What’s Causing My Elbow Pain?

When your elbow is healthy and functioning properly, it lets you bend, extend, and rotate your arm without pain. When you experience pain or limited function, it’s natural to wonder why.

In a healthy elbow joint, the ends of the bone’s surface are covered with a smooth, tough protective tissue called cartilage. Arthritis causes damage to this area of the bone’s surface and cartilage. These damaged surfaces eventually become painful as they rub together.

The elbow is a hinge joint consisting of 3 bones: the upper arm bone (humerus) and the lower arm bones (radius and ulna). A complex interaction between these bones, muscles, tendons, ligaments, and cartilage allow our elbows to bend, straighten, and rotate.

Fluid-filled sacs (bursae) cushion the area where skin or tendons glide across the bone. A lining (synovium) secretes a clear liquid called synovial fluid. This fluid lubricates the joint, further reducing friction and making movement easier. Your range of motion is dependent upon the proper articulation of this joint.

As you might expect, there are a number of reasons why you might be feeling pain in your elbow including arthritis, injury, and more.

When osteoarthritis (OA) affects the elbow joint, the cartilage that cushions the bones wears away, causing the bones to grind against one another. That grinding hurts. You can feel it when lifting groceries, swinging a golf club, or even reaching out to shake hands.

A few symptoms of osteoarthritis may include:¹

• Joint aching, soreness, or swelling
• Pain, especially following activity
• Stiffness after periods of rest
• Loss of range of motion

Serious injuries to the elbow, like bone fractures and severe dislocation, can cause the joint to heal improperly, even if surgery is performed at the time of injury. As a result, the cartilage in your elbow may wear out prematurely. This can result in post-traumatic arthritis.

Rheumatoid arthritis occurs when the synovium becomes inflamed. This inflammation causes chemicals to release that thicken the synovium and damage the cartilage and bone of the affected joint. This inflammation of the synovium causes pain and swelling.

Epicondylitis is a painful condition of the elbow caused by overuse. Epicondylitis is an inflammation of the tendons that join the forearm muscles on the outside of the elbow (lateral or tennis elbow) or inside of the elbow (medial or golfers elbow). The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness of the elbow and soreness with activity.

Olecranon bursitis is a condition where a painful fluid-filled swelling develops out of the blue or after trauma. This is typically treated with antibiotics, injection, aspiration, or compression wrapping. It rarely requires surgery.

Ulnar neuritis or cubital tunnel syndrome is another common condition with a hallmark of inner elbow pain that radiates into the ring and small finger. This condition is typically treated with splinting, physical therapy, activity modification, and possible surgery to decompress the nerve.

While this is not an exhaustive list of all the possible reasons for elbow pain, the good news about these elbow conditions is that they are treatable. Arthritis is a disease that typically worsens over the years, so it’s common for treatment to involve more than one approach and to change over time. For some people, nonsurgical treatments such as lifestyle changes, medications, and physical therapy help alleviate the pain. For others, elbow replacement surgery may be a long-term solution. Together, you and your doctor can determine the best treatment options for you.