Elbow Pain

Whether you’re putting on clothes, driving to work, or preparing a meal, your elbow joint is constantly in motion. This widely-used region of the arm is also a complex intersection of multiple different bones, ligaments, and tendons. Because of these facts, it is not unusual for pain to develop in this area of the body. In addition, soreness in this joint can occur from a more acute injury or a more chronic medical condition.

This article will outline the most common causes of elbow pain, the symptoms typically associated with it, and the available treatment options.

Symptoms of Elbow Pain

Depending on the cause of your elbow pain, several other symptoms may also be present at the same time. These vary in incidence and severity but may include:

• Stiffness or reduced range of motion
• Bruising
• Burning sensations on the outer part of the elbow
• Redness, warmth, or inflammation
• Swelling in the elbow or down the arm
• Reduced strength or ability to grip.

While these symptoms may be mild, they should be evaluated by a healthcare provider if they occur after an acute injury, are progressively worsening, or are severe.

Causes of Elbow Pain

From more repetitive conditions to acute injuries, many different things can lead to pain in the elbow. Among the most common pain-causing issues are:

• Tennis elbow (lateral epicondylitis)
• Sprains or strains
• Osteoarthritis
• Rheumatoid arthritis
• Cubital tunnel syndrome
• Fractures

Tennis elbow is a degenerative (wear and tear) issue affecting the extensor carpi radialis brevis tendon on the outer part of the elbow. It causes relatively sudden pain in the outer (lateral) portion of the joint and occasionally into the forearm. Activities like gripping, twisting, typing, lifting, or moving the wrist in an upward direction generally worsen the soreness.

Sprains occur when a ligament is damaged or torn after an acute injury. The ulnar collateral ligament, located on the inside part of the elbow, is most commonly affected. This injury is especially prevalent in throwing athletes and is accompanied by bruising, pain over the inner (medial) elbow, and feelings of instability. 

Strains also typically happen after an injury or incident but affect a muscle tendon. At the elbow, these most commonly occur in the biceps tendon in the front part of the joint. This condition causes vague pain near the crease of the elbow along with discomfort when bending your elbow or rotating your forearm in an upward direction. Depending on the degree of injury, weakness may also be present with these movements. 

Osteoarthritis happens when there is thinning or wearing away of the smooth articular cartilage that lines the endings of the bones in the elbow. The pain from this condition is generally progressive, deeper in the joint, and accompanied by stiffness, locking, clicking, or catching.

Rheumatoid arthritis is a more systemic version of arthritis where the body’s immune system attacks its own tissue. In addition, rheumatoid arthritis symptoms are frequently seen in both elbows simultaneously and multiple other joints.

Cubital tunnel syndrome is a condition where the ulnar nerve, a structure near the “funny bone” on the inner portion of the elbow, becomes compressed or irritated. This typically occurs due to repeated pressure or overstretching of the nerve but can also arise because of anatomic irregularities in the region. Along with pain in the inner elbow and forearm, this issue can also cause numbness or tingling in the fourth and fifth fingers. Eventually, weakness in the hands and night pain may also develop in severe cases.

Fractures occur when a trauma or acute injury causes a break in one of the three bones (the humerus, the radius, and the ulna) that make up the elbow. While any of these structures can be fractured, the ending of the ulna (called the olecranon) is most commonly affected. This issue is usually caused by a direct blow to the tip of the elbow or a fall onto this area and often leads to pain in the back of the joint. It can also cause significant swelling, bruising, and difficulty moving the arm.

How to Treat Elbow Pain

There are several different ways to treat elbow pain, many of which vary depending on the underlying cause. In most cases, mild elbow soreness can be treated by icing the area, refraining from pain-causing activities, and taking over-the-counter (OTC) NSAID medications. Persistent, worsening, or severe pain may need more formal treatment and should be evaluated by a healthcare provider.

In the case of sprains, strains, or tennis elbow, formal physical therapy (PT) is often initiated. This treatment aims to alleviate pain by slowly loading the affected structure while increasing strength and mobility in the area. Therapy may also be used to reduce pain and add stability to the affected joints in people with osteoarthritis and rheumatoid arthritis.

Cortisone injections may be used in some situations to provide short-term pain relief for conditions like osteoarthritis and tennis elbow. In addition, certain prescription medications, like disease-modifying anti-rheumatic drugs (DMARDs), biological agents, and oral steroids, are frequently prescribed to control the pain and swelling caused by rheumatoid arthritis.

Some conditions may also potentially require a surgical intervention. This may include a fixation procedure after an elbow fracture or an elbow arthroplasty (replacement) for advanced cases of osteoarthritis or rheumatoid arthritis.

Severe sprains or strains (that have torn) may also require surgical fixation or reconstruction. Finally, a procedure to relieve the pressure on the ulnar nerve is sometimes indicated for cubital tunnel syndrome that doesn’t respond to conservative treatment.

Are There Tests to Diagnose the Cause of Elbow Pain?

There are many different tests used to evaluate and diagnose elbow pain. These include:

• A comprehensive physical examination
• X-rays and MRIs
• Blood Tests
• Electromyography (EMG) and Nerve Conduction Testing

A physical evaluation by a healthcare provider is typically the first step to establishing the cause of your pain. During your visit, your healthcare provider will palpate the anatomy of the region and perform special tests to rule in or out the various causes. This can help with the diagnosis of sprains, strains, tennis elbow, and cubital tunnel syndrome.

In addition, images may be taken to further confirm a diagnosis. In addition, images may be taken to further confirm a diagnosis. For example, X-rays can help visualize any bone or joint irregularity and may be helpful for osteoarthritis or rheumatoid arthritis. MRIs, however, can show damage to soft tissue structures like ligaments or tendons and are useful when assessing a sprain or strain.

Blood tests that look for certain inflammatory markers may also be necessary to confirm or rule out rheumatoid arthritis. Finally, EMG tests are typically performed to assess the function of your ulnar nerve if cubital tunnel syndrome is suspected.

When to See a Healthcare Provider

Mild elbow pain can frequently be addressed using some at-home treatments detailed above. That said, there are certain situations where a healthcare provider should assess your symptoms. These include:

• Pain or other symptoms that occur after a fall or acute injury
• Pain that is severe or getting worse
• Progressive weakness in the arm or hand
• Feelings of instability or shifting in the elbow
• Numbness or tingling that extends down the arm
• Swelling or warmth in the elbow, especially if it is present in several joints.

Summary

Multiple conditions can cause elbow pain, including sprains, strains, or different forms of arthritis. More acute injuries, like a fracture, may also be to blame. Depending on the cause, several other associated symptoms may also be present in the region. While at-home remedies may be helpful for some potential causes, many require more formal treatment interventions.

A Word From Verywell

While the descriptions listed above can be helpful, it is essential to keep your healthcare provider aware of any new or worsening pain in your elbow. Remember that pain and other associated symptoms usually indicate an underlying problem and should not be ignored. To add to this, starting treatment early can help accelerate the improvement of your condition. Open communication with your healthcare provider is often the key to a speedy recovery.