Pain in the elbow


The elbow consists of the elbow joint, which consists of the humerus and the two forearm bones Elle and spoke. Numerous muscles, nerves and vessels run over the elbow joint and can be injured or ill.

Accidents or prolonged use of the elbow are the most common cause of elbow pain. But even everyday activities such as shopping claim the elbow and can cause long-term pain. For a specific therapy, the exact diagnosis of persistent pain is necessary, so the diagnosis should be made by a doctor.

Causes and forms

The causes of a painful elbow are also distinguished from acute ones by chronic or trauma-related degenerative causes. Among the acute causes that can cause pain in the elbow include all traumas and injuries that may cause a sudden functional impairment of the elbow. Fractures after heavy falls or severe bruises after a fall often cause days of intense pain in the area of ​​the elbow. In addition, the pain increases as soon as an attempt is made to bend or stretch the arm. Chronic causes are mostly of a degenerative nature or signs of chronic overstressing of the arm and elbow.

Pain in the elbow can have a variety of causes.

In addition to the causes of overuse, incorrect posture during the movements can also lead to persistent pain in the elbow. To call here the osteoarthritis in the elbow joint, which is rare, but occurs. Rheumatoid arthritis can also cause pain in the elbow in addition to the classic complaints, such as pain in the fingers and restricted mobility, if it is affected by a rheumatoid. Metabolic diseases, such as gout, can also affect the elbow in a seizure with a strong increase in uric acid and lead to very severe pain. The bursitis in the elbow joint is much more frequent and sometimes also accompanies the overload syndromes. The so-called Bursitiden often occur after overuse and lead to some very severe pain. In addition to the biceps of the elbow, the bursae of other joints, such as the knee, are often affected.

There are many other causes of elbow pain. In the so-called shoulder-arm syndrome, there is an anatomical constriction in the shoulder area. Both the nerves running there and the muscles pulling down the arm are thus narrowed. If the arm is now moved up, the nerves are compressed so much that they trigger a pain in the elbow. In the so-called Sulcus ulnaris syndrome, there is a constriction in the elbow. The ulnar nerve, which pulls through this narrowness, is compressed and causes pain in the little finger. Especially during long sitting with elbows propped up on the table, it can happen that there is a permanent irritation of the nerves and pain in elbow and hand.

Pain on the elbow during support

Pain when supporting the elbow occur especially in a bursitis.

Due to the inflammatory reaction in the bursa of the elbow, this site is particularly sensitized by the inflammatory mediators released in the tissue for pain.

When it comes to a touch, for example when supporting the elbow tip on a table, it causes a lot of pain.

For more information on elbow bursitis, see also the Inflammation section .

Pain in bending and stretching

Pain in the elbow can have different causes.

When pain occurs during flexion or extension of the elbow, the muscles responsible for these movements or their associated tendons are usually responsible.

The biceps muscle is responsible for the flexion of the elbow joint.
If it is irritated or cramped due to congestion, it can cause pain when flexing the elbow.

A painful stretching speaks for an irritation of the triceps muscle or its tendon. This leads for the most part the stretching movement in the elbow joint.

For more information read more about tendon inflammation in the elbow joint.

In both cases, ie in pain when bending and stretching, the joint should first be spared from the painful movement and the joint should be allowed to rest, so that improvement is evident.

If the recovery from bending and stretching does not improve, pain and anti-inflammatory drugs such as NSAIDs may also be used.

Pain on the elbow at night

If pain in the elbow especially at night make noticeable, it may be an elbow osteoarthritis ( cubital arthrosis ) act.

This is a degenerative wear of the cartilage in the elbow joint, so that the movement in the joint no longer runs smoothly.

Especially by stress at work or by strong athletic activity (eg as a handball player), the elbow arthrosis is increasingly caused, and usually causes stress-dependent pain.
At a more advanced stage, pain also occurs at rest and at night.

Pain on the elbow in the morning

On the other hand, rheumatoid arthritis (rheumatism) can be considered when the elbow hurts in the morning. This pain is associated with morning stiffness of the affected joint.
The morning stiffness is due to the fact that the mobility is limited by the prolonged immobilization of the joint during the night in the morning after getting up.

During the day it comes again to the improvement of mobility.

Tennis elbow

The most well-known form of the hurting elbow is the so-called tennis elbow, which in technical language is called Epicondylitis lateralis humeri . This causes pain on the outside of the elbow. Partly it comes also to the pain radiation into the hand.

Stretching and lifting movements as well as bending movements in the elbow can lead to severe pain.
Because at the very painful place - a lateral bone protrusion on the humerus - put on many muscles, which are responsible for the stretching movements of the wrist and the hand.

Repeated flexion and extension may result in irritation of the tendon insertions that causes the typical tennis elbow pain symptoms. Irritations of tendons are commonly referred to as tendinoses

The tennis elbow is not created solely by playing tennis, it can always occur when bending and stretching movements in the arm are performed very often.

As a rule, chronic stress in the workplace (eg craftsmen or secretaries) or everyday life is often the cause of a painful tennis elbow.
These include very monotonous and repetitive activities.
Often, however, no trigger for the existing pain can be made.

In order to get rid of the discomfort, it is advisable to immobilize the aching muscles.
However, this is not always so easy to implement because of various job-related obligations. In case of a tennis elbow, especially cold or warming applications or bandages with analgesic and anti-inflammatory ointments are helpful.

A pain reduction can also be promoted by the so-called Kinesio Taping. This stabilizes stressed muscles and relieves them at the same time.
In addition, gentle stretching by a physiotherapist of the tendons attached to the elbow can have the effect of relieving the tension on the aching tendons.
In addition, pain and anti-inflammatory drugs can help reduce pain.

There is also the possibility of shock wave therapy to loosen up the muscles by ultrasonic waves and relieve pain.

A relatively new therapy for the tennis elbow is the injection of low-dose botulinum toxin (better known as Botox ) into stressed muscles.
Botox is a neurotoxin that paralyzes the muscles for 2-3 months so they can recover - a good alternative to shockwave therapy.

What you can do against the pain of a tennis elbow can be found under our topic: Pain on a tennis elbow

As a last resort in case of failure of conservative treatment, it is possible to perform surgery.
Here, the aching tendon attachments of the extensor muscles are released from the bone and are to grow further down the bone, so that the train is reduced to the tendon approaches.
Also, in many cases, the nerve fibers are severed, which pass the pain from this inflamed area, so that they are no longer felt in the future.
Very rarely, however, it happens that also by means of OP no permanent painlessness is achieved.

golfer's elbow

In contrast to the tennis elbow, the golfer's elbow ( epicondylitis ulnaris humeri ) causes problems on the inside of the elbow. This is much rarer than the tennis elbow.

The there located on a bone attachment of the humerus tendon approaches of the flexor muscles of the wrist and fingers are very irritated and this pain is inflamed, which can also radiate into the flexor side of the forearm.
Beugebewegungen are particularly painful as the fist.

Tendon irritation can lead to long-term changes, so that it can lead to degenerative wear ( arthritic change ) with prolonged complaints.

The Golferarm arises in case of overloading or incorrect loading (eg incorrectly learned techniques) in sports in which the flexor muscles of the wrist and the hand are stressed.
As the name suggests, this is often the case when playing golf.

However, a golfer's elbow can also train in everyday or occupational overuse of the mentioned muscle groups.

In order to prevent a chronic pain, the tension on the attached tendon and thus the muscle itself must be relieved. First, a rest position for a short time (about 1-2 weeks) with the help of a rail is sought. Caution should be exercised, as prolonged immobilization of the elbow may lead to joint stiffness.

Beneficial for the painful arm are also cold or warmth therapies, as well as bandages with analgesic and anti-inflammatory ointments.

Also important in the conservative treatment of the golfer's arm is the physiotherapy. The physiotherapist will show how affected tendons and their tendons should be stretched easily, so that they can be performed several times a day.

In a shockwave therapy, the muscles are loosened with the help of ultrasound waves, thus reducing the painful pull on the inflamed tendon insertion.

In most cases painkillers and anti-inflammatory drugs are used as supportive agents.

In case of severe discomfort, the doctor can make a cortisone injection into the aching muscle area. Cortisone has an anti-inflammatory effect and thus reduces pain. However, it should not be given over a long period of time because cortisone can damage muscles and tendons.

An operative treatment is advised only if the conservative therapy shows no improvement or even a worsening of the symptoms even after months. In the operation, the irritated tendon attachments are separated from the humerus, and the reduced pain on the muscle often eliminates the pain condition.


The pain is described by those affected in part as very strong. Depending on the cause, it may come from weaker to quickly controlled pain, if it is only irritation of the periosteum, etc. If there were fractures or if there are arthroses that have been developing for years, they can cause so much pain that they can only be treated with pain plasters or similar. are manageable. The pain is usually as a point at the elbow arising and then described pulling into the upper and lower arm.


In many cases, an imaging diagnostic is used.

First, the patient is extensively questioned by the examiner to find out exactly where the pain is at the elbow, since when they are present, whether a corresponding trauma has preceded or whether one of the leading sports in pain was exercised. Thereafter, the physical examination, which aims to detect swelling and redness on the surface of the elbow, on the other hand to filter out the possible movements in the elbow. The examiner will first move the forearm against the upper arm of the patient himself (passive movement) and then move himself. It is interesting when the patient indicates pain and which movement impairments are present. Depending on the suspected cause, X-rays of the elbow are taken. This may include fractures or arthrotic changes. Magnetic resonance tomography can visualize soft tissues and nerves and highlight corresponding bottlenecks. If it has come to a so-called joint effusion, a puncture and a microbiological examination of the recovered liquid can provide information about the origin.


Strains or tears of the ligaments, but also muscle tension or muscle injuries can be traumatic and cause pain.

In the case of an accident or fall, the humerus, or the forearm bones may break.
But even the elbow joint itself can break and restrict the movement in the joint. In addition, severe pain.

As a result of a wrong movement or accident, the elbow joint may slip out of the socket (dislocation). This also leads to acute pain and the need for a quick therapy to relieve the pain.

Likewise, a capsule tear on the elbow, primarily caused by external trauma, leads to severe pain.


Due to prolonged stress on the elbow, the attached tendons can be inflamed by constant friction. This is called Tendovaginitis. Also, the joint itself can be inflamed by prolonged stress or infection. This is called arthritis.

Often, this form of inflammation is accompanied by other local symptoms. As a rule, arthritis develops over time and does not occur acutely. The form of rheumatoid arthritis can also cause pain. However, here is no overload or infection cause of the pain, but an innate rheumatic disease, which is chronic and not curable.
Another structure is a bursa in the area of ​​the elbow joint. This can also be infected by heavy use or germs. This is called bursitis olecrani.

Also a bursitis ( bursitis ) can cause pain in the elbow.
This results in an inflammatory reaction of the bursa, which forms the fluid-filled slide bearing between all the muscles and bones of the joint.

This inflammation can have many causes: Often a bursitis is the result of overloading, for example, the constant supporting the Ellenobgens on a table.
This happens, for example, when reading - which is why a bursitis on the elbow in the vernacular also referred to as " student elbow " .
Furthermore, injuries in which bacteria (including staphylococci ) gain access to the bursa may provoke inflammation.

Also, the metabolic disease gout can cause bursitis on the elbow, namely by irritation of the bursa by deposits of uric acid crystals. Due to the inflammatory reaction, the bursa produces more fluid and swelling of the joint.

The flexion of the arm in the elbow can therefore be very painful and limited. At the same time, the affected joint is in many cases overheated and reddened.
The involvement of bacteria also causes infection in the bursa with the formation of pus.

Normally, inflammation in the bursa is treated conservatively. The first measure here is the immobilization, possibly with the help of a rail or a plaster. Anti-inflammatory and pain-relieving medication (NSAIDs, eg diclofenac) further improves the improvement of the symptoms.
Likewise, cold therapy or shock wave therapy can have a beneficial effect. If the joint is too swollen and the patient complains of a feeling of tightness, a puncture of the joint for pressure relief is indicated. The withdrawn liquid may additionally give indications of possible pathogens.

At the same time, cortisone may be injected into the bursa during the puncture to further reduce inflammation, thus minimizing excessive fluid production.
A local and purulent infection may sometimes develop into sepsis with symptoms such as fever and chills when the pathogens enter the bloodstream, if left untreated. To prevent this, this bacterial infection should be treated as early as possible with antibiotics. If antibiotic therapy fails, the purulent bursa must be removed in one operation.

The well-known "tennis elbow" is also an inflammatory form of overuse. This causes inflammation at the bony approach of the radial tendon ( Epicondylitis humeri radialis ). Because this inflammation often arises due to the ongoing strain, which is typically similar to exercise in a tennis game, it is referred to as a tennis elbow. The bony insertion point of the ulnar tendon can also inflame ( epicondylitis humeri ulnaris ). Since this tendon is particularly stressed during the golf movement, this form of inflammation is called golfer elbow.


Prolonged overload can worsen the cartilage layer in the elbow joint. This is called osteoarthritis. This arises from years of incorrect stress and leads to slowly increasing pain during exercise. Over time, the pain occurs especially at rest and improves in the short term by slight movements. The disease is usually chronic and difficult to treat. Everyday work on the computer, which requires the same movement in the elbow joint for years, can also create the Repetitive Strain Injury.

Neurological diseases

A form of nerve irritation is the irritation of the elbow nerve ( ulnar nerve ), for example, by the impact on one edge. It is the popular musician's bone, as the pain is felt throughout the forearm. This form of pain, however, quickly returns and can not be compared with other neurological diseases. These are chronic diseases of the nerves, which prevents the transmission of information about the nerves or causes severe pain of the nerves without apparent external cause. This form of the disease usually affects not only the elbow, but is particularly common on the legs.


Ultrasound is also suitable for diagnosis.

Many forms of elbow pain are self-defeating and do not require special diagnostics. However, if the pain lasts longer, a doctor should be consulted. A detailed medical history is especially important here. The character of pain, pain localization and pain duration are important information.

Numerous underlying diseases such as rheumatological diseases, diabetes or neurological diseases should be mentioned in the doctor's consultation. Also special stress of the elbow should not go unmentioned. Subsequently, the elbow, its mobility and painful pressure points are tested. This gives the doctor hints as to whether mobility is impaired or the elbow is overheated or reddened. In addition, the doctor checks whether the joint is swollen, or an effusion is present. If there is a suspicion of certain causes, such as an inflammation or injury, further investigations are connected. If there is a possible bone fracture or serious muscular injury, an X-ray is taken.

If inflammation is suspected, the inflammatory parameters are determined in the laboratory. An ultrasound examination of the joint can represent an articular effusion, which can be punctured in the ultrasound. If there is a suspicion of chronic joint wear and tear, arthroscopy should be performed. Here, the joint can be considered closely and at the same time be therapeutically intervened.
For more accurate imaging there is the possibility of magnetic resonance imaging of the elbow (MRI), which makes the muscles and nerves representable. Straight pain caused by the soft tissues can be well represented by an elbow MRI.


Therapy varies and depends on the condition. For elbow fractures, a conservative therapy consisting of pain management and immobilization may be selected, or surgical therapy may be used using screws, plates, or nails. For arthrotic changes, a conservative approach is usually preferred. In the case of involved nerves, it may be necessary to surgically relieve the compressed nerves. Pain in the elbow caused by overloading (tennis elbow or golfer elbow) should be treated in this way, in which the triggering sport should not be exercised for a while. Furthermore, the pain should be treated symptomatically with cold application or pain medications.

Many forms of elbow pain are harmless and soon fade away. For muscular causes bandages or ointment dressings are often sufficient to relieve the pain. If there is a fractured bone or the joint has been severely injured, in some cases surgery may be required to re-direct the bones. Even if the elbow was unusually heavily loaded for a few days, the pain usually goes away by itself.

These are often acute onset moderately severe pain, for example, in a tennis elbow, which go back a few days immobilization. Through anti-inflammatory drugs such as acetylsalicylic acid or diclofenac, the pain and inflammation can be inhibited by medication. However, this should not be a long-term medication, but should only be used in the acute phase. For pain in the joint, cortisone-containing drugs or local anesthetics can be injected into the joint space. Existing chronic elbow pain may necessitate a hospital stay in hospital. There, a brachial plexus anesthesia can be performed. This is the interruption of the large plexus around the axilla, which blocks pain transmission.

Articular arthroscopy can eliminate some causes of joint discomfort. In more severe cases, an artificial joint replacement may be necessary if the joint is overused. In each case physiotherapy, heat or cold treatments, muscle training, electrotherapy or ultrasound therapy and orthopedic aids can be used. Which form of therapy makes sense should be decided by a doctor if symptoms persist for a long time, in order to achieve a successful therapy.


Pain in the elbow is a widespread symptom that can have a variety of causes. One of the most common causes is overloading reactions that can occur due to frequent unilateral movements. To name a tennis elbow or golfer elbow, which can cause tendon irritation to tendon irritation. In the tennis elbow, the outside of the elbow shows painfully, according to the position of the stressed muscles, the inner side of the golfer elbow. In addition to the overuse, malpositions in the sense of arthrosis can also lead to pain in the elbow. In addition, traumas can also cause fractures in the area of ​​the elbow. From the upper arm numerous nerves pull over the elbow to the forearm. These can be impaired in their course and lead to pain. Known is the so-called ulnar nerve syndrome, in which it can come to the so-called " musical bone " constrictions and sometimes sensitive pain. The diagnosis of elbow pain causing causes are made by X-ray, or magnetic resonance imaging.
The therapy depends entirely on the triggering cause. Thus, fractures are treated conservatively or surgically, arthroses are mostly conservative, and when nerves are impaired, a decompression operation is often necessary.

Pain in the elbow is a relatively common symptom, the cause of which in most cases is chronic or unfamiliar overload. In addition to the forms of the tennis elbow or golfer elbow, chronic inflammation of the tendons or in the joint as well as joint wear ( arthrosis ) can also lead to pain. Acute pain usually goes away without further treatment. Inflammation of the tendons or the joint must be treated by immobilization, or by medication. If the joint or one of the bones has been severely injured or broken by an accident, surgery may be necessary in some cases. Neurological diseases are usually of a chronic nature and usually affect other organs, so that a more extensive or systemic therapy must be started here. In most cases, additional physiotherapeutic measures can contribute to symptom relief. Because of the variety of causes, a doctor should decide on the diagnosis and therapy.

Common Reasons for Elbow Pain and Treatments (February 2020).

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