Lateral Elbow Pain (Outside)

Elbow pain

Lateral elbow pain refers to pain on the outside of the elbow. The most cause of pain on the outside of the elbow is known as Tennis Elbow (Lateral Epicondylitis). However, there are a number of other causes of pain on the outside of the elbow, including referred pain, nerve compression, synovitis, bursitis ligament sprains, and fractures.

On this page:

  • Tennis elbow (lateral epicondylitis)
  • Radial tunnel syndrome
  • Osteochondritis dissecans

Tennis Elbow

Tennis Elbow - lateral elbow pain

Tennis Elbow is a general term used to describe outer elbow pain or which there may be a number of specific causes or diagnosis. The most common causes are inflammation (or more likely degeneration) of the tendon at the point the wrist extensor muscles attach to the outside of the elbow and is known as Tennis elbow, lateral epicondylitis or extensor tendinopathy. It is more likely to be caused by overuse or work-related activities involving a lot of gripping than actually playing tennis.

The main symptom is a pain about 1 to 2 cm down from the bony part on the outside of the elbow, known as the lateral epicondyle. In addition, there may be a weakness in the muscles around the forearm and wrist, causing difficulty in performing simple tasks, weakness gripping things, opening a door handle or shaking hands with someone.

Treatment involves reducing pain and inflammation with rest and applying ice or cold therapy. Then, once the acute phase is over gradually increasing the load through the elbow with exercises to a point where normal training and competition can be resumed. A tennis elbow brace or support can help reduce the strain on the elbow whilst it is healing and during rehabilitation.

Read more on Tennis elbow (lateral epicondylitis).

Radial Tunnel Syndrome

Radial tunnel syndrome is also known as radial nerve entrapment or posterior interosseous nerve entrapment. It occurs when the radial nerve in the arm becomes compressed or restricted in the tunnel it passes through. Radial tunnel syndrome is more often caused by rotation of the wrist/lower arm rather than repetitive extension as in the case of tennis elbow, but the symptoms of both these injuries can be similar.

Pain on the outside of the elbow is a common symptom, but Radial tunnel syndrome symptoms may also include pins and needles or tingling in the hand and outer forearm. Tenderness may be felt in the muscles of the upper forearm with the maximum tenderness at a point about 4-6 cm down from the lateral epicondyle (a bony bit on the outside of the elbow) in the supinator muscle.

Treatment involves applying the PRICE principles of protection, rest, ice/cold therapy to reduce pain and inflammation, in particular, avoiding any repetitive wrist movements. When pain allows stretching and strengthening exercises can begin.

Read more on radial tunnel syndrome.

Radiohumeral Bursitis

Radiohumeral bursitis can also give similar symptoms to tennis elbow. This is inflammation of a bursa or small sack of fluid which sits between the tendon and the bone to help lubricate it. This elbow injury can be caused by a direct impact to the joint or arm, with some common symptoms being elbow pain, swelling, and restricted movement.

The main symptoms of Radiohumeral bursitis are a pain, tenderness and a limited range of movement in the elbow. The joint will be swollen and redness can occur in some cases, this may cause a fever if an infection is present. The type of injury may be caused by a direct blow to the elbow or forearm, arthritis, gout or acute infection but frequently the cause is unknown.

Treatment of Radiohumeral Bursitis is to rest the inflamed area as much as possible. If you must resume normal activity immediately, wear a sling until the pain becomes more bearable. To prevent a frozen elbow, begin normal, slow joint movement as soon as possible. Painkillers and anti-inflammatory drugs may be prescribed or Corticosteroid injections into the bursa to reduce inflammation.

Osteochondritis dissecans in the elbow joint

Osteochondritis dissecans - lateral elbow pain

Osteochondritis dissecans, sometimes known as an Osteochondral fracture, is a fragmentation of the cartilage and sometimes the underlying bone that lines the ends of bones in the elbow joint. It is common in adolescents as the ends of the bones are not yet fully hardened and it may be caused and exacerbated by throwing sports. Symptoms include locking and clicking of the elbow, swelling which comes and goes, restricted movement, intermittent pain and pain after activity.

Treatment depends on the severity of the injury. Mild injuries may only require conservative treatment of rest, ice and mobility exercises until the pain has gone. More serious fractures will require surgery.

Read more on Osteochondritis Dissecans in the elbow.

Synovitis

Synovitis of the elbow joint (radiohumeral joint) is inflammation of the synovial membrane which surrounds the joint. Symptoms include elbow joint pain and redness over the area. However, synovitis is itself usually caused by another condition, including an injury to the joint or an illness like cancer. Because of this, synovitis can indicate a serious problem so getting medical advice is essential.

Symptoms include pain and swelling with stiffness in the joint. There will be an increased skin temperature and redness over the area. When a patient presents with suspected synovitis, they may be referred for scans such as an MRI, and fluid may be taken from the knee and sent for testing.

Referred pain

Pain on the outside of the elbow may have been caused by or referred from the upper back or neck.

This article has been written with reference to the bibliography.