Elbow Pain: Many Possible Causes

The elbow is a complex joint with many structures that can cause pain. Accurate diagnosis is essential because treatment varies significantly depending on whether the pain is from lateral tendinopathy (tennis elbow), medial tendinopathy (golfer's elbow), a nerve entrapment (radial or ulnar nerve), bursitis (olecranon), joint arthritis, or referred pain from the cervical spine.

Common Elbow Conditions

Lateral epicondylalgia (tennis elbow): most common. Pain at the outer elbow. Medial epicondylalgia (golfer's elbow): inner elbow pain. Cubital tunnel syndrome: ulnar nerve entrapment at the elbow causing inner elbow and little/ring finger symptoms. Radial tunnel syndrome: radial nerve irritation causing outer forearm pain -- frequently misdiagnosed as tennis elbow. Olecranon bursitis: swelling at the elbow tip. Post-fracture elbow stiffness: very common after radial head fractures. Osteoarthritis: older adults and throwing athletes.

Physiotherapy Assessment

A thorough assessment differentiates these conditions using: provocation tests (Cozen's test, Mill's test for lateral epicondylalgia; Tinel's test at cubital tunnel for ulnar nerve), neurological assessment (sensation, reflexes, grip strength), and cervical spine examination (to exclude referred pain from C6-C7).

Treatment Varies by Diagnosis

Tennis elbow: progressive tendon loading, manual therapy, dry needling. Cubital tunnel: neural mobilisation, splinting. Olecranon bursitis: aspiration (by physician) then padding modification. Post-fracture stiffness: manual therapy and progressive range of motion.