Elbow Pain: Causes, Symptoms, Treatment and When to Get Help

Elbow pain is more common than you think. Whether you’re lifting weights, typing, or playing sports, the elbow is involved in almost everything you do with your arms. When it starts to hurt, even simple tasks like pouring a drink or using a mouse can be a challenge.

A common cause of elbow pain is “tennis elbow,” but it affects more than just athletes. It’s usually caused by doing the same movements over and over, like lifting, gripping, or typing.

In fact, about 1-3% of adults experience tennis elbow every year, most often between the ages of 30 and 50. The good news? With the right care, you can find relief and get back to what you enjoy.²

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What is Elbow Pain?

Elbow pain can be caused different issues in the bones, tendons, or nerves around the joint. Common causes include inflammation of the tendons (like tennis or golfer’s elbow), bursitis, and nerve entrapment. It’s usually related to activities like gripping, lifting, or typing, making it a problem not just for athletes but for anyone with repetitive arm movements.

Elbow pain affects 1-3% of adults annually, with repetitive strain being a key risk factor.² Identifying the cause early can lead to effective treatment and quicker relief.

Common Symptoms of Elbow Pain

• Pain When Lifting or Gripping: Sharp discomfort during tasks like lifting or gripping.
• Tenderness on the Elbow: Soreness when touching the outer or inner elbow.
• Swelling and Warmth: Visible swelling or a feeling of warmth around the joint.
• Limited Motion: Difficulty fully bending or straightening the elbow.
• Pain with Specific Movements: Sharp pain when extending or rotating the wrist.
• Weak Grip Strength: Struggling to grip objects firmly.
• Locking or Stiffness: A sensation of the elbow “locking” or feeling stiff.
• Radiating Pain: Pain spreading from the elbow into the forearm or wrist.
• Numbness or Tingling: Tingling or numbness, especially in the fingers.
• Clicking or Popping Sounds: Hearing or feeling a popping sensation during movement.

When to Have Elbow Pain Assessed in Person

Why Does Elbow Pain Happen?

Elbow pain often comes from repeated strain or pressure on the joint, which affects different structures inside. But what exactly causes elbow pain?

Is it your tendons, nerves, or something deeper in the joint? Why does your elbow hurt when you lift, grip, or even rest it on a desk? Let’s break it down:

Tendon Strain and Damage

Repeated movements like lifting or typing cause tiny tears in your elbow tendons. If these tears don’t heal properly, the tendons weaken and lead to pain. This is less about inflammation and more about poor healing and wear over time.³

Nerve Pressure

Nerves in your elbow pass through tight spaces. Activities like leaning on your elbow or repetitive bending can squeeze these nerves, causing pain, numbness, or tingling.⁵

Cartilage Wear

Cartilage cushions the bones in your elbow, but overuse or injury can wear it down. As the cushioning thins, bones rub together, leading to stiffness and pain.⁵

Overuse and Joint Strain

Frequent or intense movements overload the joint, causing micro-damage in tendons, muscles, and ligaments. Without enough recovery, this damage builds up and causes pain.¹

Conditions That Cause Elbow Pain

1. Tennis Elbow (Lateral Epicondylitis): Pain on the outer elbow, especially when gripping or lifting, caused by overuse of forearm muscles. Tender at the outer bony area.¹
2. Golfer’s Elbow (Medial Epicondylitis): Inner elbow pain, often due to repetitive wrist flexion and forearm rotation, worsens with gripping.⁶
3. Ulnar Nerve Compression: Tingling or numbness in the ring and pinky fingers, worsened by prolonged elbow bending.⁵
4. Olecranon Bursitis: Swelling at the tip of the elbow, especially painful when resting on a hard surface.²
5. Medial Collateral Ligament Injury: Pain on the inner elbow, typically from throwing motions; worsens when pulling or throwing.⁸
6. Elbow Osteoarthritis: Gradual pain and stiffness with a “grating” feeling, due to cartilage wear.⁵
7. Radial Tunnel Syndrome: Deep ache along the top of the forearm due to radial nerve compression, especially during wrist rotation.⁵
8. Distal Biceps Tendon Rupture: Sudden, sharp pain with weakness in bending or turning the forearm, often with a “pop” and visible bruising.⁸

Tennis Elbow vs Golfer’s Elbow: How to Tell Them Apart

The two most common causes of elbow pain are often confused. Tennis elbow (lateral epicondylalgia) is felt on the outer side of the elbow and is aggravated by gripping, lifting, and wrist extension — it affects roughly 1–3% of adults each year and peaks between ages 45 and 54.⁴ Golfer’s elbow (medial epicondylalgia) is felt on the inner side and is aggravated by gripping, pulling, and wrist flexion. It is far less common than tennis elbow, but the two can feel similar early on — which is why a hands-on assessment, rather than self-diagnosis, is the reliable way to tell them apart.⁶

Cubital Tunnel Syndrome (Ulnar Nerve Irritation)

Not all elbow pain is tendon-related. When the ulnar nerve is compressed as it passes behind the inner elbow, you may feel pins and needles or numbness in the ring and little fingers, aching on the inner elbow, and a weaker grip — often worse when the elbow is bent for long periods, such as holding a phone or sleeping with the arm folded.⁵ Nerve symptoms that persist or come with weakness are worth having assessed rather than pushing through.

Olecranon Bursitis

The olecranon bursa is a small fluid-filled sac at the tip of the elbow. It can swell after a knock, a fall, or prolonged leaning on hard surfaces, producing a soft lump at the back of the elbow. Most cases settle with load management, but a bursa that becomes hot, red, and tender — especially with fever or feeling unwell — needs prompt medical assessment, as this can signal infection.²

Distal Biceps and Triceps Tendon Injuries

Less common, but important not to miss: the biceps tendon at the front of the elbow or the triceps tendon at the back can partially or fully tear, usually during a sudden heavy load — often with a “pop,” bruising, and weakness when bending, straightening, or rotating the forearm. A suspected tendon rupture should be assessed promptly, as some are time-sensitive for treatment.⁸

What Happens If You Ignore Elbow Pain?

Ignoring Early Pain

Ignoring elbow pain often leads to worsening issues. What starts as mild pain can turn into chronic discomfort and limited movement if left untreated.²

Self-Diagnosing

Assuming all elbow pain is the same can delay proper treatment. Misdiagnosis risks doing ineffective exercises or therapies, worsening the condition.⁵

Doing Too Much Too Soon

Continuing painful activities without rest prevents healing and can cause long-term damage, turning minor injuries into bigger problems.¹

Consequences of Neglect

If untreated, elbow pain can lead to chronic pain, nerve damage, or even tendon tears. This can impact everyday tasks and possibly require surgery.

What Treatment Options Are There For Elbow Pain?

Treatment depends on the diagnosis. For tendon-related elbow pain, progressive loading and strength work are usually central, with hands-on treatment, dry needling, bracing, laser, or shockwave used as adjuncts depending on the condition, how irritable it is, and your goals.

As your physiotherapist, I want to help you feel better and get you back to doing what you love. Here are some treatments we might consider:

Myofascial Release

This hands-on technique involves applying gentle pressure to tight spots in your muscles and the connective tissue around them. It helps release tension, improves blood flow, and eases movement. Many people feel immediate relief and increased flexibility with this approach.⁹

Orthopedic Manual Therapy

With orthopedic manual therapy, I’ll use specific movements to help ease your joint stiffness and pain. This includes gentle stretches and mobilizations, which improve range of motion and reduce discomfort, especially if stiffness is holding you back.¹⁰

Dry Needling

In dry needling, I use thin needles to target and release “knots” in the muscles. This technique is great for relieving muscle tightness and can improve pain and strength. It’s often effective for elbow pain, helping muscles relax and recover faster.¹¹

Laser Therapy

Laser therapy uses focused light to reduce pain and inflammation. It’s painless, and it can work wonders for sore areas by speeding up healing. If inflammation is part of the issue, this can provide quick relief alongside other treatments.¹²

Strapping or Bracing

A strap or brace provides support to the elbow, taking some strain off the muscles and tendons. This can make daily tasks or exercise more comfortable while reducing stress on your elbow. It’s a simple but effective option for keeping pain at bay during activity.¹⁴

Shockwave Therapy

Shockwave therapy uses sound waves to promote healing. It’s helpful if other treatments haven’t fully relieved your symptoms, as it breaks down scar tissue and boosts blood flow to the painful area. Many people find lasting pain relief with this option.¹³

Exercise Therapy

Exercise is a key part of treating elbow pain, helping to strengthen and stretch the muscles around your elbow, which supports the joint and reduces strain. Here’s a quick look at some effective exercises:

• Strengthening Exercises: Start with light wrist curls and gripping exercises to strengthen forearm muscles and support the elbow joint. These can be increased as you build strength.¹⁵
• Stretching: Gentle stretches for wrist flexors and extensors improve flexibility and prevent stiffness, keeping your elbow moving smoothly.
• Eccentric Exercises: Slowly lowering a light weight in a wrist curl motion helps target and strengthen tendons, especially useful for tendon-related issues.⁷
• Grip Strength Training: Squeezing a soft ball or using resistance bands helps build grip strength, reducing elbow strain from daily tasks.

Frequently Asked Questions About Elbow Pain

What is the most common cause of elbow pain?

The most common cause is tendon overload — tennis elbow (outer side) and golfer’s elbow (inner side) — usually from repeated gripping, lifting, or overhead activity rather than a single injury.

How do I know if I have tennis elbow or golfer’s elbow?

Tennis elbow is felt on the outer elbow and is worse with gripping and wrist extension; golfer’s elbow is felt on the inner elbow and is worse with gripping and wrist flexion. An assessment can confirm which structures are involved.

Should I rest or exercise with elbow pain?

Short-term relative rest can settle a flare, but most tendon-related elbow pain improves with progressive loading rather than complete rest. Doing too much too soon — or too little for too long — both slow recovery.

Why does my elbow hurt when gripping or lifting?

Gripping and lifting load the forearm tendons where they attach at the elbow. When those tendons are irritated or overloaded, these movements reproduce the pain — a hallmark of tennis and golfer’s elbow.

When should I worry about elbow pain?

Have it assessed promptly if it follows a fall, the elbow looks deformed, you can’t straighten or bend it, the joint is hot and swollen with fever, a lump is growing quickly, or you have numbness or weakness in the hand.

Can physiotherapy help elbow tendinopathy?

Yes. Progressive strengthening is the core treatment for elbow tendinopathy, with manual therapy, bracing, dry needling, laser, or shockwave used as adjuncts depending on your diagnosis, irritability, and goals.

About the Author

Daniel da Cruz is a licensed physiotherapist in Sandton, Johannesburg, holding a Bachelor of Physiotherapy (BPhysT), a FIFA Diploma in Football Medicine, and Precision Nutrition (PN-SSR1) and SportTape UK certifications. He has a clinical focus on elbow and upper-limb conditions, helping active adults, gym-goers, and desk-based professionals recover from problems like tennis and golfer’s elbow, tendon overload, and nerve-related arm pain using evidence-based exercise rehabilitation, targeted manual therapy, and load-management coaching.

He helps patients recover through evidence-based rehabilitation that combines targeted exercise therapy, manual treatment, and education. His approach is centered on restoring pain-free movement, building long-term strength, and preventing future flare-ups so patients can return to work, sport, and daily life with confidence.

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