Elbow pain

The elbow is a hinge joint which connects the upper arm (humerus) to the forearm (radius and ulna). Its primary movements are to bend and straighten the elbow. 

What are the common causes of Elbow pain? 

Common causes of musculoskeletal related pains tend to originate from bones, ligaments, tendons and muscles. These symptoms tend to settle with time and good self-management.

These pains may be a result of an acute injury or a flare up of a long standing issue. Simple advice is keep active and keep moving, it will often settle with time.

Click on the following information to find out about common conditions related with elbow pain.

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Early management of sprains and strains

Minor injuries to the elbow such as a mild sprain or strain should settle with time. They can often be managed very well at home.  

A soft tissue injury to the elbow may result in the following: 

  • Pain
  • Swelling
  • Bruising
  • Stiffness and loss of function

The pain can be particularly strong in the first three weeks as this is the inflammatory phase of your body healing itself. Typically, these injuries last 4 to 6 weeks depending on the severity.

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.

Up to date guidelines can be found on the NHS website:

Ibuprofen

Paracetamol

Go to an urgent treatment centre or emergency department if your arm:

  • has been injured and you heard a snapping noise or your arm has changed shape
  • is swollen and you have a very high temperature or feel hot and shivery
  • is extremely painful and difficult to move
  • tingles or feels numb

These could be signs of something more serious. You can also call 111 for advice or go 111.nhs.uk.

Speak to a GP or physiotherapist if:

  • the pain is severe or stopping you doing normal activities
  • the pain is getting worse and/or keeps coming back
  • the pain has not improved in any capacity after following the simple advice below
  • Visit the Patient self referral form to self-refer to a physiotherapist.

DAY 1 – Early Management

Protect by minimising use of the affected arm and initially avoiding stretching the area which could cause further injury.

Rest can be beneficial in the very early stages of the injury (days 1-4). Complete rest, however, is not advisable.In the early stages, gentle active movements and specific exercises can help decrease pain and swelling, they also promote good tissue healing with less unwanted scar tissue and joint stiffness. It is important to move the shoulder and wrist gently so that these joints do not stiffen.

Ice pack/frozen peas wrapped in a damp cloth, placed on the swollen area for up to 20 minutes at a time, 3 times a day. So long as there is swelling you will need to continue ice therapy, often beyond the third week.

  • Please note only use ice if you have normal skin sensation
  • Check the skin regularly
  • Stop if there is excessive pain, numbness or tingling
  • Do not put ice directly on to the skin as this may cause a burn.

Compression of the elbow can be achieved by using a tubigrip or crepe bandage. It should compress firmly but not restrict blood flow and create a tourniquet.  Remove if there are signs of poor circulation, or if you start to experience pins and needles or numbness.

Elevation. This is difficult for the elbow. If you have swelling in your arm sit on a chair and place your arm on cushions so it is supported.

Visit the video of how to manage a sprain or strain at home.

WEEK 1 – Early Mobilisation

After 72 hours is important to start using your elbow normally again. Start to do normally everyday activities. You should also try doing these exercises 3 – 4 times a day. Repeat each one 10 times.

Sitting or standing – Slowly bend your elbow and then straighten it.

You may need to assist your arm with the other hand in the early days after an injury.

Start with your elbows bent. Clasp your hands together. Turn your palm towards the floor and then back towards the ceiling. You can use the other hand to assist.

Rest your forearm on a table with your hand over the edge. Using your wrist only, move your hand down towards the floor, and then back up towards the ceiling in a patting motion.

You can use the other hand to assist if needed.

Support your elbow on a table make a fist bend your fingers into your palm as tightly as you can and feel them stretching. Now stretch your fingers as wide as you can and feel them stretching.

WEEK2 – Strengthening Exercises

 

Sitting or standing – hold on to a small weight, such as a can of beans or bottle of water. Bend and straighten your elbow.

Sit or Stand with one elbow bent and palm turned up. Hold on to a small weight such as a can of beans or bottle of water. Turn your palm down by rotating your forearm .

As you start to do these exercises you may feel there is some discomfort, however, this is normal and you should continue. If you have discomfort and pain for more than 2 hours after these exercises, then you shoulder reduce the number and gradually build up again.  

Recovery time and returning to activity

It usually takes 6 weeks to heal from simple soft tissue injuries to the elbow.  However, everyone recovers from injuries at different rates. Some may be back in 2 weeks however for some it can take up to 3 months.     

Returning to work – Gradually build up your strength and function, practice doing similar tasks that you would do at work before returning. Start doing this little and often ensuring there is minimal pain or swelling.  

Returning to hobbies/sport – it is advised not to return to these activities until you have full strength and range of movement without pain or swelling. Try to practice the specific movements of your hobby / sport in a controlled manner and build up the time and intensity that you do the movements before returning to your activity fully.  

Osteoarthritis of the elbow

What is it?  

Osteoarthritis is a wear and repair process and can affect the elbow, however, this is less common than other joints. It can lead to joint pain with limitation of movement, this can affect daily activities.  Osteoarthritis is the most common type of arthritis, affecting approximately 9 million people in the UK. In general people who have osteoarthritis of the elbow can manage well and can continue with activity and exercise without many problems. 

Versus arthritis have produced a summary of ‘What is Osteoarthritis?’

Visit this video that will help explain.

In osteoarthritis we see changes to the cartilage of the joint as well as other secondary changes such as inflammation. Cartilage helps our joints move freely. Changes to the cartilage can lead to pain, stiffness, and loss of movement. This can in time lead to weakness around the muscles of the joint.  

It most commonly affects people older than 45 and is more common if have a family history of it, overweight or have previously injured the joint in question. Osteoarthritis has varying degrees on functional limitation and effect on quality of life. Contrary to popular belief it does not affect everyone as you get older and does not necessarily get worse.  

What are the common symptoms of Osteoarthritis of the elbow? 

Symptoms of osteoarthritis of the elbow may include gradual onset of pain and limited movement of the joint. There is often a restriction in fully straightening the elbow. Other symptoms include stiffness first thing in the morning for less than 30 minutes. Noises coming from the joint (crepitus) on movement is also common.  

How to manage it? 

If you think you have or have been diagnosed with osteoarthritis of the elbow from a healthcare professional there are several things you can do to help manage your symptoms and to stop them from worsening. 

Exercise 

Do exercises and stretches to keep the joints healthy and stimulate the natural lubricating fluid, keep it moving through as much of the range of movement that is available to you. It is important to get a balance of exercising and rest. By exercising the elbow in this way you will not make the symptoms worse. You can improve you symptoms

Exercises  

Bend and straightening your elbow 

Sitting or standing – Slowly bend your elbow and then straighten it.   

Repeat x 10. Rest for a minute. Repeat x 3.

Rotation at the wrist and elbow 

Start with your elbows bent. Clasp your hands together. Turn your palm towards the floor and then back towards the ceiling. You can use the other hand to assist. 

Repeat x 10. Rest for a minute. Repeat x 3.

Making a fist

Support your elbow on a table make a fist bend your fingers into your palm as tightly as you can and feel them stretching. Now stretch your fingers as wide as you can and feel them stretching. 

Repeat x 10. Rest for a minute. Repeat x 3.

Bicep curls

Sitting or standing – hold on to a small weight, such as a can of beans or bottle of water. Bend and straighten your elbow.  

Repeat x 10. Rest for a minute. Repeat x 3.

Rotation with a small weight 

Sit or Stand with one elbow bent and palm turned up. Hold on to a small weight such as a can of beans or bottle of water. Turn your palm down by rotating your forearm  

Repeat x 10. Rest for a minute. Repeat x 3.

Wall press up 

Now put your hands on the wall as if you are going to do a press up. Make sure your hands are placed a little wider than the width of your shoulders, your hands are turned out slightly and your elbows are below your shoulders. 

Now lower your body towards the wall keeping your body nice and tall.  

Repeat x 10. Rest for a minute. Repeat x 3.

Simple painkillers   

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet. 

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Topical (applied directly on the affected body area) anti-inflammatories are recommended initially. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions 

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing. 

Up to date guidelines can be found on the NHS website: 

Ibuprofen 

Paracetamol 

Other medicines can help to reduce inflammation, swelling and pain. You should discuss this with your GP if the simple pain relief advice does not help or if you are needing to take ibuprofen for more than 10 days. 

Ice or heat therapy  

Heat may be helpful in the form of a hot water bottle, wheat pack or hot shower. This can help to relax the muscles around your elbow and may allow exercises to be more effective.   

For ice therapy use a damp cloth containing an icepack (or bag of frozen peas) over the top of the painful area to help numb the pain. Leave it on for up to 20 minutes and use up to three times a day.  

  • You should be cautious using these treatments if you have altered skin sensation or circulatory problems.   
  • Check the skin regularly during and after the ice pack application  
  • Stop if there is excessive pain, numbness or tingling   
  • Do not put ice directly on to the skin as this may cause a burn.  

Physiotherapy  

If you find that you are not improving, some advice or treatment from a physiotherapist can be helpful in managing elbow pain. Visit the Patient self referral form to self-refer to a physiotherapist.

Tennis Elbow

What is it?

Tennis elbow (lateral epicondylitis) is a condition that causes pain and tenderness around the outer elbow joint. It is called tennis elbow because it can be associated with repetitive forceful gripping activities such as encountered during racquet sports. It is also common amongst manual workers, although it can happen to anybody.     

Usually, tennis elbow is caused by overloading the tendon that attaches your wrist muscles to your outer elbow joint. These muscles are the ones that cause your wrist to extend and twist, and fingers straighten. It is often aggravated by lifting, gripping and repetitive action of the wrist and hand.  

Changes to the structure of the tendon cause pain to occur around the outer elbow joint, usually, close to where the tendon attaches to the bone, see picture below, discomfort can also be felt in the forearm.  

The site of tennis elbow

Picture from Versus Arthritis shows a right elbow and the common site for tennis elbow.

How to manage it?

Tennis elbow is usually the result of overloading the tendon that attaches your wrist muscles to your outer elbow.  

It is a condition that most people can easily self-manage at home, with the right combination of:   

  • Relative rest 
  • Modify your activity – you may need to change the way you lift or carry things for a short period of time 
  • Painkillers if necessary  
  • Orthoses – A support or strap in the early stages of the injury 
  • Ice or heat therapy 
  • Exercise – stretches and strengthening 
  • Steroid injections are no longer routinely offered for the treatment of tennis elbow as there have been studies to suggest they can make symptoms and outcomes worse in the long term. 

Simple painkillers

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet. 

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Topical (applied directly on the affected body area) anti-inflammatories are recommended initially. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions 

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing. 

Up to date guidelines can be found on the NHS website: 

Ibuprofen

Paracetamol

Other medicines can help to reduce inflammation, swelling and pain. You should discuss this with your GP if the simple pain relief advice does not help or if you are needing to take ibuprofen for more than 10 days. 

Support

Using a splint to support your elbow may ease the strain when you’re doing certain activities that cause it to flare up. They’re available online or can often be purchased from a pharmacist. 

An epicondylitis clasp

To the left is an example of a support – the picture is from Versus Arthritis. 

The support or strap is placed on the forearm close to the elbow.  

This can reduce pain and improve function in the early days of the condition. 

Ice or heat therapy 

Heat may be helpful in the form of a hot water bottle, wheat pack or hot shower. This can help to relax the muscles around your elbow and may allow exercises to be more effective.   

For ice therapy use a damp cloth containing an icepack (or bag of frozen peas) over the top of the painful area to help numb the pain. Leave it on for up to 20 minutes and use up to three times a day.  

You should be cautious using these treatments if you have altered skin sensation or circulatory problems.   

  • Check the skin regularly during and after the ice pack application  
  • Stop if there is excessive pain, numbness or tingling   
  • Do not put ice directly on to the skin as this may cause a burn.  

Exercises

Following simple advice of rest and then gradual loading of the tendon, tennis elbow can make a full recovery. It may take time and you will need to follow a graded loading program.  

Wrist extensor stretch

Start with your palm of your hand down towards the floor. With your opposite hand take hold of the back of your hand and fingers.  

Bend the wrist towards the floor. Try to straighten your elbow fully. 

You should feel a stretch on your forearm and elbow. This should not be painful. 

Hold the stretch for 30 secs and repeat little and often throughout the day. 

Wrist flexor stretch

Start with the palm of your hand facing up. With opposite hand, take hold of palm of your hand and fingers.  

Bend the wrist towards the floor. Try to straighten your elbow fully. 

You should feel a stretch on your forearm and elbow. This should not be painful.

Hold the stretch for 30 secs and repeat little and often throughout the day. 

Eccentric strengthening exercises 

Start with your arm supported on a table. Try to have to elbow straight. Hold on to a small weight (e.g. bottle of water) with your wrist extended and the back of your hand towards the ceiling. 

Slowly lower the weight towards the floor.  

Use your opposite hand to return to the starting position.  

Repeat 15 times. Rest for 60 secs. Repeat x 3.

Concentric strengthening exercises – perform this once the eccentric exercise is comfortable

Start with your arm supported on a table or your knee. Hold on to a small weight (e.g. bottle of water) or resistance band. The back of your hand should be towards the ceiling. 

Raise you wrist up towards the ceiling as far as is goes then lower slowly, keeping your forearm supported. 

Repeat 10 times. Rest for 60 secs. Repeat x 3.

Physiotherapy  

If you find that you are not improving, some advice or treatment from a physiotherapist can be helpful in managing tennis elbow. Visit the Patient self referral form to self-refer to a physiotherapist. 

How to prevent and manage future flare ups?  

As tennis elbow is often caused by overloading the tendon that connects your wrist muscles to the outer side of your elbow joint, the key to helping the condition is to take care when carrying out activities or sports that place pressure on the tendon with repetitive or forceful gripping.  

It takes time for your body to get used to a new activity and tendons take longer than muscles to adapt. So, it’s important to pace yourself and if in doubt, take advice from a physiotherapist. 

Golfer's elbow

What is it? 

Golfer’s elbow (medial epicondylitis) is a condition that causes pain and tenderness around the inner side of the elbow joint. The condition is called golfer’s elbow because it is associated with repetitive, forceful gripping and twisting activities of the wrist and fingers – a common activity with a golf swing. It also affects people who play sports that involve throwing such as cricket and baseball – as well as climbers or manual workers. However, the condition can affect anybody.

Usually, golfer’s elbow is usually caused by overloading the tendon that attaches the muscles in your forearm to the inner side of your elbow joint. These muscles are the ones that cause your wrist to bend and twist, and fingers curl. The pain is usually triggered by actions that require gripping such as bending the palm downwards and rotating the forearm inwards

Changes to the structure of the tendon cause pain and tenderness to occur around the inner elbow joint, usually, close to where tendons attach to the bone, but discomfort can also be felt into the forearm.

The site of golfer’s elbow

Picture from Versus Arthritis shows a right left elbow and the common site for golfer’s elbow

How to manage it?

Golfer’s elbow is usually the result of overloading the tendon that attaches the forearm muscles to the wrist.

It is a condition that most people can easily self-manage at home, with the right combination of:

  • Relative rest
  • Modify your activity – you may need to change the way you lift or carry things for a short period of time
  • Painkillers if necessary
  • Ice or heat therapy
  • Exercise – stretches and strengthening
  • Steroid injections are no longer routinely offered for the treatment of tennis elbow as there have been studies to suggest they can make symptoms and outcomes worse in the long term.

Simple painkillers

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Topical (applied directly on the affected body area) anti-inflammatories are recommended initially. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.

Up to date guidelines can be found on the NHS website:

Ibuprofen 

Paracetamol 

Other medicines can help to reduce inflammation, swelling and pain. You should discuss this with your GP if the simple pain relief advice does not help or if you are needing to take ibuprofen for more than 10 days.

Ice or heat therapy 

Heat may be helpful in the form of a hot water bottle, wheat pack or hot shower. This can help to relax the muscles around your elbow and may allow exercises to be more effective.

For ice therapy use a damp cloth containing an icepack (or bag of frozen peas) over the top of the painful area to help numb the pain. Leave it on for up to 20 minutes and use up to three times a day.

  • You should be cautious using these treatments if you have altered skin sensation or circulatory problems.
  • Check the skin regularly during and after the ice pack application
  • Stop if there is excessive pain, numbness or tingling
  • Do not put ice directly on to the skin as this may cause a burn.

Exercises

Following simple advice of rest and then gradual loading of the tendon, golfer’s elbow can make a full recovery. It may take time and you will need to follow a graded loading program.

Wrist extensor stretch

Start with your palm of your hand down towards the floor. With your opposite hand take hold of the back of your hand and fingers.

Bend the wrist towards the floor. Try to straighten your elbow fully.

You should feel a stretch on your forearm and elbow. This should not be painful.

Hold the stretch for 30 secs and repeat little and often throughout the day.

Wrist flexor stretch

Start with the palm of your hand facing up. With opposite hand, take hold of palm of your hand and fingers.

Bend the wrist towards the floor. Try to straighten your elbow fully.

You should feel a stretch on your forearm and elbow. This should not be painful.

Hold the stretch for 30 secs and repeat little and often throughout the day.

Eccentric strengthening exercise 

Start with your arm supported on a table. Try to have to elbow straight. Hold on to a small weight (e.g. bottle of water) with your wrist extended and the back of your hand towards the floor.

Slowly lower the weight towards the floor.

Use your opposite hand to return to the starting position.

Repeat 15 times. Rest for 60 secs. Repeat x 3.

Concentric strengthening exercises – perform this once the eccentric exercise is comfortable 

Start with your arm supported on a table or your knee. Hold on to a small weight (e.g. bottle of water) or resistance band. The back of your hand should be towards the floor. 

Raise your hand up towards the ceiling as far as is goes then lower, keeping your forearm supported. 

Repeat 10 times. Rest for 60 secs. Repeat x 3. 

Physiotherapy  

If you find that you are not improving, some advice or treatment from a physiotherapist can be helpful in managing golfer’s elbow. Visit the Patient self referral form to self-refer to a physiotherapist. 

How to prevent and manage future flare ups?  

As golfer’s elbow is often caused by overloading the tendon that connects your wrist muscles to the inner side of your elbow joint, the key to helping the condition is to take care when carrying out activities or sports that place pressure on the tendon with repetitive or forceful gripping.  

It takes time for your body to get used to a new activity and tendons take longer than muscles to adapt. So, it’s important to pace yourself and if in doubt, take advice from a physiotherapist. 

Recovering from a traumatic Elbow injury

Most elbow injuries recover quickly, and it is common to experience pain and stiffness. You may feel stiffness on straightening the elbow and some pain with movement is to be expected.  

It is a condition that most people can easily self-manage at home, with the right combination of rest, changes in your activity levels, gentle exercise and if necessary, painkillers. 

Some simple range of movement exercises that move your elbow to the end of range (bending and straightening of the elbow) can help to alleviate pain and improve movement.  

Stand. Grasp the wrist of the arm you want to exercise.

Bend your elbow and assist the movement with your other hand. Straighten your elbow. 

Repeat 10 times 3 times a day.

 

If your symptoms do not settle within 6 weeks, please seek further professional advice. For further advice on managing a soft tissue injury on the elbow, see the section on Soft tissue injuries in the blue box below.

Other causes of elbow pain

Referred pain 

Elbow pain can be as result of pain elsewhere in the body, it can be from the neck or shoulder. Commonly this is known as referred pain. Your physiotherapist or GP can advise on how to manage this with advice and exercises. 

Olecranon bursitis

The olecranon bursa is a sac overlying the olecranon process (the bony tip) of the elbow beneath the skin. It reduces friction on movement between the skin, tendons, ligaments, and bone, and allows them to glide smoothly over one another.  

Bursitis occurs when the bursa is irritated and inflamed. This can be as a result of overuse or trauma. It can be due to an infection within the bursal sac. If there are any signs of infection (redness, heat, swelling and tenderness worsening or feeling unwell) this needs to be treated immediately. 

Olecranon bursitis is more common in 

  • Young or middle-aged men. 
  • People in jobs which involve risk of regular elbow trauma or pressure on the bursa. For example gardeners and mechanics. 
  • Athletes who play sports which involve repetitive overhead throwing or elbow flexion and extension. 

Most cases of olecranon bursitis resolve without complications; however, recurrent episodes may occur especially after recurrent minor trauma. 

What are the common symptoms of olecranon bursitis? 

  • Swelling over the elbow that appears over several hours to several days, may be tender or warm (but may be painless). 
  • Movement at the elbow joint is painless except at full flexion when the swollen bursa is compressed. 
  • There is a history of preceding trauma or bursal disease. 
  • There is evidence of local skin abrasion. 

How to manage it? 

The management of olecranon bursitis includes 

  • Rest,  
  • compression bandaging,  
  • avoidance of trauma to the elbows, 
  • Simple pain killers 
  • On rare occasions a bursitis may require an aspiration or a steroid injection. 

If there is any heat; significant swelling; redness or restriction within the joint, there may be an infection. You need to urgently seek the advice of your GP. 

Simple painkillers   

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet. 

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Topical (applied directly on the affected body area) anti-inflammatories are recommended initially. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions 

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing. 

Up to date guidelines can be found on the NHS website: 

Ibuprofen 

Paracetamol 

Other medicines can help to reduce inflammation, swelling and pain. You should discuss this with your GP if the simple pain relief advice does not help or if you are needing to take ibuprofen for more than 10 days. 

Ice  

For ice therapy use a damp cloth containing an icepack (or bag of frozen peas) over the top of the painful area to help numb the pain. Leave it on for up to 20 minutes and use up to three times a day.  

  • You should be cautious using these treatments if you have altered skin sensation or circulatory problems.   
  • Check the skin regularly during and after the ice pack application  
  • Stop if there is excessive pain, numbness or tingling   
  • Do not put ice directly on to the skin as this may cause a burn.  

If you have not responded to any of the above advice after 2 months please discuss with your GP. 

When to seek medical advice

The above advice can help you to manage your condition at home. The majority of musculoskeletal conditions get better within six to eight weeks although sometimes they can persist for longer but this doesn’t mean there is something seriously wrong. 

However, rarely, musculoskeletal symptoms can be caused by something more serious and it is important for you to know when to seek advice. We would advise if you experience any of the following you should seek the advice of you GP. 

  • the pain you are experiencing is getting worse rather than better despite following the self-management guidance above for the condition  in the time frame expected 
  • symptoms have not been significantly helped by a trial of medication as expected 
  • you feel unwell and suffer symptom such as fever, night sweats or weight loss 
  • you experience pain at night, possibly worse than during the day that prevents you from sleeping due to increasing pain and/or difficulty lying flat. 
  • you experience a change in your ability to walk including balance problems or weakness/heaviness in your legs 
  • you develop a hot and swollen joint for no apparent reason 
  • early morning stiffness, lasting for longer than 30 minutes 

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Soft tissue injuries

Elbow injuries

Minor injuries to the elbow such as a mild sprain or strain should settle with time. They can often be managed very well at home.  

A soft tissue injury to the elbow may result in the following: 

  • Pain 
  • Swelling 
  • Bruising 
  • Stiffness and loss of function 

The pain can be particularly strong in the first three weeks as this is the inflammatory phase of your body healing itself. Typically, these injuries last 4 to 6 weeks depending on the severity.  

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet. 

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.

Up to date guidelines can be found on the NHS website:

https://www.nhs.uk/medicines/ibuprofen-for-adults/

https://www.nhs.uk/medicines/paracetamol-for-adults/

For up to date guidelines on the government about Ibuprofen use and Coronavirus (COVID-19)

https://www.gov.uk/government/news/ibuprofen-use-and-covid19coronavirus

DAY 1 – Early Management

Protect by minimising use of the affected arm and initially avoiding stretching the area which could cause further injury. 

Rest can be beneficial in the very early stages of the injury (days 1-4). Complete rest, however, is not advisable. In the early stages, gentle active movements and specific exercises can help decrease pain and swelling, they also promote good tissue healing with less unwanted scar tissue and joint stiffness. It is important to move the shoulder and wrist gently so that these joints do not stiffen. 

Ice pack/frozen peas wrapped in a damp cloth, placed on the swollen area for up to 20 minutes at a time, 3 times a day. So long as there is swelling you will need to continue ice therapy, often beyond the third week.   

  • Please note only use ice if you have normal skin sensation  
  • Check the skin regularly  
  • Stop if there is excessive pain, numbness or tingling  
  • Do not put ice directly on to the skin as this may cause a burn. 

Compression of the elbow can be achieved by using a tubigrip or crepe bandage. It should compress firmly but not restrict blood flow and create a tourniquet.  Remove if there are signs of poor circulation, or if you start to experience pins and needles or numbness. 

Elevation. This is difficult for the elbow. If you have swelling in your arm sit on a chair and place your arm on cushions so it is supported. 

WEEK 1 – Early Mobilisation

After 72 hours is important to start using your elbow normally again. Start to do normally everyday activities. You should also try doing these exercises 3 – 4 times a day. Repeat each one 10 times.

1. Sitting or standing – Slowly bend your elbow and then straighten it.  

2. You may need to assist your arm with the other hand in the early days after an injury.

3. Start with your elbow bent and palm turned down. Turn your palm up and then back down.

4. Rest your forearm on a table with your hand over the edge. Using your wrist only, move your hand down towards the floor, and then back up towards the ceiling in a patting motion.

 

 

 

5. Support your elbow on a table make a fist bend your fingers into your palm as tightly as you can and feel them stretching. Now stretch your fingers as wide as you can and feel them stretching.

 

 

WEEK 2 – Strengthening Exercises

1. Sitting or standing – hold on to a small weight, such as a can of beans or bottle of water. Bend and straighten your elbow. 

2. Sit or Stand with one elbow bent and palm turned up. Hold on to a small weight such as a can of beans or bottle of water. Turn your palm down by rotating your forearm 

 

As you start to do these exercises you may feel there is some discomfort, however, this is normal and you should continue. If you have discomfort and pain for more than 2 hours after these exercises, then you shoulder reduce the number and gradually build up again. 

Further elbow exercises can be found following the link below: 

https://www.poole.nhs.uk/a-z-services/t/therapy-services/therapy-outpatients/patient-information-leaflets.aspx 

Recovery time and returning to activity 

It usually takes 6 weeks to heal from simple soft tissue injuries to the elbow.  However, everyone recovers from injuries at different rates. Some may be back in 2 weeks however for some it can take up to 3 months.    

Returning to work – Gradually build up your strength and function, practice doing similar tasks that you would do at work before returning. Start doing this little and often ensuring there is minimal pain or swelling. 

Returning to hobbies/sport – it is advised not to return to these activities until you have full strength and range of movement without pain or swelling. Try to practice the specific movements of your hobby / sport in a controlled manner and build up the time and intensity that you do the movements before returning to your activity fully.    

Get advice from 111 now if your arm: 

  • hurts when you exercise but the pain goes away when you rest 
  • is swollen and you have a very high temperature or feel hot and shivery 
  • is extremely painful and difficult to move 
  • tingles or feels numb 
  • has been injured and you heard a snapping noise or your arm has changed shape 

These can be signs of a heart problem (angina), an infection or a broken arm. 

111 will tell you what to do. They can tell you the right place to get help if you need to see someone. Go to 111.nhs.uk or call 111.

Futher links:

External links for further information on elbow pain: 

https://www.csp.org.uk/conditions/managing-your-bone-joint-or-muscle-pain/managing-your-elbow-pain 

https://www.versusarthritis.org/about-arthritis/conditions/elbow-pain/ 

https://www.nhs.uk/conditions/elbow-and-arm-pain/ 

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