Elbow pain can be a sign of a wide range of conditions. It’s most often a sign of tendinitis (tennis elbow, golfer’s elbow, or distal biceps tendinitis). However, it can sometimes be a sign of osteoarthritis or referred pain from the neck or shoulder.

Here are a few rules of thumb that can help point to a diagnosis:

Pain localized over an area a few centimetres long on the external side of the joint that increases when closing the fist tightly or extending the wrist forcefully: likely lateral epicondylitis (tennis elbow).

Pain on the external side of the joint but over a larger area that can extend to the middle of the forearm or wrist and that does not increase during exertion: likely myalgia (muscle pain) or pain referred from somewhere else (the neck or shoulder).

Anterior, centralized pain in the crease of the elbow that increases with active flexion or external rotation of the forearm (supination): issue with distal biceps tendon.

Pain on the internal side of the joint over an area several centimetres long that increases with the internal rotation of the forearm (pronation) or active flexion of the wrist: likely medial epicondylitis (golfer’s elbow).

Posterior pain that occurs during forced passive elbow extension accompanied by loss of movement: elbow osteoarthritis or loose bone or cartilage fragments in the joint.

Diffuse pain with swelling: synovitis, arthritis or arthrosis.

Internal pain that increases with direct contact or full elbow flexion, accompanied by numbness in the ring and pinkie fingers: cubital tunnel syndrome or ulnar nerve entrapment (if associated with atrophy of the hand muscles).

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