Surgery is a last resort and involves cleaning up the tendon from diseased tissue, shaving down the bone and re-attachment of the tendon. This is necessary in 10-15% of the patients. Conservative treatment is in two phases, Phase I is to get rid of the pain and Phase II is to prevent it from coming back with stretching and strengthening exercises. To reduce the pain, using the elbow in a flexed position and the use of an elbow strap counterforce brace is usually the first line of treatment. If the patient has persistent symptoms a cortisone injection may be considered. No more than three injections are recommended per year and if the patient still has persistent symptoms despite conservative treatment surgery is considered.