Aim: Review the state of art on epicondylitis treatment and access the best management approach, focusing in the new promising treatments.  

Materials and methods: A research was performed on PubMed / MEDLINE  including systematic reviews and clinical trials published between 2011 and 2016, using MeSH terms: "Tennis Elbow"," Tennis Elbow/ surgery "," Tennis Elbow/ therapy "," Tennis Elbow/ drug therapy "," Tennis Elbow/ rehabilitation. 

Results: The first approach on epicondylitis treatment is conservative with rest and activity modification, nonsteroidal anti-inflammatory drugs, bracing, physical therapy and kinesio taping therapy. In refractory cases, injection therapy and surgical intervention may be indicated. Despite its controversy, corticoidsteroid injection is still widely used when conservative treatment fails. Recent studies, are focusing on the potential use of growth factors as stimulant for tendon regeneration leading to the new promising injection therapies like autologous blood and platelet-rich plasma injections. Other promising therapies, namely, injection of botulinum toxin A, glycosaminoglycan and polidacanol are also being studied with still few long-term follow up studies proving their efficacy. Some pilot studies are also studying the possible use of stem cells on epicondylitis treatment. 

Conclusion: For the past 5 years, several studies have evaluated the effectiveness of different epicondylitis therapies and tried to describe a consensual treatment algorithm. 
Despite the abundance of studies, it still does not exist a globally accepted treatment algorithm. Whatsoever, a first approach consisting on a conservative treatment with rest and activity modification, physical therapy, nonsteroidal anti-inflammatory drugs and kinesio taping therapy seems to be consensual. The use of biological substances like autologous blood and platelet-rich plasma injection achieves good results and are indicated in refractory cases. Alternatively, corticoidsteroid injections can be used, with a positive short-term response but is associated with a high rate of recurrence and augmented tendon degeneration. As last resource, surgical intervention is indicated and is associated with a high rate of success with no significant differences between the various surgicals techniques. Regardless these promising therapies for epicondylitis, continued research and randomized clinical trials are needed to enable determination of a consensual and globally accepted treatment algorithm.

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