Assessment
A detailed history, then a thorough examination of movement, strength and the affected area. You leave knowing what is wrong, why it happened, and exactly what we are going to do about it.
Concern
Elbow, Wrist & Hand Pain Treatment in London
Tennis elbow, golfer's elbow and carpal tunnel respond to graded strengthening, not rest or splints alone. We rebuild your grip, wrist and forearm capacity.
Our elbow, wrist and hand team
Overview
Understanding elbow, wrist & hand pain
Elbow, wrist and hand pain is one of the most common upper-limb problems we see, and most of it is load-related rather than joint damage. Tennis elbow, golfer's elbow and carpal tunnel are nearly all about load tolerance, not lasting harm.
Do I need rest, splints or injections?
Rarely as the first step. Progressive loading of the forearm muscles is first-line for the tendinopathies and outperforms rest, and NICE and CSP guidance support conservative care for mild-to-moderate carpal tunnel before surgery. We confirm the cause, screen for referral, then rebuild around how you grip, type and lift.
We treat City professionals, racquet-sport athletes and manual workers across our Soho, Liverpool Street and Marylebone clinics. Self-referral; no GP letter needed.
Why it happens
What causes elbow, wrist & hand pain?
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Repetitive gripping, typing, lifting or racquet and club use that loads the forearm tendons faster than they can adapt, the usual driver of tennis and golfer's elbow
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A rapid spike in training, DIY, manual work or sport that outpaces the wrist and forearm's current capacity
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Sustained, awkward wrist postures: long keyboard, mouse or tool use without a break, that load the median nerve and the wrist tendons
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Strength and endurance deficits in the forearm, wrist and shoulder-girdle muscles, so the elbow and wrist absorb load they are not prepared for
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Fluid changes and reduced carpal-tunnel space associated with pregnancy, thyroid conditions, diabetes or inflammatory arthritis, which raise the risk of median-nerve compression
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A wrist sprain, fall onto an outstretched hand, or thumb-side overload (de Quervain's) where strength and load tolerance need rebuilding
Physiotherapy for elbow, wrist and hand pain can help to:
Confirm what is driving the pain
Tennis elbow, golfer's elbow, carpal tunnel, de Quervain's and a plain wrist sprain each behave differently under load. The assessment separates them and screens for the features that need onward referral, so the plan targets the right structure from the first week.
Rebuild your grip
Progressive strengthening of the forearm muscles is first-line for tennis and golfer's elbow, and it outperforms rest, bracing or repeated injections for lasting recovery. We rebuild grip and forearm capacity gradually, so lifting, carrying and racquet sport stop provoking the tendon.
Settle carpal tunnel without surgery where possible
Mild-to-moderate carpal tunnel often settles with conservative care: a night splint, nerve-gliding exercises and activity changes, in line with NICE and CSP guidance. We assess your severity honestly and refer promptly when constant numbness or weakness says surgery deserves a look.
Fix the desk set-up feeding it
Long keyboard, mouse and tool use in awkward wrist positions loads the tendons and the median nerve all day. We review how your workstation and work pattern load the arm and adjust both, because an ergonomic fix makes the rehabilitation stick.
Keep you working and playing through recovery
Complete rest lets the tendon lose capacity, and the pain returns with the first heavy week back. Relative rest works better: easing the aggravating grips and loads while structured exercise rebuilds tolerance. Most people keep typing, lifting and playing while they recover.
Make the recovery durable
Forearm tendons adapt over six to twelve weeks of consistent loading, sometimes longer. We set milestones, reassess against them, and finish with the strength and endurance that stop the problem returning next time work or sport gets busy.
At your first appointment we look for the cause: your history, how you move, and what your work, sport and life ask of your body.
The assessment covers a detailed history and a thorough examination of movement, strength and the affected area. We explain what we find and agree a working diagnosis and plan you understand before you leave.
You go home with a written summary and a home-exercise programme built around your diagnosis and goals, so progress continues between visits.
From pain to performance. Pain relief that lasts is not enough on its own: we rebuild the strength behind the pain so it stays gone.
- Three central London clinics: Soho, Liverpool Street and Marylebone, plus home visits across London and online sessions.
- Led by physiotherapist Sam Harvey: 15 years of clinical practice and an elite-sport background across football, rugby and GAA.
- Physiotherapy, strength and nutrition under one roof: three clinicians, three disciplines, joined-up care.
Fees and booking
You can self-refer and book directly: no GP letter needed, and every new patient can start with a free 15-minute consultation call. The same fees apply across our Soho, Liverpool Street and Marylebone clinics.
- Physiotherapy: a full 60 minutes for £145, whether it is your first visit or a follow-up
- 30-minute follow-ups at £90, with video appointments from £70
- Strength training and Reformer Pilates £120, sports massage from £75
- VALD performance and strength testing with a written report, £195
- 5% off a block of five sessions, 10% off a block of ten
- An itemised receipt with every session, for claiming back where your policy covers physiotherapy
Your journey
with Physio and Performance
Everything starts with finding the cause. Whether the goal is a marathon start line or a week at your desk without pain, we treat what is driving the problem, then build the strength that keeps it fixed.
Treatment
Hands-on manual therapy combined with a progressive, tailored exercise programme. Sports massage, dry needling, shockwave or Reformer Pilates are added where they help your specific problem.
Rebuild
Coached, progressive strength work restores the load tolerance your body lost, paced to where you start. This is the stage that decides whether the fix lasts.
Perform
Each follow-up reassesses you against your baseline, with VALD testing where useful, so your return to work, sport or training rests on measured readiness. Discharge happens by mutual agreement when you can manage independently.
We specialise in:
- Physiotherapy and sports rehabilitation
- Coached strength and conditioning
- Reformer Pilates
- Sports massage and soft-tissue therapy
- Dry needling and shockwave therapy
- VALD performance and strength testing
- Post-operative rehabilitation
- Running and gait analysis
- Sports nutrition and dietetics
Treatment approach
How do we treat elbow, wrist & hand pain?
Physiotherapy & Sports Rehabilitation
£145Assessment first confirms whether your pain is a forearm tendinopathy, a compressed wrist nerve or a sprain, and screens for features needing referral, then delivers a graded loading and load-management programme with an ergonomic review: the first-line, best-evidenced approach for tennis elbow, golfer's elbow and mild-to-moderate carpal tunnel.
See treatment detail →Strength Training
£120Progressive strength work rebuilds endurance and capacity in the forearm, wrist and shoulder-girdle muscles, addressing the deficits behind tennis and golfer's elbow and supporting a durable return to gripping, typing, lifting and racquet sport without symptoms recurring.
See treatment detail →Shockwave Therapy
Price on enquiryFor stubborn lateral or medial epicondylalgia that has not settled with first-line loading, extracorporeal shockwave therapy may be considered as an adjunct alongside continued rehabilitation, in line with NICE interventional procedures guidance; the evidence is mixed and it is never a substitute for progressive loading.
See treatment detail →FAQ
Frequently asked
questions
What is the best treatment for tennis or golfer's elbow?
Progressive strengthening of the forearm muscles is first-line and outperforms rest, bracing or repeated steroid injections for lasting recovery. A graded loading programme rebuilds the tendon's capacity while you modify the aggravating grip and lifting loads. Manual therapy and an ergonomic review help alongside, but the exercise is the core of recovery, not an optional extra.
Do I need surgery for carpal tunnel syndrome?
Often not. For mild-to-moderate carpal tunnel, NICE and CSP guidance support conservative care first: a night wrist splint, nerve-gliding exercises and activity modification, which settles many cases. Surgery is reserved for severe or persistent symptoms, or where there is constant numbness or muscle wasting. We assess your severity honestly and refer onward promptly when an opinion is warranted.
Should I rest my elbow or keep using it?
Usually keep using it within sensible limits. Complete rest tends to let the tendon lose capacity, so pain returns when you resume gripping or lifting. The evidence supports relative rest: temporarily easing the most aggravating loads while progressively rebuilding tolerance through structured exercise. Your physiotherapist guides exactly how much load is right for your stage of recovery.
How long does tennis elbow take to recover?
Tendons adapt gradually, so recovery is rarely quick: often six to twelve weeks of consistent, progressive loading, and sometimes longer for stubborn cases. We set realistic milestones at your first appointment and reassess regularly. Most people improve well without injection or surgery when they commit to a graded strengthening plan and manage the aggravating loads.
When should I seek urgent help for hand or wrist symptoms?
Seek prompt care after significant trauma or a suspected fracture, or if you have constant numbness, weakness, visible muscle wasting at the base of the thumb, or symptoms that are rapidly worsening. A hot, swollen, red joint with feeling unwell can signal infection or acute inflammatory arthritis and needs urgent medical assessment rather than physiotherapy as the first step.
Related Concerns
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Physio and Performance • 111 Charing Cross Road, Soho, London WC2H 0DT
BookAppointments typically available within 1–2 weeks