Elbow Pain

This article was written, reviewed and contributed to by some of Australia’s leading experts in the field of pain and elbow pain. We aim to empower you with the knowledge that helps you understand the cause of your pain and alleviate any concerns or anxiety you may have.

If you have been dealing with elbow pain for a long time, then we hope this guide gives you some new information that may help you on the road to recovery.

This guide contains a comprehensive, practical and actionable plan, backed by the latest medical research to treat your elbow pain (including things you can do from home) and help you get back to feeling your best.

Continue reading as we help you understand the different types of elbow pain and discover what type you may have.

What is Elbow Pain?

Elbow pain is a term used for describing conditions or issues leading to discomfort around the elbow joints (humeroulnar and radioulnar joints). Injuries to structures, such as ligaments, tendons and joints can lead to elbow pain. Examples of common elbow conditions include tendinopathy and sprains.

In Australia, elbow pain is most commonly seen in the workplace and among young athletes. According to Safe Work Australia, elbow pain constitutes more than 10% of upper limb problems.[1] Additionally, information collected by the Australian Institute of Health and Welfare showed that males in between the ages of 15-34 were the most likely to be admitted to hospital with a sports elbow injury.[2]

Pain is categorised as either acute, subacute or chronic elbow pain

Acute elbow pain: (0 days - 6 weeks)

Acute elbow pain is usually the result of a minor injury or problem, typically from overuse or sporting injuries. These types of injuries typically recover quickly once the appropriate treatment is prescribed.

Subacute elbow pain: (6 weeks - 3 months)

Sub-acute elbow pain usually occurs when there are other factors involved, causing the injury to heal slower. These factors could include serious tissue damage or other complications like circulation issues.

Chronic elbow pain: (3 months +)

Chronic elbow pain is defined as any pain that goes beyond the three-month mark. In these cases, there are almost certainly other issues that are preventing the injury from healing quicker. These could include complications like circulation issues, general health problems and/or issues with the elbow joint itself.

What are the symptoms of elbow pain?

Elbow pain is often characterised by a dull ache and tenderness at the point of the elbow. People may also experience pain when gripping, have a weak grip, redness or swelling and occasionally numbness or tingling may occur.

Common complaints of pain in the elbow

• Tenderness

• Swelling

• Stiffness

• Weakness of the forearm muscles

• Weak grip strength

• Pain with lifting

• Forearm pain

• Issues when playing sports like golf or tennis

• Cracking feeling when moving the elbow

People may experience

Pain areas: in the elbow, forearm, muscles and bones

Sensory: pins and needles, tingling into the hand

Also common: weakness, lack of grip strength

What causes elbow pain?

Elbow pain is most commonly caused by an injury from overuse, with many sports and activities requiring repetitive movements involving the elbow muscles, like tennis. People may also experience elbow pain due to poor lifting techniques, a fall, arthritis or gout.

According to the Mayo Clinic, elbow pain is defined as “physical discomfort in the elbow joint, or in the muscles, tendons and ligaments supporting the elbow.”[3] Repetitive stress and sports injuries are the most common causes of elbow pain.

Elbow pain can result from a problem in one or several parts of the elbow, including:

• Muscles (strain)

• Ligaments (sprain)

• Nerves

• Bone injuries - the bones of the elbow include; the humerus (upper arm) and the radius and ulnar (forearm).

Common reasons why people experience pain in the elbow:

• Sporting injuries

• Plumbing or carpentry

• Insufficient warm-up and conditioning

• Arthritis

• Prolonged computer work.

Common injuries that cause elbow pain

Sprain or strains

Muscles and ligaments can be damaged by tearing due to overstretching or overuse. This is common in racquet sports.

Bursitis

Repetitive stress and excessive use of the elbows can cause inflammation of the bursa. A bursa is a fluid-filled sac that serves as a cushion between bones and other soft tissues.

Tennis Elbow

Tennis elbow is one of the most common overuse injuries in the elbow joint, caused by microtears and damage to the extensor muscle group of the forearm.

Golfer’s Elbow

Similar to tennis elbow, but on the inside of the elbow - Golfer's elbow results from overuse of the flexor muscles of the forearm.

Dislocation

This happens with the displacement of the bone at the elbow joint. A fall onto an outstretched hand is one of the most common reason for dislocation.

Cubital Tunnel Syndrome

When the nerve (ulnar nerve) that passes in your arms gets trapped inside the elbow. This is characterised by burning or numbness of the hands and arms.

Osteoarthritis

Cartilage inside the elbow joint wears down over time resulting in pain and stiffness - leading to osteoarthritis.

Fractures

Although rare, fractures of the elbow do happen. This usually happens with a direct blow during contact sport or in a motor vehicle accident.

Common conditions that cause elbow pain

Various conditions may present as elbow pain which may need medical attention. That’s why it is essential to identify the root cause of your elbow pain.

• Gout

• Lupus

• Osteochondritis dissecans

• Rheumatoid Arthritis

• Lyme Disease

Sports that increase the risk of elbow pain

Tendons that control the movement of your wrist are attached to the top of your elbow. Sports that rely heavily on your wrist for prolonged periods can increase the risk of elbow pain over time. Here is a list of the most common sports that can result in elbow pain:

• Tennis

• Golf

• Archery

• Javelin Throw

• Baseball

How is elbow pain diagnosed?

Elbow pain can limit you from doing daily activities and may prevent you from participating in your favourite sports or hobbies. What’s worse, is if it is chronic or left untreated.

There are several options available to you when it comes to diagnosing the underlying cause of your elbow pain. One of the most common, and one that is most recommended by Australian GP’s, is an assessment from a physiotherapist.

Physiotherapists are rehabilitation experts when it comes to pain and injuries. They are high-qualified medical professionals that diagnose and treat joint pain and tendon problems such as conditions related to elbow pain.

A physiotherapy assessment is similar to visiting a GP. Your assessment will start with a consultation where you will ask several questions about your health, sports activities and lifestyle to provide a background of your condition. This is similar to having a mini-interview about your overall health status. You’ll get the time to discuss all relevant issues relating to your elbow pain.

After establishing the background of your condition, your physiotherapist will perform a physical assessment and movement screens to determine the best possible cause of your pain and rule out other conditions.

From here, your physiotherapist will give you the details of your treatment program, this will include:

• Number of treatment sessions

• List of exercises you need to do at home

• Strategies to manage the pain and to prevent worsening of the condition

• Timeline of your total recovery

• Recommendations,

How is elbow pain treated?

Elbow pain can be stressful and may impact your daily activities. Ignoring signs of tendon damage or joint problems such as elbow pain can make the condition worse over time.

It is vital to have your condition seen by a physiotherapist to give you effective treatment for elbow pain and help you recover fast.

There are several options when it comes to treating the conditions that cause elbow pain. One of the more common, and the treatment option referred to by Australian GP’s the most is physiotherapy.

Elbow pain is an injury that physiotherapists come across regularly, and the process of treating it is straightforward. Following an initial consultation, the physiotherapist will be in the best position to determine your treatment plan.

A combination of effective treatment protocols such as manual therapy, pain modalities, and specific movement exercises will be given to you by your physiotherapist. Your treatment will focus on decreasing your pain and improving the strength of your forearm muscles.

Your physiotherapist will discuss each treatment and make sure that you better understand your condition after your initial evaluation.

Depending on the severity of your elbow pain, a physiotherapist may provide you with a combination of the following types of treatments:

• Therapeutic exercises - Exercises given to you to correct impairments and improve the function of your muscles and tendons. This is one of the most vital parts of rehabilitation.

• Stretching exercises - Techniques used to lengthen your muscles, decrease tension and decrease pain.

• Manual therapy - Hands-on treatment technique applied by your physiotherapist to improve joint mobility and decrease pain.

• Joint mobilisation - Techniques used to apply rhythmic or sustained pressure on the joint to promote natural movements, resulting in an increased range of motion and decreasing pain.

• Soft tissue massage - Hands-on treatment to relieve muscle tension, spasm and pain.

• Dry needling - A specialised technique used to decrease pain and muscle spasms.

• Heat therapy - Heat can increase blood circulation and aid the body’s healing process.

• Cryotherapy - Uses the advantages of cold treatment to control inflammation and decrease pain.

• Kinesio taping - Specialised taping to inhibit muscle spasms and allow pain-free movement.

• Advice and education - Professional expert advice to help you manage the pain and improve your recovery.

Physiotherapy treatment can last for about 30 to 60 minutes. Most patients can feel the benefits in just a single session.

Next step - Creating a treatment plan made for you

Following your initial evaluation, your physiotherapist will create a detailed treatment plan that will guide you step-by-step to maximise your recovery.

Self-care strategies

If you are experiencing elbow pain, here are the best things you can do from home and those things you can avoid.

Things to do:

• Rest

Elbow pain is usually caused by overworking muscles and tendons or inflamed structures inside the joint. The best way to alleviate the pain is to rest your elbow.

• Use hot compress / Ice compress

Use a cold compress to minimise the swelling and decrease your pain. Do this in the first 48 hours of your injury. Apply for 10 to 15 minutes every 2 hours.

If you have elbow pain for a long time without any swelling, you can use a hot compress to relax the muscles and relieve stiffness around the elbow joint.

• Gentle stretching

Stretching your forearm muscles will help prevent muscle tightness and will keep your normal range of motion.

Things to avoid:

• Avoid activities that worsen the pain

Avoid activities that rely heavily on your wrist. Rest up and consult a physiotherapist if you are having persistent elbow pain.

Do I need a specialist or surgery?

Most cases of elbow pain respond well with physiotherapy. However, some severe cases need re-evaluation and coordination with a surgeon or physician.

X Rays or MRIs can screen the elbow joint for possible fractures, spurs and other bone or ligament pathology. A blood test can be done to rule out cases of infection.

In rare cases, a surgeon must reconstruct the elbow joint and clean up any debris that can cause pain.

A good surgeon will always collaborate with your physiotherapist to develop the best possible solution to your condition and coordinate treatment goals even after the surgery.

What is the recovery time / prognosis for elbow pain?

Ultimately, recovery time is dependent on your proactiveness to seek professional treatment and the severity of your elbow pain.

In some cases, patients can feel the benefits of physiotherapy after just one session!

Important factors in your recovery post-treatment:

• Following the treatment plan provided

• Not returning to sports too early

• Paying attention to pain and resting when needed.

Other factors that may influence your recovery time:

• Age

• Severity of condition

• Previous injury

• Lifestyle factors,

Can pain in the elbow be prevented?

Preventing elbow pain is an understandable goal, but isn’t always guaranteed. However there are some things you can do to minimise your risk.

These tips can double as things to prevent elbow pain from occurring as well as help reduce symptoms if you already have elbow pain.

• Strengthening exercises: If you can’t avoid repetitive stress to your elbow, you need to strengthen your forearm muscles to make them more resistant to strain and injury.

• Stretch regularly: Stretching can increase the length of your muscles and maintain your normal range of motion.

• Avoid prolonged activity: Take enough rest periods and phase your activities. Avoid prolonged repetitive tasks for your wrist and forearm muscles.

Outlook and the main takeaways

If there is one thing to take away from this guide to elbow pain, it’s that there are many causes, symptoms and severities associated with elbow pain. The best thing to do is to listen to your body. Pain is a message that is telling you to do something about it. Book a time, and have your elbow pain assessed by a physiotherapist today.

Anatomy of the elbow

Your elbow joint comprises three different bones: the upper arm bone (humerus) and the two bones of your forearm (radius and ulna).

At the bottom of the humerus, you will find bony bumps called the medial and lateral epicondyles, where tendons and several forearm muscles are attached.

Muscles that are attached to the medial epicondyle:

• Pronator teres

• Flexor carpi radialis

• Palmaris longus

• Flexor digitorum superficialis

• Flexor carpi ulnaris.

Muscles attached at the lateral epicondyle:

• Extensor Carpi Radialis Brevis

• Extensor Carpi Radialis Longus

• Extensor Digitorum Communis

• Extensor Digiti Minimi

• Extensor Carpi Ulnaris

• Anconeus.

Ligaments of the elbow:

• Lateral ulnar collateral ligament

• Lateral radial collateral ligament

• Accessory lateral collateral ligament

• Annular ligament.