My elbow hurts, what’s the problem?

Elbow pain can be a symptom of various conditions. While it is most often the result of “tendinitis” (lateral epicondylitis, medial epicondylitis, distal biceps), in some cases it is caused by osteoarthritis or referred pain from the neck or shoulder.

Some keys to help guide the diagnosis are provided below:

a) Pain over an area of a few centimetres on the outside of the elbow that increases if the fist is squeezed tightly or if the wrist is extended forcefully: probably lateral epicondylitis (tennis elbow).
b) Pain over a large area on the outside of the elbow that extends to the middle of the forearm or the wrist that does not really increase with effort: probably muscle pain (myalgia) or pain radiating from higher up (shoulder or neck).
c) Pain in the front and middle of the elbow and in the elbow crease that increases during active flexion or external rotation of the forearm (supination): distal biceps tendon problem.
d) Pain over an area of a few centimetres on the inside of the elbow that increases on internal rotation of the forearm (pronation) or active flexion of the wrist: probably medial epicondylitis (golfer’s elbow)
e) Pain over an area of a few centimetres on the inside of the elbow that increases on internal rotation of the forearm (pronation) or active flexion of the wrist: probably medial epicondylitis (golfer’s elbow)
f) Pain behind the elbow on forced passive extension of the elbow with loss of range of motion: osteoarthritis of the elbow or intra-articular fragments (joint mice)
g) Diffuse pain with swelling: synovitis, arthritis or osteoarthritis
h) Pain on the inside of the elbow that is exacerbated by direct contact or complete flexion of the elbow, and is accompanied by numbness of the ring finger and little finger (4th and 5th fingers): ulnar neuritis or ulnar nerve compression at the elbow (if associated with atrophy of the hand muscles)