Aim: Tennis elbow is a common musculoskeletal condition, which has been treated with surgical and non-surgical modalities. This thesis aims to evaluate whether two common treatments for acute and chronic tennis elbow offer any benefit in outcomes over and above placebo treatment, as well as investigating any differences in presentation in acute versus chronic tennis elbow. Methods: A prospective randomised double blinded placebo-controlled trial was conducted to investigate whether the use of a

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... counterforce forearm brace in the management of acute tennis elbow offered any benefits over and above a placebo brace. A prospective randomised double blinded placebo-controlled trial was conducted to investigate whether the surgical excision of diseased extensor carpi radialis brevis (ECRB) tendon in chronic tennis elbow offered any advantage over and above a skin incision alone. A post hoc review of data collected from the two prospective trials was used to investigate whether there are any differences in initial presentation between the acute (<6 months) and chronic (>6 months) patients enrolled in the following clinical trials. Results: Patients with symptoms longer than 6 months reported more severe pain at rest and during sleep, reduced level of sport and reduced strength, compared to patients with symptoms less than 6 months. All patients treated with a brace improved in every outcome measure by 26 weeks and maintained or improved the result at long term (3 years). Significant intergroup differences favouring the treatment brace over the placebo brace were detected for frequency of pain at rest at 6 and 12 weeks (p<0.05), level of pain at rest at 2 weeks (p<0.001) and for patient rated overall elbow function at 26 weeks (p<0.041). All patients undergoing surgery improved in every outcome measure by 26 weeks and maintained or improved the result at long term (2.5 years). There was no intergroup difference observed in any parameter, at any time point. A post hoc power analysis showed 6500 patients woul [...]