Elbow Pain and Elbow Conditions: Treatment

The muscles that bend the wrist and grip with the fingers attach through a common tendon origin to the bony prominence on the inner side of the elbow. Golfer's elbow develops when repeated gripping, carrying weights, using a screwdriver or hammer, kneading dough, or racket and golf movements cause strain and microscopic wear at this origin. Pain begins on the inner elbow and may spread into the forearm; it increases with handshaking, carrying bags and bending the wrist downwards. If numbness in the little and ring fingers is also present, the nerve in the same area should be assessed.

Treatment starts without surgery: temporarily reducing painful movements, reviewing grip technique, stretching and progressive strengthening, and taping, wrist supports, medicines or physiotherapy as needed. If symptoms persist for months and restrict daily work, further treatments are discussed at examination. A detailed page on this subject is being prepared; for pain on the outside of the elbow, see tennis elbow.

An inability to straighten the elbow through the final few degrees, catching or clicking during movement, or the arm suddenly becoming stuck usually suggests a mechanical obstruction. Common causes include a loose piece of cartilage or bone inside the joint (a loose body), worn joint surfaces and bony spurs, and stiffness or adhesions following a fracture, dislocation or prolonged casting. Progressive loss of movement accompanied by swelling and pain should not be ignored; preserving movement early is easier than recovering it later.

Assessment measures range of movement, uses X-rays to examine bone structure and look for loose fragments, and adds further imaging when needed. Treatment depends on the cause: guided exercise and physiotherapy, temporary support or, in selected cases, an intra-articular procedure. A detailed page on this topic is being prepared; do not delay assessment if an injury has left the arm locked.

A bursa is a thin fluid-filled sac that reduces friction between bone and skin. Irritation and fluid accumulation in the bursa over the bony prominence at the back of the elbow is called bursitis. It occurs in people who lean on desks, steering wheels or hard surfaces for long periods, after repeated knocks, and sometimes without an obvious cause. Typically it appears as a soft, well-defined swelling behind the elbow, sometimes reaching the size of an egg, usually painless or slightly tender; joint movement is generally preserved.

Bursitis and swelling inside the joint are different: bursitis causes a localised bulge immediately beneath the skin, whereas joint fluid fills the elbow more generally and restricts bending and straightening. Examination distinguishes them. Treatment usually involves avoiding leaning on the elbow, a protective elbow pad, cold applications and anti-inflammatory medicines; fluid is drained when necessary. Redness, warmth, rapid enlargement or fever requires prompt assessment because infection is possible. Do not attempt to drain it with a needle or burst it at home.

Two main ligament groups hold the elbow in place: the inner (medial collateral) and outer (lateral collateral) ligaments. If these cannot function adequately after a dislocation, repeated strain or, in some people, congenital generalised joint laxity, the elbow feels unstable. Patients often describe this less as pain and more as 'it feels as if it will give way', 'I cannot lean on my arm to get out of a chair', or 'it feels as if it slips when I carry something heavy'. Symptoms may increase when pushing a door, doing press-ups or rotating the arm outwards.

Assessment considers elbow range of movement, ligament tests and any previous dislocations or fractures together; X-rays show the bone structure, while MRI can show ligament condition when needed. Many mild and moderate cases follow a non-surgical pathway: temporarily avoiding aggravating movements, strengthening the forearm and shoulder girdle muscles, maintaining range of movement and, if necessary, using temporary support. Surgical repair or reconstruction is discussed when a ligament is completely insufficient, dislocations recur or catching and locking develop in the joint. In people with generalised joint laxity, the aim is to improve muscle control; all joints are considered together rather than the elbow alone.

Numbness and tingling in the little and ring fingers, hand weakness and loss of grip often result from compression of the ulnar nerve as it passes through the tunnel on the inner elbow. Patients describe 'an electric shock when I knock my elbow' or 'my hand goes numb when I am on the phone'. Because symptoms start at the elbow, people often look under elbow conditions; however, diagnosis, non-surgical treatment and surgery for this condition are explained in detail under hand surgery.

Do not delay assessment if numbness increases over weeks, hand muscle wasting appears or you start dropping objects; non-surgical options for nerve compression are more effective early on.

• Hand Surgery and Wrist Conditions

A fall onto the hand, a road traffic accident or a direct blow can fracture the lower end of the upper arm bone, the tip of the elbow (olecranon) or the radial head, or dislocate the elbow. Inability to move the arm, rapidly increasing swelling, deformity, bruising, and numbness or coldness in the hand are warning signs. Fractures here often involve the joint surface, so detailed imaging is needed for planning; fixation methods and recovery are explained on the fracture treatment page.

Elbow fractures in children are a separate topic: growth plates mean assessment and follow-up differ from adults. A young child who will not lift an arm after being pulled by it often has pulled elbow, rather than a fracture. In either situation, do not try to straighten or reduce the arm at home.

The clinic is not a 7/24 emergency service. If the arm cannot move, is deformed, has an open wound, or the hand is discoloured or numb, call 112 or attend the nearest hospital emergency department.

• Fracture Treatment
• Pulled Elbow (A Child Unable to Lift Their Arm)
• Paediatric Orthopaedics

Foreign bodies such as glass, metal or thorns embedded around the elbow, growing masses, bone and joint infections, and congenital or post-fracture angular deformities (cubitus varus–valgus) require distinct assessments. These topics are covered on their own pages, so only links are provided here; follow the one that matches your symptoms.

• Foreign Body Embedded in Tissue
• Bone and Joint Infections
• Bone and Soft Tissue Tumours
• Deformity Correction

The following are also common elbow problems seen in consultation. Detailed pages are being prepared; symptoms matching any of these subjects are assessed fully during examination.

• Elbow osteoarthritis
• Loose body — a fragment of cartilage and bone moving freely within the joint
• Stiffness and joint adhesions after surgery, casting or trauma