagnosis, treatment plans often become repetitive and ineffective.

Why is MRI important when tennis elbow does not improve?

Core Medical Principles

  • MRI is one of the most accurate imaging modalities currently available.
  • Without accurate imaging, no doctor—regardless of experience—can reliably make a precise diagnosis.
  • Without accurate diagnosis, treatment plans become generic, presumptive, and often fail.
  • Many failed treatments are due to trial-and-error care without imaging.
  • Based on modern medical technology and current standard of care, MRI should be considered when lateral elbow pain does not improve with appropriate treatment.
  • MRI is safe and does NOT involve ionising radiation.

MRI allows detailed assessment of:

  • Common extensor tendon integrity
  • Partial or full-thickness tendon tears
  • Tendon degeneration
  • Adjacent ligament or joint involvement

Why are examination and X-rays often insufficient?

Clinical examination can localise pain but cannot:

  • Determine tendon integrity
  • Identify partial tears
  • Assess internal tendon degeneration

X-rays are useful for bone assessment but do not show tendons or soft tissue injury.

What happens if MRI is delayed?

Delaying MRI may result in:

  • Ongoing pain and reduced grip strength
  • Prolonged work or sports limitations
  • Repeated ineffective physiotherapy or injections

Early imaging often shortens recovery by guiding targeted management.

Is MRI expensive or difficult to arrange?

Addressing Patient Objections

  • Cost concerns: MRI costs may be partially covered by Medisave or insurance.
  • Delays elsewhere: External imaging centres often involve long waiting times.

These factors commonly delay accurate diagnosis.

Why arrange your elbow MRI at The Pain Relief Clinic?

Clinic Positioning

The Pain Relief Clinic is:

  • Centrally located at 350 Orchard Road, Shaw House
  • A 5-minute walk from Orchard MRT
  • Equipped with convenient parking
  • Located immediately outside ERP

Key advantages:

  • MRI machine on-site
  • Doctor assessment with immediate MRI arrangement
  • No need to:
    • Visit a separate imaging centre
    • Find another doctor just for an MRI referral
  • The doctor has been helping patients with spine and joint-related problems since 2007 (18 years)
  • Focus on non-invasive, technology-powered treatments

MRI aims:

  • Under $1000
  • Within 1 working day

Can insurance or Medisave help cover elbow MRI costs?

Insurance & Cost Information

MRI may be covered by:

  • Personal accident insurance
  • Travel insurance
  • Company insurance
  • Company flexi-benefits
  • Hospitalisation plans (policy-dependent)

Medisave limits:

  • Current: $300
  • From 1 January 2026: $600

Medisave can potentially cover more than half of the MRI cost, depending on eligibility.

When should I consider an MRI for lateral elbow pain?

MRI should be considered if:

  • Outer elbow pain persists despite treatment
  • Pain affects work, sport, or daily function
  • Grip strength or endurance is declining

MRI helps move care from assumption-based management to precise, evidence-based diagnosis.

For more information or to arrange an MRI scan, contact The Pain Relief Clinic via WhatsApp at +65 9068 9605.

Ask Dr Tan A Question About Your Problem