Elbow pain
Pain - elbow
This article describes pain or other discomfort in the elbow that is not related to direct injury.
Causes
Elbow pain can be caused by many problems. A common cause in adults is tendinitis. This is inflammation and injury to the tendons, which are soft tissues that attach muscle to bone.
People who play racquet sports are most likely to injure the tendons on the outside of the elbow. This condition is commonly called tennis elbow. Golfers are more likely to injure the tendons on the inside of the elbow.
Other common causes of elbow tendinitis are gardening, playing baseball, using a screwdriver, or overusing your wrist and arm.
Young children commonly develop "nursemaid elbow," which often occurs when someone is pulling on their straightened arm. The bones are stretched apart momentarily and a ligament slips in between. It becomes trapped when the bones try to snap back into place. As a result, the child will usually quietly refuse to use the arm, but often cries out when they try to bend or straighten the elbow. This condition is also called an elbow subluxation (a partial dislocation). This often gets better on its own when the ligament slips back into place. Surgery is usually not needed.
Other common causes of elbow pain are:
I'm Dr. Alan Greene and let's talk for a moment about tennis elbow. Tennis elbow is a kind of tendonitis. It's an inflammation and injury to the tendons usually on the outside of the elbow. Tendons are those fibrous bands that connect the muscle into the bone. When those tendons get damaged, as they often can in racquet sports or also in baseball, sometimes over using a screwdriver, a lot of ways you can do it, we typically call it tennis elbow or tendonitis. How do you prevent it? When you are playing tennis one of the most important things is to avoid putting too much stress on that tendon on the outside of the elbow. The problem usually comes with your backhand. So if you do a two-handed backhand, you can greatly reduce the stress. You can also reduce the stress by using a racquet that has the right size grip for your hand. Don't play with somebody else's racquet very often. And make sure the strings are not over tightened. It puts too much stress when the ball hits suddenly with over tightened strings. If you have a tendency to get tennis elbow, it could also be very useful immediately after playing to ice the elbow and take some ibuprofen to prevent swelling and inflammation. Now, if you do develop tennis elbow how do you treat it? It comes down to a combination of rest, ice, compression, and elevation. In terms of rest, you want to completely rest your elbow for at least a couple of days and really for as long as it is still sore. In terms of ice that first day, ice very frequently. It's great even every 15 minutes to have an ice pack on there briefly and for the next couple of days, at least every 3 or 4 hours if you can. It will help speed the healing. Wearing a bandage on there to help support the elbow is good. It can also be good when you are playing tennis to help prevent tennis elbow. The wrap on there can help support the elbow and keep it warm and make it less likely to injure. And finally when you are having the severe pain at the beginning especially, keeping your elbow elevated above your heart can help as well and hopefully this will get you back out and physically active again very quickly.
Home Care
Gently try to move the elbow and increase your range of motion. If this hurts or you cannot move the elbow, contact your health care provider.
When to Contact a Medical Professional
Contact your provider if:
- You have a prolonged case of tendinitis that doesn't improve with home care.
- The pain is due to a direct elbow injury.
- There is obvious deformity.
- You can't use or move the elbow.
- You have fever or swelling and redness of your elbow.
- Your elbow is locked and can't straighten or bend.
- A child has elbow pain.
- There is a lot of swelling and bruising around the elbow.
What to Expect at Your Office Visit
Your provider will examine you and carefully check your elbow. You will be asked about your medical history and symptoms such as:
- Are both elbows affected?
- Does the pain shift from the elbow to other joints?
- Is the pain over the outside bony prominence of the elbow?
- Did the pain begin suddenly and severely?
- Did the pain begin slowly and mildly and then get worse?
- Is the pain getting better on its own?
- Did the pain begin after an injury?
- What makes the pain better or worse?
- Is there pain that goes from the elbow down to the hand?
Treatment depends on the cause, but may involve:
- Physical therapy
- Antibiotics
- Corticosteroid shots
- Manipulation
- Pain medicine
- Surgery (last resort)
References
Clark NJ, Elhassan BT. Elbow diagnosis and decision making. In: Miller MD, Thompson SR, eds. DeLee Drez & Miller's Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 58.
Kane SF, Lynch JH, Taylor JC. Evaluation of elbow pain in adults. Am Fam Physician. 2014;89(8):649-657. PMID: 24784124
Lazinski M, Lazinski M, Fedorczyk JM. Clinical examination of the elbow. In: Skirven TM, Osterman AL, Fedorczyk JM, Amadio PC, Feldscher SB, Shin EK, eds. Rehabilitation of the Hand and Upper Extremity. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 7.
Version Info
Last reviewed on: 9/20/2022
Reviewed by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
