Elbow Pain

What is Elbow pain?

Elbow pain is a common condition that can affect people of all ages, from athletes to office workers. It can be caused by a variety of factors such as:

• Trauma injuries to the elbow.
• Overuse – many sports, hobbies and jobs require repetitive hand, wrist or arm movements.
• Lack of strength or flexibility in the forearm muscles.
• Lack of strength in the shoulder muscles.
• Age-related – conditions such as osteoarthritis and elbow fractures are more common as we age.

Symptoms of elbow pain can range from mild to severe and can include tenderness, swelling, stiffness, and reduced range of motion.

Common musculoskeletal conditions at the elbow joint

Golfers and Tennis elbow – Despite its name, this injury can affect anyone who performs repetitive motions that strain the muscles and tendons in the forearm. Tennis elbow is pain at the outer (lateral) aspect of the elbow (also known as lateral epicondylitis), and golfers is pain at the inner (medial) part of the elbow (also known as medial epicondylitis). Both conditions are caused by overuse of the forearm muscles and tendons, resulting in tendon irritation. Symptoms include pain and tenderness, weakness in the forearm, and difficulty gripping objects.

Elbow arthritis – the protective cartilage in the elbow joint breaks down as we age, which results in pain, swelling, and restricted movement of the elbow joint. The area can become inflamed, and bony growths may occur known as osteophytes.

Elbow ligament injuries – These injuries are common in athletes who engage in activities that require repetitive arm motions, such as throwing a ball or swinging a racket. There are 3 main ligaments at the elbow which are the medial collateral ligament (MCL), lateral collateral ligament (LCL) and the annular ligament. These types of injuries may present with varus or valgus laxity due to overuse or trauma at the elbow.

Radial head fracture – A radial head fracture is a type of injury that occurs when there is a break in the radius bone at the elbow joint. This is a common injury among adults, especially those who engage in activities that involve falling on an outstretched hand or elbow. Symptoms of a radial head fracture include pain, swelling, stiffness, and difficulty moving the arm. It’s important to seek medical attention if you suspect you have a radial head fracture to prevent further damage and promote proper healing.

Cubital tunnel syndrome – Cubital tunnel syndrome is a medical condition that affects the ulna nerve, which runs from the shoulder to the hand. This nerve is responsible for transmitting sensation and controlling the movement of certain muscles in the arm and hand. Cubital tunnel syndrome occurs when there is pressure or irritation on the ulna nerve as it passes through the cubital tunnel, a narrow passageway on the inside of the elbow. Symptoms include numbness, tingling, and weakness in the hand and fingers, especially the ring and little fingers. These symptoms may worsen when the elbow is bent for a prolonged period, such as during sleep or while holding a phone. In severe cases, cubital tunnel syndrome can lead to muscle wasting and permanent nerve damage.

Tips for treating elbow pain

Treatment for elbow pain depends on the underlying cause and severity of the condition. Consider the following:

• Identify what factors may be contributing to your pain (e.g. slumped postures, repetitive use of the arm at home or work, smoking, and stress) and modifying your activity to try to minimise these factors.
• Talk to your GP or pharmacist about what pain relief or anti-inflammatory medication may be right for you. If your pain is controlled, you will be able to maintain more movement, while anti-inflammatory medication such as ibuprofen would help to reduce inflammation.
• Apply an ice pack (wrapped in a towel) to reduce pain and inflammation.
• Using proper form during physical activity.
• Elbow braces may help provide support to the joint.

Physiotherapy

A physiotherapist can work with you to develop a personalised treatment plan that may include exercises to improve range of motion, increase strength, and reduce pain. They may also use manual therapy techniques such as massage or mobilisation to help ease symptoms and improve function.

In addition to in-clinic treatments, a physiotherapist may also provide education on proper posture and ergonomics to prevent further injury. They can also recommend modifications to your daily activities to reduce strain on your elbow and can determine whether onward referral may be appropriate, for example for a corticosteroid injection.

When should I seek further help for my elbow pain?

Non-urgent advice

Signs that you should see a Physiotherapist about your hip pain include:

• The pain is interfering with your everyday activities or causing sleep disturbance.
• The pain is progressively worsening or recurring frequently.
• No improvement has been observed after 2-4 weeks of treating the pain at home.
• You experience elbow stiffness for more than 30 minutes after waking up.

Urgent advice

Ask for an urgent GP appointment or get help from NHS 111 if:

• Sudden and severe elbow pain without any fall or injury.
• You elbow feels hot and is swollen.
• Discoloration or deformity around the elbow area.
• General discomfort, high temperature, or chills along with elbow pain.

You can call 111 or get help from 111 online.

Immediate action required: Call 999 or go to A&E if:

• Severe elbow pain following a fall or injury.
• Inability to move or put weight through your elbow.
• Tingling or loss of feeling in your elbow or upper/lower arm following an injury.