In short
Most elbow pain is an overuse injury of the tendons, either tennis elbow on the outer side or golfer's elbow on the inner side. A soft swelling over the point of the elbow is usually bursitis. Numbness in the ring and little fingers points to the ulnar nerve. Most causes settle with rest from the aggravating activity, ice, and a gradual strengthening program. A hot, red elbow or pain after a fall needs prompt attention.
On this page
What causes elbow pain?
The most common cause is overuse. Repeated strain or pressure overloads the tendons near the elbow, particularly where they anchor to the bone, and causes pain when you use the wrist and hand.1 Where it hurts tells you most of what you need to know.
| Where it hurts | Likely cause |
|---|---|
| Outer side of the elbow, worse when opening the fingers | Tennis elbow, the most common type of elbow pain1 |
| Inner side of the elbow, worse with gripping or making a fist | Golfer's elbow1 |
| A soft swelling over the point of the elbow | Bursitis2 |
| Numbness or tingling in the ring and little fingers | Ulnar nerve entrapment3 |
| Stiffness and aching in the joint itself | Osteoarthritis1 |
| Pain after a fall or a blow | A fracture or sprain1 |
Tennis elbow and golfer's elbow
These are the same kind of problem on opposite sides of the joint. The forearm muscles that pull the wrist back attach to the bump on the outer side of the elbow, and the muscles that bend it forwards attach to the bump on the inner side.1
Neither needs a racquet or a club. They follow all sorts of repetitive work and sport.1 In a Finnish population study, 1.3 per cent of adults aged 30 to 64 had tennis elbow and 0.4 per cent had golfer's elbow. Both were most common between 45 and 54, and both were linked to repetitive and forceful arm work, smoking and obesity.4
Pain that keeps coming back?
Talk it through with an Australian doctor online. No referral needed.
Bursitis
A bursa is a small fluid-filled sac that cushions moving parts. Bursitis at the elbow often shows up as a swollen lump at the back of the joint. It can follow repetitive use, frequent pressure on the elbow or an injury, and it is also seen with conditions such as gout and rheumatoid arthritis.1,2
Most cases are not infected and settle without an operation. A review of 29 studies covering 1,278 patients found that treatment without surgery was more effective and safer than surgery, and that steroid injections into the bursa were linked to more complications.5
A bursa can become infected. Redness and warmth are warning signs, and a doctor may take a sample of the fluid to check.2 With a fever, get it seen quickly.
A trapped ulnar nerve
The ulnar nerve runs down the inside of the arm and past the elbow into the hand. When it is squeezed or irritated at the elbow, the condition is called cubital tunnel syndrome.3 It is one of the most common trapped-nerve problems of the arm.6
- The first symptom is usually numbness in the ring finger and little finger.3
- Weakness, pain and difficulty using the hand can follow.3
- Smoking, obesity, diabetes, joint conditions and past elbow injuries raise the risk, as do jobs or hobbies that involve repeatedly bending and straightening the elbow.3
Mild cases can be treated without surgery. That includes physiotherapy, changing how you use the arm, and a splint at night to stop the elbow bending fully.3,6 Surgery for severe cases is not guaranteed to help and can cause complications.3
Other causes
- Osteoarthritis. The cartilage lining the joint wears and splits, leading to inflammation and pain.1
- Referred pain. Problems in the neck can irritate the nerves that supply the arm and be felt around the elbow.1 See neck pain.
- Fractures and sprains. A heavy fall or a blow can crack a bone or tear a ligament.1
What helps?
- Rest from the trigger. Stop or cut back the activity that brought it on, and ice the area often in the first days.1
- Adjust the task. Avoid or modify work that involves forceful, repetitive gripping in awkward positions, and take breaks.1
- Support. Taping or bracing the elbow and forearm helps in some cases.1
- Strengthen gradually. A physiotherapist can prescribe exercises that build the tendons back up.1
Steroid injections for tendon pain at the elbow are no longer recommended in most cases, because there is evidence they can be harmful in the longer term.1 A review of 41 trials found they eased pain for a few weeks, with worse results at 6 and 12 months.7
Surgery is for severe cases where pain has not resolved within 12 months.1
When to see a doctor
- Symptoms are not improving, or you keep getting bouts of elbow pain1
- Numbness, tingling or weakness in the hand3
- A hot, red, swollen elbow, or swelling with a fever2
- Pain after a fall or a heavy blow, or an elbow you cannot bend or straighten
See also wrist pain, shoulder pain and tendonitis.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- Better Health Channel (Victorian Government). Elbow pain.
- healthdirect. Bursitis.
- healthdirect. Ulnar nerve entrapment.
- Shiri R, Viikari-Juntura E, Varonen H, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11):1065-74.
- Sayegh ET, Strauch RJ. Treatment of olecranon bursitis: a systematic review. Arch Orthop Trauma Surg. 2014;134(11):1517-36.
- Ferguson DP, Grewal R. Cubital Tunnel Syndrome: Review of Diagnosis and Management. Handchir Mikrochir Plast Chir. 2022;54(3):253-262.
- Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010;376(9754):1751-67.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.