Causes of Elbow Joint Pain: A Map by Location

The causes of elbow joint pain are easier to sort out than they first seem, because the place that hurts points to where to look. If your elbow aches and you cannot remember an injury, you are in good company. Most of the time the trouble comes from the tendons and soft tissue around the joint, not from the joint itself.

Here is the one idea to take with you. Where the elbow hurts, and which movement brings it on, tell you far more than how strong the pain feels. This page walks around the elbow, spot by spot, so you can see which one sounds like yours.

Tendons are the strong cords that attach muscle to bone. At the elbow, they anchor the forearm muscles that move your wrist and fingers. That is why gripping, twisting and typing can all show up as elbow pain. Tennis elbow, one of the best known tendon problems, is most common between the ages of 35 and 54 (NHS). And most people who get it are not tennis players.

Causes of elbow joint pain on the outer side

Pain on the outer, thumb side of the elbow is often called tennis elbow. The doctor's name is lateral epicondylitis. The bony bump on the outside is where the tendons that lift your wrist and fingers attach. When that attachment gets irritated, the spot becomes tender.

You may notice it when you:

• lift a full kettle or a bag of shopping
• twist a jar lid or turn a key
• shake hands
• use a mouse or keyboard for a long time

The sore spot is usually small, and pressing on it with a fingertip often shows you exactly where it is. Pain that you can point to with one finger is a useful clue.

Causes for elbow joint pain on the inner side

Pain on the inner side, the side nearest your body, has two common sources. They feel quite different.

Golfer's elbow. This is the mirror image of tennis elbow. The tendons that bend your wrist and fingers attach to the bump on the inside. Gripping, carrying and wringing a cloth can bring on an ache there.

The funny bone nerve. A nerve called the ulnar nerve runs in a groove just behind that inner bump. Hitting it gives the familiar buzzing "funny bone" feeling. If the nerve is irritated, you may feel tingling or numbness in the ring finger and little finger. Resting the elbow on a hard surface, or keeping it bent for long periods, such as on the phone or in sleep, can stir it up.

So a rule of thumb: an ache at one spot that grows with gripping suggests a tendon. Tingling in the ring and little fingers suggests the nerve. Some people have both.

The back point of the elbow

The pointed bone at the back of the elbow is called the olecranon. A small, fluid filled cushion, the bursa, sits over it. When this cushion becomes irritated, it can swell into a soft, squishy lump, like a small egg or a golf ball, right on the point.

Common triggers are leaning on the elbow for hours (a desk, a car window, a bed rest), a knock, or no obvious trigger at all. Often the swelling is not very painful, and the elbow still bends well. Our guide to olecranon bursitis goes into more detail, and the Feldypedia page on bursitis explains the general idea.

One safety point matters here. If the swelling turns hot and red, or you have a fever, the bursa may be infected. That needs a doctor the same day.

Causes of elbow joint pain deep inside the joint

Sometimes the ache really is inside the joint. This is less common than the tendon problems above, and it tends to feel different: deeper, broader and harder to point to. These are the main possibilities:

• Osteoarthritis. The smooth cartilage lining the joint wears thin over the years. You may notice stiffness after rest and a joint that does not quite straighten. The Feldypedia page on osteoarthritis and joint discomfort explains how this feels in daily life.
• Loose fragments. Small pieces of bone or cartilage can float inside the joint. They may make the elbow catch, click or briefly lock.
• Gout. Uric acid crystals can build up in a joint and cause sudden, hot, very painful swelling. It most often affects the big toe, but it can reach the elbow. An infection can look the same, so a sudden hot joint needs a check the same day.
• Rheumatoid arthritis. This is a condition in which the immune system irritates the joint lining. When it reaches the elbow, it often affects both sides, along with the hands or other joints, and brings morning stiffness.

Only a clinician can tell these apart, often with an exam and sometimes with a scan or blood test. If your pain sounds like this group, please book a visit rather than guessing.

When to get your elbow checked

Most elbow pain is not an emergency. A few signs, however, deserve prompt attention:

• Same day: a hot, red, swollen elbow, especially with a fever
• Emergency care: an elbow that looks deformed, or that you cannot bend or straighten, after a fall, or a hand that turns cold, pale or numb after an injury
• Call emergency services: pain spreading down the arm with chest pressure, breathlessness or sweating, which can come from the heart
• Soon, with a doctor: numbness or weakness in the hand, locking or catching, pain at night, or pain that has not eased after a few weeks

How Feldenkrais® looks at elbow pain

An elbow rarely works alone. Every time you grip, the shoulder, the shoulder blade, the forearm and the wrist take part. In the Feldenkrais Method®, we ask how the whole arm shares the job. If the wrist locks up or the shoulder hunches, the elbow tendons may end up doing extra work.

This is one way of looking, and it sits alongside medical care, not instead of it. Other approaches, such as strength training or yoga, work through different mechanisms. If you want to begin noticing your own movement, Feldy offers short guided lessons you can try free. A good first step is somatic exercises for beginners, which builds the skill of sensing slowly. You can also browse more on the body awareness page and our guide to pain in the elbow when bending.

One thing to notice this week

Pick one day and watch your elbow like a curious observer. Which small action sets the pain off? It may be gripping, twisting a jar lid, or leaning on the elbow while you read.

Then look at what your shoulder and wrist were doing at that moment. Was the shoulder lifted? Was the wrist bent back or held stiff? You do not need to change anything yet. Writing down the action and the position is useful information for you, and for a clinician if you decide to see one.

Common Questions about causes of elbow joint pain (FAQ)

Why does my elbow joint hurt when I do not remember hurting it?

Most elbow pain builds up slowly. Tendons around the elbow can become irritated from repeated gripping, twisting or typing, even when each single action feels small. Leaning on the elbow for long periods can irritate the back point too. A fall is not needed.

What is the difference between tennis elbow and golfer's elbow?

Tennis elbow hurts on the outer side of the elbow, where the tendons that lift the wrist and fingers attach. Golfer's elbow hurts on the inner side, where the tendons that bend the wrist and fingers attach. You do not need to play either sport to get them.

How long does elbow tendon pain usually last?

It varies a lot between people. Tendon pain often settles over weeks to months, and some people take longer, especially if the same action keeps repeating. If the pain is not changing after a few weeks, or is getting worse, have a clinician take a look.

When should I see a doctor about elbow pain?

See a doctor if the elbow still hurts after a few weeks, the pain disturbs your sleep, your hand turns numb or weak, or the joint locks or catches. Get help the same day for a hot, red, swollen elbow with fever. After a fall, an elbow that looks deformed or will not bend or straighten needs emergency care.

How often should I move a sore elbow?

Gentle, small movements spread through the day usually suit a sore elbow better than one long session. Stay in a comfortable range and stop if the pain sharpens or tingling starts. If an action clearly sets the pain off, rest from that action for a while.

How is arthritis elbow pain different from tendon pain?

Tendon pain sits at one spot on the outer or inner side and flares with a particular grip or twist. Arthritis pain is deeper in the joint, often with stiffness after rest, and may come with swelling or loss of range. When rheumatoid arthritis reaches the elbow, it often affects both sides plus other joints, such as the hands.

What should I avoid when my elbow hurts?

Try not to keep repeating the action that sets it off, and avoid long spells of leaning on the elbow. Do not push hard into the sore spot or force the joint to its end range. Please do not wait out warning signs such as fever, heat or numbness.