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5 Common Causes of Elbow Pain

Those aches and pains could be anything from tennis elbow to a pinched nerve


5-minute read

 

 


abstract representation of an elbow joint constructed from tennis racket handles, with a yellow tennis ball serving as the joint's pivot point. Glowing red fibers wrap around the ball like inflamed tendons, and wisps of white smoke rise from the joint against a solid black background.
Photo by Adam Voorhes

Key takeaways 

  • Your elbow joint works like a hinge and pivot. 
  • The most common cause of elbow joint pain is tennis elbow. ​
  • Osteoarthritis can create swelling and stiffness in your elbow joint.
  • A pinched nerve can cause pain in your elbow known as cubital tunnel syndrome.

Do you have joint pain when you move your elbow or when you hold it in a bent position? Tenderness in your elbow joint can impact many of your routine tasks and really slow you down. You don’t even realize how often you move your elbows until one of them is injured or tender.

Your elbow is a complex joint that works as both a hinge — when you bend and straighten it — and a pivot, when you rotate your forearm. Besides the bones that form this joint, your elbow is also home to cartilage, ligaments, tendons, muscles, nerves and blood vessels. Any of these could be contributing to your pain.

How exactly elbow joint pain feels depends on what’s causing it. You might simply feel sore when you move it or bend it. You could also have inflammation and swelling that can cause your elbow to feel warm or look red. Or the joint could feel stiff, like you can’t bend and straighten it easily.

What’s causing my elbow pain? 

The pain you feel in your elbow could be caused by bones, muscles, nerves, tendons or ligaments. Here’s a look at five of the top causes of elbow joint pain.

1. Tennis elbow (lateral epicondylitis) 

Don’t scroll past thinking you can’t possibly have tennis elbow. It’s actually one of the most common causes of elbow pain. It just gets its name because it’s a frequent injury among tennis players.

“Most people who get this don’t get it from tennis, they get it from [their] daily activities,” says Dr. James Carr II, a sports medicine surgeon at the Hospital for Special Surgery in New York City.

Formally known as lateral epicondylitis, tennis elbow causes pain in the outside (lateral side) of your forearm muscles that connect your tendons to your elbow. The pain might be sharp or burning and it gets worse when you twist or bend your arm. It can also radiate down your forearm and into your wrist, especially at night. You might have stiffness, swelling and a weakened grip, for example, when you try to hold a pen or shake a hand.

“It’s usually a breakdown of the tendons,” Carr says. “You get it with a lot of lifting or gripping activities.”

To diagnose tennis elbow, your doctor will examine your elbow, ask what kinds of movement makes it hurt and possibly order imaging scans like X-rays, ultrasound or MRI to look for damage in your arm.

The best thing to treat it, Carr says, is physical therapy.

Your health care provider might also recommend:​

2. Golfer’s elbow (medial epicondylitis)

This pain, formally known as medial epicondylitis, is also caused by a breakdown of the tendons due to repetitive motion that doesn’t have to be golf related ­­— though it certainly can be.

You can also get it, Carr says, from “heavy lifting, yard work or any kind of repetitive gripping activities.”

Unlike tennis elbow where pain is on the outside of your forearm, golfer’s elbow pain is usually felt on the inside of the elbow.

Beyond just the elbow joint, you might also have:

  • Aching in your wrist or forearm
  • Pain that radiates up or down your arm
  • Numbness or tingling in your hand
  • A weakened grip

Your doctor will likely diagnose golfer’s elbow just like tennis elbow: a physical exam of the elbow, some background questions about the pain and possibly X-rays, ultrasound or other imaging to look for damage.

Your doctor’s recommendations for golfer’s elbow may also be the same as those for tennis elbow, including:

  • Rest, ice, compression and elevation (RICE method)
  • A supportive brace or splint
  • Non-steroidal anti-inflammatories (NSAIDs)

You also just need to give it a rest from whatever repetitive action that caused it, says Helen Anzick, an occupational therapist at Mass General Brigham Spaulding Rehabilitation in Wellesley, Massachusetts. “If the elbow pain is from a sport, or improper mechanics in that sport, and you’re playing three times a week, then you’re causing microscopic tears every time you play.”

3. Elbow pain from osteoarthritis 

Osteoarthritis is the most common type of arthritis, and it can cause pain in any of your joints. It happens when the lining of your joints, called cartilage, wears down over time. This leaves your bones to painfully rub against each other with no cushion in between. It’s caused by a lifetime of wear and tear, so your risk for it increases with age.

If osteoarthritis is the cause of your elbow pain, you might have:     

  • Pain when you move your elbow
  • Stiffness or decreased range of motion
  • Weakness or instability in the elbow
  • Swelling in the elbow
  • Visible changes in the shape of the elbow

Doctors diagnose osteoarthritis with a physical exam of the elbow and X-rays or other imaging tests. 

Doctors may recommend a range of treatments, including over the counter and prescription pain medication, injections and physical therapy.

4. Elbow bursitis

The olecranon bursa is the fluid-filled sac that cushions the bones that form your elbow joint. If your olecranon bursa gets injured or infected, it can become severely inflamed and swollen and cause extreme pain.

“It’s usually swelling at the back of the elbow,” Carr says. “People get a golf- or tennis-ball-sized sac of fluid on the back of their elbow.”

Besides the swelling and pain, you might feel heat in the area and see redness in the swollen bursa, and you may also have bleeding under your skin that looks like a large bruise.

Elbow bursitis is fairly common. You can get it from repetitive motion in sports — like a pitcher — or if you have a physical job where you’re on your hands and knees, like a carpenter. Sitting for long periods while you put pressure on your elbow, or infection (known as septic bursitis), can also be the culprits, but most times an injury, like falling and landing on your elbow, is to blame.

Doctors can usually tell you have bursitis from a physical exam. They might order tests to rule out infection as the cause.

“Usually, we’ll drain the fluid and put a little bit of cortisone in it,” Carr says. “If it keeps coming back, you can do a surgery to take it out.”

5. Ulnar nerve compression (cubital tunnel syndrome)

The ulnar nerve starts at your elbow and runs, by way of a protective tunnel of tissue called the cubital tunnel, down your arm, into your palm, toward your little finger. This is the nerve that causes that cringe-worthy tingling when you bump your “funny bone” in just the right spot.

When you put pressure on your bent elbow for long periods of time ­— for example, if you sleep on your side with your elbow folded tightly underneath you — you can pinch the ulnar nerve. It can also happen if you sit for prolonged periods at a computer with your hands on the keyboard and your elbows bent at a right angle. But this one can also just be another case of wear and tear.

“Low-grade ulnar nerve symptoms are just scar tissue buildup and compression over time,” Carr says. “The ulnar nerve coming around the elbow is like a hose coming around the house that gets kinked when it comes around the side.”

When this nerve gets pinched, also called compressed or entrapped, in the elbow region, it can have effects that reach from the elbow to the tips of the fingers. This is called cubital tunnel syndrome.

Besides elbow pain, you might have:     

  • Numbness and tingling in your pinky and ring fingers
  • Curving, claw-like pinky and ring fingers
  • Hand weakness that you’ll notice when you try to hold onto or pick things up, write or button a shirt

To diagnose the problem, your doctor might tap your funny bone and also observe you doing specific tasks, such as holding a piece of paper between your thumb and forefinger.

The typical treatment for a pinched nerve in the elbow is NSAIDs, such as ibuprofen and naproxen, for the pain, and physical therapy to get your movement and strength back.

When to see the doctor for elbow pain

Experts recommend you first try the RICE method for elbow pain. You might add over-the-counter NSAIDs too.

But once you’ve tried ice, OTC painkillers and resting your elbow for about a week, Anzick says, “It needs to be assessed.” If you keep pushing through it, she adds, “you could be making it worse.”

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