Andy Murray’s return to tennis after more than a month away from the Tour with an elbow injury lasted only two matches – and the world No 1 looks certain to take another break to prepare for the French Open, which is less weeks away.

Murray was irritated rather than devastated after losing in three sets to the Spanish claycourter Albert Ramos-Viñolas in the third round of the Monte Carlo Masters on Thursday, having led 4-0 in the third, and admitted he has some work to do on his conditioning.

“I’m disappointed to lose from the position that I was in,” he said after Ramos-Viñolas hung on against the odds to win 2-6, 6-2, 7-5 in just over two-and-a-half hours in perfect conditions for players and spectators alike. “It was 7-5 in the third; a week ago, I would have been OK with that. But sitting here, being 4-0 up in the third … I haven’t lost many matches like that in my career. I had enough chances to win. At 5-4 I had a chance in that game as well. Maybe tomorrow or the day after I’ll be able to look back and think where I’m at now from where I was a week ago.”

A week ago Murray was uncertain about playing, but he decided at the last minute that the elbow which hindered him when he lost to the world No129 Vasek Pospisil at Indian Wells on 12 March had healed sufficiently to allow him to go full bore on his serve. That, at least, improved after a stuttering performance in his first match here against the 33-year-old Gilles Müller.

“My elbow felt pretty good,” he said. “I served much better today than I did yesterday. That’s only going to get better. Hopefully I keep going in the right direction.” He will choose that direction after consulting his team: and it may lead either to the new ATP 250 tournament in Budapest or the tougher 500 assignment in Barcelona. However, it sounds as if he might not play at all.

“I need to decide whether I try to get matches or whether I try to get myself in better shape physically, put as much work in as I can. If I was to play Budapest or Barcelona, and do well, I would not really have a chance to train much between now and the French Open. Whereas if I wasn’t to play next week, I get the chance to put in some hard work – which is maybe what’s needed.

“I had to go a little bit easy when I first came back from the elbow, whereas now I’m ready to really put in some hard work as well.”

Before that, he will put his feet up in front of the television this Sunday to watch his father-in-law, Nigel Sears, run in the London Marathon – only 16 months after he collapsed in the stands during the Australian Open, while Murray was playing on an adjoining court.

Meanwhile, Ramos-Viñolas, grinning broadly, said: “Today? It’s one of those days that sometimes happen. I knew I needed to keep playing every point. He was returning so good in the first set, then I changed my second serve to his forehand. It worked a little bit. In the third set I lost concentration the first few games. Then I just play really good.”

The 29-year-old Spaniard, who was playing in his 19th claycourt match of the season, ranked reaching the quarter-finals at Roland Garros in 2016 as his finest achievement but said adding Murray to Roger Federer as a scalp was, “very important”. He also fulfilled Murray’s pre-match prediction that he “doesn’t give anything away for free”.

While Murray correctly identified his serve as a cause for minor encouragement, he was still broken on seven occasions, the first time that has happened to him in a three-setter since his defeat by Rafael Nadal in the semi-finals here six years ago.

After grinding his way through two breaks of service to take the opener in style, Murray saved one set point in the second with an unreachable cross-court forehand but lobbed wide to hand the set to the Spaniard, whose diligence in cutting his unforced errors to four earned him a third set and the chance of an improbable victory.

Some of Murray’s winners in the first four games of the decider were breathtaking. Then the whole tone of the match changed in a twinkling. Murray was running away with it before allowing the Spaniard a couple of unearned looks to get back to 4-4. “Come on! Come on! I don’t know how to play!” he screamed at himself at one changeover.

He had to save three break points in the ninth game, and broke a string at 4-5, 0-30 on his opponent’s next serve before twice clawing his way to deuce. Ramos-Viñolas held for 5-5 and broke for a seventh time when Murray hit a regulation forehand long. He struck wide to present his opponent with his first match point but hung on for deuce. Ramos-Viñolas caught Murray cold on the baseline with a smash and was decidedly relieved and elated when the Scot’s final drop-shot clipped the net and fell back towards him.