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Elbow Pain & Problems

Most elbow pain comes from overused tendons — tennis elbow on the outside, golfer’s elbow on the inside — and gets better with time, rest and the right exercises. A deformed elbow, numb or cold fingers, a hot swollen elbow with fever, or a child who won’t use an arm needs care right away.

Get emergency or urgent care right away if:

Don’t wait for a chiropractic, acupuncture or massage appointment for any of these.

What causes elbow pain?

The elbow is a joint where three bones meet: the upper arm bone (humerus) and the two forearm bones (radius and ulna) (AAOS OrthoInfo). Elbow pain can come from many problems. In adults a common cause is tendinitis — irritation and injury of the tendons that attach muscle to bone (MedlinePlus). Other common causes include bursitis, arthritis, strains, infection and a torn biceps tendon (MedlinePlus).

  • Tennis elbow (lateral epicondylitis): pain on the outside of the elbow from overused forearm tendons. See below.
  • Golfer’s elbow (medial epicondylitis): the same kind of problem on the inside of the elbow. See below.
  • Elbow (olecranon) bursitis: swelling of the fluid-filled sac at the bony tip of the elbow, from a hard knock, leaning on the elbow for long periods, infection, or conditions such as rheumatoid arthritis and gout (AAOS OrthoInfo). See our bursitis guide.
  • Ulnar nerve problems (cubital tunnel syndrome): numbness and tingling in the ring and little fingers. See Ulnar nerve (cubital tunnel) below.
  • Sprains, dislocations and fractures after a fall or blow. See below.
  • Nursemaid’s elbow in toddlers and young children. See below.
  • Arthritis. Elbow osteoarthritis is less common than in the hip and knee; it often follows an old fracture or dislocation, or years of heavy use, and causes pain, stiffness and a grating or locking feeling (AAOS OrthoInfo). See our arthritis guide.

Tennis elbow and golfer’s elbow

Tennis elbow is a painful overuse condition: the tendons that join the forearm muscles to the outside of the elbow wear down or develop tiny tears from repeating the same motions (AAOS OrthoInfo). Despite the name, Cleveland Clinic says experts estimate more than 9 in 10 people get it for reasons other than tennis (Cleveland Clinic). Painters, plumbers, carpenters, cooks and butchers are more prone to it (AAOS OrthoInfo), and so are people who do a lot of typing and mouse work, sewing or screwdriver work, or play a musical instrument (NHS). It is more common between 35 and 54 years of age (NHS).

How common is it? In a Finnish population study of adults aged 30 to 64, 1.3% had definite tennis elbow and 0.4% had golfer’s elbow at the time of the study; smoking, obesity, repetitive movements and forceful activities were linked to these conditions (Shiri et al., 2006).

Symptoms: pain or burning on the outer elbow, weak grip, and sometimes pain at night; it usually starts mild and slowly worsens over weeks and months, often without a specific injury, and is made worse by holding a racquet, turning a wrench or shaking hands (AAOS OrthoInfo). Pain may spread down the forearm to the back of the hand when grasping or twisting (MedlinePlus).

Golfer’s elbow causes pain on the inside of the elbow that runs along the forearm toward the wrist on the pinky side, pain when shaking hands and a weak grasp; it can come from golf, throwing sports, racquet sports, weight training or repeated wrist twisting, and it can bring numbness and tingling into the ring and little fingers from irritation of the ulnar nerve (MedlinePlus).

How long it lasts: tennis elbow usually goes away with rest but can sometimes last over a year (NHS); Cleveland Clinic says recovery usually takes around six months, and up to 18 months for some people (Cleveland Clinic). About 80 to 95% of people have success without surgery (AAOS OrthoInfo). A fuller MBHA guide to tennis elbow is on the way.

How is elbow pain diagnosed?

Most elbow problems are diagnosed with your history and a physical exam. For tennis elbow, the doctor asks how symptoms developed and about your work and sports, presses gently on the bony bump on the outside of the elbow, and may ask you to straighten your wrist and fingers against resistance (AAOS OrthoInfo). Imaging is used when needed: X-rays to rule out arthritis, an MRI to judge tendon damage or check the neck, and an EMG nerve test to rule out a pinched nerve, whose symptoms can look like tennis elbow (AAOS OrthoInfo). After an injury, an X-ray checks for broken bones (MedlinePlus), and X-rays are the best way to confirm a dislocation (AAOS OrthoInfo). For a swollen elbow bursa, a doctor may draw fluid with a needle to check for infection or gout (AAOS OrthoInfo).

When to see a provider (not an emergency): if this is the first time you’ve had these symptoms or home treatment isn’t helping (MedlinePlus); if tennis elbow pain continues after at least 2 weeks of rest and self-care (NHS); if the elbow is locked and won’t straighten or bend, there is a lot of swelling and bruising, or a child has elbow pain (MedlinePlus); or if numbness in the ring and little fingers is severe or has lasted more than 6 weeks (AAOS OrthoInfo).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Rest and activity changes, a forearm (counterforce) brace, physical therapy with strengthening exercise, and over-the-counter pain relievers or anti-inflammatory gels; injections only selectively; surgery rarely. Physical therapy about $50–$350+ a session without insurance ($10–$75 copay with); Medicare Part B covers medically necessary PT. Other costs being researched. Most tennis elbow improves without surgery, though it can take months. Steroid shots help for a few weeks but led to worse results at a year in trials; PRP evidence is mixed.
Chiropractic Elbow mobilization and manipulation (such as mobilization with movement) plus exercise and advice on activities — never on a fresh injury, deformed elbow or infected bursa. Cost estimate being researched. Some evidence for manual therapy plus exercise in tennis elbow, mostly from trials run by physiotherapists; benefits were clearest in the first weeks.
Acupuncture Needle treatments around the forearm and elbow for tennis elbow pain, alongside exercise and activity changes. Cost estimate being researched. Low-level evidence of short-term pain relief; an older Cochrane review found too little evidence to say. Sterile, single-use needles matter.
Herbal medicine Topical anti-inflammatory gels (diclofenac is sold over the counter) are the best-studied rub-on option; arnica and turmeric are sometimes tried but untested for elbow pain. Cost estimate being researched. Topical NSAIDs may ease pain for a few weeks (low-quality evidence). Check herbs with a pharmacist if you take NSAIDs or a blood thinner.
Massage therapy Soft-tissue work on the forearm muscles, including transverse friction massage and myofascial release — never on a fresh injury or a red, hot elbow. Cost estimate being researched. Friction massage has not shown clear benefit in small trials; myofascial release had some support in one review. Best as part of an exercise plan.
MBHA Wellness Coach Workstation and grip ergonomics, tool, racquet and grip size, pacing your return to activity, sticking with PT strength work, elbow pads instead of leaning, and safe ways to lift young children. Cost estimate being researched. Supports — never replaces — medical care. These habits lower strain on the elbow and the chance of problems coming back.

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Conventional medicine (AMA)

Treatment depends on the cause. The steps below focus on tennis and golfer’s elbow, the most common overuse problems; injuries, nerve problems and children’s elbows are covered in their own sections below. In most cases of tennis elbow, primary care doctors, physical or occupational therapists and sometimes surgeons work together (AAOS OrthoInfo).

1. Rest and activity changes

The first step is to rest the arm: cut back on sports, heavy work and other activities that cause pain for several weeks (AAOS OrthoInfo). MedlinePlus suggests resting the arm and avoiding or changing the triggering activity for 2 or 3 weeks (MedlinePlus). Ice or a cold pack wrapped in a towel can ease pain (MedlinePlus, NHS); don’t fall asleep with ice on (MedlinePlus).

2. A forearm (counterforce) brace

A brace worn around the upper forearm takes some pressure off the muscles and can be bought at most drugstores (MedlinePlus); OrthoInfo says it may help by resting the muscles and tendons (AAOS OrthoInfo). A Cochrane review found too few good trials to draw firm conclusions about how well braces work (Struijs et al., Cochrane, 2002).

3. Physical therapy and strengthening (including eccentric) exercise

Specific exercises help strengthen the forearm muscles (AAOS OrthoInfo), and a physical therapist can show you stretches and strengthening work (MedlinePlus). The NHS suggests physiotherapy if symptoms haven’t improved after 6 weeks of home treatment (NHS). Eccentric exercise — slowly lowering a load as the muscle lengthens — reduced pain and improved function in the short term compared with other exercise and pain-relief treatments in a 2021 review of eight studies, but long-term results were inconclusive (Chen and Baker, 2021). In one trial, eight sessions of physiotherapy (elbow mobilization plus exercise) beat “wait and see” at six weeks; by one year most people in both groups had improved (Bisset et al., 2006). A later trial found physiotherapy made no difference to outcomes at one year (Coombes et al., 2013) — so exercise may mostly speed early recovery.

4. Pain relievers (by class)

We don’t list doses; ask your doctor or pharmacist what is safe for you.

5. Corticosteroid injections — short-term relief, worse long-term results

A steroid shot can relieve tennis elbow pain quickly, but OrthoInfo says it should be used very sparingly, because repeated use can weaken the bone where the tendon attaches (AAOS OrthoInfo). The research is consistent:

  • A 2010 review of 41 trials found steroid injections reduced tennis elbow pain more than no treatment in the short term, but at six months and one year no treatment came out ahead (Coombes et al., 2010).
  • In a trial of 198 people, injections worked best at six weeks, but most early successes relapsed and long-term results were worse than with physiotherapy; the authors advise caution (Bisset et al., 2006).
  • In a 2013 trial of 165 people, those given a steroid injection were less likely to have recovered at one year than those given a placebo injection, and more likely to relapse (Coombes et al., 2013).

Cleveland Clinic adds that injections may not help if symptoms have lasted more than six weeks (Cleveland Clinic). If you’re offered one, ask how it fits with an exercise plan.

6. Platelet-rich plasma (PRP) — mixed evidence

PRP uses a concentrate of your own blood platelets, injected into the tendon. OrthoInfo notes that some studies were inconclusive while others were promising (AAOS OrthoInfo). A 2021 Cochrane review of 32 studies concluded that PRP or whole-blood injections probably give little or no meaningful benefit over a placebo injection, and do not support their use (Karjalainen et al., Cochrane, 2021).

7. Surgery (rarely)

It’s very rare to need surgery for tennis elbow (Cleveland Clinic). It may be considered if symptoms haven’t responded after 6 to 12 months of nonsurgical treatment; it usually removes damaged tendon and reattaches healthy tendon, succeeds in 80 to 90% of patients, and return to sport usually takes 4 to 6 months (AAOS OrthoInfo). Golfer’s elbow follows a similar path: rest, ice, exercises, a brace and sometimes an injection, with surgery considered only after 6 to 12 months (MedlinePlus).

What it costs

  • Physical therapy: about $50–$350 or more a session without insurance, or a $10–$75 copay or 10%–50% coinsurance with it (cost guide: CostHelper). Medicare Part B covers medically necessary outpatient PT when your provider certifies you need it; you pay 20% of the approved amount after the deductible (Medicare.gov).
  • Office visits, braces, imaging, injections and surgery: MBHA cost estimate being researched.

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Chiropractic

Some people with tennis elbow see a chiropractor for hands-on treatment of the elbow. The research on manual therapy for this condition is real but modest — and most of it was done by physiotherapists rather than chiropractors.

What the research says

  • Mobilization with movement plus exercise: in the Bisset trial, eight physiotherapy sessions combining elbow manipulation (mobilization with movement) and exercise did better than “wait and see” at six weeks and better than steroid injections after six weeks; at one year it was no different from waiting (Bisset et al., 2006).
  • Joint mobilization reviews: a 2019 review of 20 studies found mobilization with movement improved pain ratings and grip strength compared with control groups, and its authors concluded joint mobilizations have a positive effect (Lucado et al., 2019).
  • As part of a package: a 2016 review found that care for persistent tennis elbow may include education, exercise, manipulation and massage, but called the overall evidence limited (Sutton et al., 2016).
  • Not a long-term fix on its own: in a 2013 trial, a physiotherapy program that included manual therapy and exercise made no difference at one year (Coombes et al., 2013).
  • Research on chiropractic care specifically for elbow problems is thin, so ask any practitioner what results you can reasonably expect and over what time frame.

Safety

  • Never have an elbow adjusted or manipulated after a fall or injury until a doctor has ruled out a fracture or dislocation, and never put hands-on pressure on a red, hot, swollen elbow — see the warning signs at the top of this page. A pulled elbow in a child should be put back by the child’s provider, not at home (MedlinePlus).
  • Mild, short-lived side effects such as more pain or stiffness are common after spinal manipulation and usually go away within 24 hours; serious problems, including strokes involving neck arteries, have been reported but are very rare (NCCIH).

What it costs

Cost estimate being researched.

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Acupuncture

Acupuncture has long been used for elbow pain, and it has been tested in several small trials for tennis elbow. The results suggest possible short-term relief, with a lot of uncertainty.

What the research says

  • Cochrane review (2002): four small, flawed trials. Needle acupuncture gave short-term pain relief in two trials, but no benefit lasting more than 24 hours after treatment was shown, and laser acupuncture was no better than placebo. The reviewers found the evidence insufficient to support or refute acupuncture for tennis elbow (Green et al., Cochrane, 2002).
  • A newer review (2021) of 14 trials found a moderate short-term effect of manual acupuncture on elbow pain, disability and strength, but not of electroacupuncture; because trial results varied, the authors rated the evidence low-level (Navarro-Santana et al., 2021).
  • Part of acupuncture’s benefit in pain studies appears to come from nonspecific (placebo) effects (NCCIH).

In practice, acupuncture may be worth discussing as an add-on for short-term relief while you work on strengthening and activity changes — not as a replacement for them.

Safety

Relatively few complications have been reported, but problems have come from non-sterile needles and poor technique; the FDA requires acupuncture needles to be sterile and single-use (NCCIH). Don’t have needles placed into a red, hot or swollen elbow.

What it costs

Cost estimate being researched.

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Herbal medicine

Topical anti-inflammatory gels (conventional, but sold over the counter)

The best-studied rub-on option for tennis elbow is a topical NSAID, a medicine rather than an herb. Topical NSAIDs may ease pain for up to about four weeks, though the evidence is low quality; some people get a mild rash (Pattanittum et al., Cochrane, 2013). In the United States, diclofenac gel (Voltaren Arthritis Pain) was switched from prescription to nonprescription in 2020 for temporary relief of arthritis pain (FDA). Read the label, and ask a pharmacist whether it suits your kind of elbow pain and your other medicines.

Arnica gel

Arnica creams and gels are traditionally used for bruises, sprains and arthritis pain. A few clinical trials suggest topical arnica helps osteoarthritis, but one small study found it increased pain after calf exercises, and rigorous research is still needed (Memorial Sloan Kettering). MBHA found no trials of arnica for tennis elbow. Arnica on the skin can cause irritation; avoid it if you’re allergic to sunflowers, marigolds or ragweed; and talk to your provider if you take a blood thinner such as warfarin, because arnica may raise bleeding risk (Memorial Sloan Kettering).

Turmeric (curcumin)

Turmeric is promoted for osteoarthritis. Early evidence for oral turmeric or curcumin for knee osteoarthritis pain is positive but needs higher-quality research, it’s unclear whether curcumin ointment helps, and overall we don’t know enough to say it helps any condition (NCCIH). MBHA found no trials of turmeric for tennis elbow. Turmeric can cause stomach upset, liver damage has been reported with highly absorbable curcumin products, and turmeric supplements may be unsafe in pregnancy (NCCIH).

Herbs, NSAIDs and blood thinners: some herbs interact with medicines — for example, ginkgo taken with the blood thinner warfarin raises the risk of major bleeding, and cat’s claw may interact with anticoagulant and antiplatelet drugs (NCCIH). If you take an NSAID, a blood thinner or any other medicine, show every herb or supplement to your doctor or pharmacist first (NCCIH). We don’t list doses here, and no herb treats a broken bone, a dislocation or an infected bursa.

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Massage therapy

Massage is often part of physiotherapy for tennis elbow (NHS), and a therapist may also use ice massage (AAOS OrthoInfo).

What the research says

  • Deep transverse friction massage — firm rubbing across the tendon — was tested in only two small trials; a Cochrane review found no clinically important benefit for pain, grip strength or function and rated the evidence very low quality (Loew et al., Cochrane, 2014).
  • Other soft-tissue work: a 2016 review found myofascial release improved outcomes compared with sham ultrasound for tennis elbow, and that movement re-education (contraction and passive stretching) gave better long-term benefit than one steroid injection; the authors called for more high-quality research (Piper et al., 2016).
  • Massage may be one piece of a broader care package for persistent tennis elbow, alongside education and exercise (Sutton et al., 2016).

Safety

After a sprain or strain, the NHS advises avoiding massage for the first couple of days (NHS). Avoid direct pressure on a swollen elbow bursa (AAOS OrthoInfo), and skip the area entirely if it is red or hot or you have a fever. Rare serious problems such as a blood clot, nerve injury or broken bone have been reported, some with vigorous deep-tissue massage or in older adults (NCCIH).

What it costs

Cost estimate being researched.

Find a massage therapist in our directory

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MBHA Wellness Coach

Most elbow overuse problems come from everyday habits at work, in sport and at home. An MBHA Wellness Coach can help you spot and change them, alongside — never instead of — your medical care.

Workstation and grip ergonomics

  • If computer work is part of the problem, ask your manager about changing your chair, desk and computer setup; a wrist support or roller mouse may help (MedlinePlus).
  • For tingling in the ring and little fingers, make sure your chair isn’t too low, don’t rest your elbow on the armrest, avoid keeping the arm bent for long periods, and don’t drive with your arm resting on the open window (AAOS OrthoInfo).

Tool, racquet and grip size

Pacing your return

Strength work, as guided by your physical therapist

A coach can help you stick with the stretching and strengthening program your physical therapist gives you (MedlinePlus). People in heavy work or sports should keep the muscles around the elbow strong, condition properly and use correct technique (AAOS OrthoInfo). Smoking and obesity are linked to tennis and golfer’s elbow (Shiri et al., 2006), so quitting tobacco and a healthy weight are worth working on too.

Don’t lean on your elbows

Leaning on the tip of the elbow on a tabletop or car armrest for long periods can cause elbow bursitis (AAOS OrthoInfo). Wear elbow pads if your job or hobbies put pressure on your elbows (Cleveland Clinic).

Lifting and playing with young children

Lift a child by grasping gently under the arms, and don’t lift or swing children by their hands or arms or tug on their arms (AAOS OrthoInfo). To swing a young child in circles, support them under the arms and hold their upper body next to yours (MedlinePlus).

Another approach

Ulnar nerve (cubital tunnel)

The ulnar nerve runs through a tunnel of tissue behind the bony bump on the inside of the elbow — the “funny bone.” Pressure or irritation there is called cubital tunnel syndrome (AAOS OrthoInfo).

  • Symptoms: numbness and tingling in the ring and little fingers that often come and go and are worse with the elbow bent, such as when driving, holding a phone or sleeping; in more severe cases, a weaker grip and clumsy fingers (AAOS OrthoInfo).
  • Causes and risks: keeping the elbow bent for long periods, leaning on it, a blow to the inside of the elbow, throwing, or a past fracture or dislocation, arthritis or swelling of the elbow (AAOS OrthoInfo); diabetes can also damage the nerve (MedlinePlus).
  • Diagnosis: an exam of the elbow, hand and neck, X-rays to look for bone spurs or arthritis, and nerve conduction studies to show where the nerve is squeezed (AAOS OrthoInfo).
  • Treatment: usually nonsurgical first — changing activities, a padded night brace or splint to keep the elbow straight, nerve gliding exercises and, early on, an NSAID. Steroid injections are generally not used here because of the risk of nerve damage. Surgery to free or move the nerve is considered if other treatment fails or the nerve is badly squeezed (AAOS OrthoInfo).

Don’t wait too long. Long-term pressure can cause muscle wasting in the hand that cannot be reversed, so see a doctor if symptoms are severe or have lasted more than 6 weeks (AAOS OrthoInfo).

How is this different from carpal tunnel syndrome? Carpal tunnel syndrome squeezes a different nerve — the median nerve — at the wrist, and affects feeling in the thumb, index and middle fingers and half of the ring finger (AAOS OrthoInfo). The ulnar nerve covers the little finger and the other half of the ring finger (AAOS OrthoInfo). See our carpal tunnel guide to compare.

Another approach

Sprains, dislocations and fractures

Sprains. A sprain is an injury to the ligaments that hold the elbow bones together, from a fall on an outstretched arm, a hard blow, or overuse in sport. Most people recover completely from a simple elbow sprain in about 4 to 6 weeks, with rest, ice, compression and elevation, and sometimes a sling or splint; tell your provider if you heard a “pop,” which can mean a torn ligament (MedlinePlus).

Dislocations. The elbow usually dislocates in a fall onto an outstretched hand, and a dislocation should be treated as an emergency. In the emergency room the elbow is gently put back in place, then splinted; simple dislocations are usually kept still for 1 to 3 weeks before range-of-motion exercises, while dislocations with broken bones often need surgery (AAOS OrthoInfo).

Fractures. Signs of a broken arm include pain, swelling, bruising, trouble moving it, and a change in color or shape or numbness. While waiting for care, support the arm with a towel as a sling, hold a wrapped ice pack to it, remove rings and watches, and don’t eat or drink in case you need surgery. Recovery usually takes around 6 to 12 weeks (NHS). In children, elbow fractures make up about 10% of all childhood fractures; the most common type, just above the elbow, usually happens before age 8 and can injure nerves and blood flow (AAOS OrthoInfo).

After a dislocation or a fracture into the joint, the risk of later elbow arthritis rises (AAOS OrthoInfo) — one more reason to follow your rehabilitation plan.

Another approach

Nursemaid’s elbow in young children

Nursemaid’s elbow (“pulled elbow”) is a common injury of early childhood in which one of the forearm bones slips partly out of place at the elbow. It happens most often between ages 1 and 4 (AAOS OrthoInfo), usually when a child is pulled up by the hand or wrist — for example, lifted over a curb — or swung by the arms while playing (MedlinePlus).

Nursemaid’s elbow is rarely caused by a fall. If a child hurts the elbow falling onto an outstretched hand or onto the elbow, it may be a broken bone instead (AAOS OrthoInfo). A child with elbow pain after a fall who refuses or is unable to move the arm should see a doctor immediately (AAOS OrthoInfo).

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This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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