Elbow pain

Medically reviewed by Dr. K. G. Gopalakrishna, Consultant Orthopaedic Surgeon · Last reviewed: August 2026

The elbow is a hinge joint that takes constant strain from everyday gripping, lifting, and repetitive arm movements, which is why so much elbow pain comes from the tendons around it rather than the joint itself. Most cases settle well with simple changes, once the specific tendon or structure involved is identified.

What's actually there

The elbow joins the upper arm bone (humerus) to the two forearm bones (radius and ulna), allowing bending, straightening, and forearm rotation. Tendons attach on both the outer bump (lateral epicondyle) and inner bump (medial epicondyle) of the elbow, connecting to the muscles that extend and flex the wrist. A nerve called the ulnar nerve runs along the inner side of the elbow, close enough to the surface that a knock there causes the familiar "funny bone" sensation.

Common causes

• Wear-related: Osteoarthritis of the elbow itself is relatively uncommon compared to other joints, but can develop after previous fractures or heavy repetitive loading over many years.
• Injury-related: A fall onto an outstretched hand can fracture the elbow or cause a dislocation. A sudden pull or heavy lift can strain the tendons around the joint.
• Inflammatory or overuse: Tennis elbow (pain on the outer elbow) and golfer's elbow (pain on the inner elbow) are both overuse tendon conditions from repetitive gripping or wrist movements, common well beyond just those two sports. Bursitis can cause a soft, sometimes painless swelling at the tip of the elbow.
• Referred pain: Nerve irritation at the neck or shoulder can occasionally send pain down into the elbow and forearm without any actual elbow problem.
• Gym and training-related: Bicep curls, tricep dips, and heavy gripping exercises are common triggers for tennis and golfer's elbow in regular gym-goers, particularly when curl or dip weight increases faster than the tendons can adapt.

What it tends to feel like

Pain on the outer elbow that worsens with gripping, lifting, or twisting the wrist (like turning a doorknob or shaking hands) points toward tennis elbow. Pain on the inner elbow, worse with wrist-flexing movements, points toward golfer's elbow. Tingling or numbness in the ring and little fingers, especially with the elbow bent for long periods, suggests ulnar nerve irritation rather than a tendon problem. A soft swelling at the very tip of the elbow, often without much pain, is usually bursitis.

When to seek care urgently

• The elbow is visibly deformed after a fall or injury
• You cannot bend or straighten the elbow at all after an injury
• The joint is hot, red, and rapidly swelling with no clear injury
• Numbness or weakness spreading down into the hand

What's usually tried first

• Activity modification - reducing the specific gripping or wrist movements that provoke pain
• Physiotherapy focused on forearm stretching and gradual strengthening, which resolves the large majority of tennis and golfer's elbow cases
• A counterforce brace (a strap worn just below the elbow) for tendon-related pain during activity
• Anti-inflammatory medication for short-term flare-ups
• For tendon pain that isn't settling with the above, a guided injection can help reduce pain and support rehabilitation

Myths vs facts

• Myth: Tennis elbow only happens to tennis players.
  Fact: Most cases have nothing to do with tennis - repetitive gripping, typing, or manual work are far more common causes.
• Myth: Elbow pain from overuse always needs an injection to fix it.
  Fact: The majority of tennis and golfer's elbow cases improve with structured physiotherapy and activity changes alone, without needing an injection at all.

When surgery enters the conversation

The large majority of tennis elbow, golfer's elbow, and mild ulnar nerve irritation improve with physiotherapy, activity changes, and time - often several months. Surgery is considered for a confirmed significant tendon tear that hasn't responded to at least 6 months of proper non-surgical treatment, a displaced fracture, or ulnar nerve compression that's causing progressive numbness or muscle weakness.

Recovery, broadly:

• Tennis or golfer's elbow, non-surgical: gradual improvement over 2-6 months with consistent physiotherapy.
• Elbow fracture fixation, weeks 1-6: protected movement in a splint or brace, guided by your surgeon.
• Weeks 6-12: progressive physiotherapy to regain full bending and straightening.

Looking after your elbow

• Warm up and stretch the forearm muscles before repetitive gripping activities or racquet sports
• Take regular breaks during repetitive manual tasks rather than pushing through discomfort
• Check that grip size and technique are appropriate for your activity, particularly in racquet sports
• Strengthen the forearm muscles gradually, even without existing pain, if your work or hobbies involve repetitive gripping
• Avoid excessive wrist curling during bicep work, and increase curl or dip weight gradually rather than jumping levels
• Don't ignore tingling in the ring and little fingers - early attention to ulnar nerve irritation prevents it from progressing

FAQs: questions worth asking your doctor