Arm or Elbow Pain

Plymouth Orthopaedic and Sports Injury Clinic

Arm pain is common and usually happens after an injury or fall. Occasionally, it can be a sign of an underlying condition.
If your arm has suddenly started hurting and you don't know why, try caring for it at home using ice and over-the-counter painkillers (see the advice in the box on this page).

If the pain doesn't improve after several days, or if there's increasing redness, swelling or pain, see your GP.

See your GP immediately if:

  • Your arm pain is brought on by exercise and relieved with rest, as it may be a sign of angina.
  • You think you may have a broken arm.

Go to your nearest hospital accident and emergency department if:

  • The pain has come on suddenly and your chest feels like it is being squeezed (you may be having a heart attack).
  • You have obviously broken your arm (it looks the wrong shape).

The information below should give you more of an idea of what might be wrong, although it shouldn't be used to self-diagnose your condition.
This page concentrates on pain that just affects the arm. It doesn't cover widespread pain that affects many areas, and shoulder pain is covered separately.

Common causes of arm and elbow pain

The most common causes of arm pain are:

  • A simple sprain
  • Tennis elbow or golfer's elbow (known medically as epicondylitis)
  • Bursitis
  • A squashed or trapped nerve
  • Angina (when the pain is brought on by exercise)

These are explained below.

Simple sprain

If you think your pain has resulted from doing more activity than you're used to, you've probably just sprained your arm. This means that the arm tissues have stretched, but are not permanently damaged.

Avoid exercising the arm and care for it at home using painkillers and an ice pack (see box on this page for advice) until the pain goes away.

Tennis elbow or golfer's elbow

Tennis elbow is a condition that results in pain around the outside of the elbow. It often occurs after strenuous overuse of the muscles and tendons near the elbow joint, for example after playing tennis.

The medical name for tennis elbow is lateral epicondylitis. This is because the pain is usually felt around the bony lump on the outside of the elbow, known as the lateral epicondyle. Pain can also occur on the inner side of the elbow, which is known as golfer's elbow.

The pain caused by tennis elbow or golfer's elbow can last for several weeks or months, but will eventually get better.

Bursitis

Repetitive movement of the arm can cause a build-up of fluid over the elbow joint, known as olecranon bursitis (the olecranon is the bony tip of the elbow). This results in pain and swelling.

In most cases, bursitis can be successfully treated at home (see box with tips on managing pain). The pain will usually improve within a few weeks, although the swelling may take longer to completely disappear. 

Squashed or trapped nerve

Sometimes, the general "wear and tear" that occurs in the joints and bones of the spine as people get older can cause the nerves in the spinal cord to become squashed or trapped. It can cause pain that radiates from the neck to the arms, and sometimes also pins and needles.

This type of wear and tear is called spinal arthritis, or cervical spondylosis.

Arm pain caused by cervical spondylosis varies from person to person, but it is typical to have "good days" and "bad days". In most cases, symptoms can be controlled using over-the-counter medication (such as ibuprofen or paracetamol) and exercise. Read more information about treating cervical spondylosis

Angina

Angina is a heart condition caused when the blood supply to the muscles of the heart is restricted. It usually occurs when the arteries that supply the heart become hardened and narrowed.

Usually, angina causes a dull, heavy or tight pain in the chest that can sometimes spread to the left arm, neck, jaw or back. The pain is usually triggered by physical activity or stress and usually only lasts for a few minutes.

But sometimes, angina may only be felt as pain in the arm. This is why it's important to see your GP as soon as possible if your arm pain comes on after exercise and is relieved with rest. Angina is a serious warning sign that you have an increased risk of experiencing more serious conditions, such as a heart attack or stroke. 

Less common causes of arm and elbow pain

Less commonly, arm pain may be caused by one of the following conditions or injuries:

  • De Quervain's tenosynovitis, which is inflammation of the tendons on the inside of the wrist. Read about tendonitis and tenosynovitis.
  • Carpal tunnel syndrome, which is pressure on the nerve that controls sensation and movement in your hand. It usually causes pain and a burning feeling in the hand and fingers. Read about carpal tunnel syndrome.
  • Cervical rib – this is having an extra rib above your normal top rib, which may cause pain, tingling or numbness in the arm.
  • Inflammation of the nerves in the arm, known medically as brachial and ulnar neuritis (this pain may occur after shingles).
  • Arthritis of the elbow, which can cause the elbow joint to become inflamed (swollen, warm and painful).
  • Broken or cracked bone, which will cause extreme pain and occur after a fall or blow to the arm

Anatomy of the Elbow

There are 3 bones which allow the elbow to bend to the mouth, straighten and allow the hand and wrist to turn up (to carry a plate) or turn down (to use a keyboard). These are the humerus, the radius and the ulna. 

The humerus runs from the shoulder and forms the upper bone of the elbow joint. The lateral epicondyle provides attachment for the wrist extensor muscles (which bend the wrist and fingers back). The medial epicondyle provides attachment for the wrist flexor muscles which bend the wrist down. 

The humerus ends in a rounded capitellum which articulates with the head of the radius and grooved region, the trochlea, which articulates with the ulna.

The radius and ulna run from the elbow to the wrist. The two are joined together throughout their length by a strong interosseous ligament and have a small joint between them at each end.

The radius has a small button shaped head at the elbow which articulates with the capitellum of the humerus. This allows the radius (and hencs the whole of the forearm) to rotate. The other end is broader and ends under the thumb, giving 3/4 of the width of the wrist.

The ulna has a saddle shaped end, the olecranon, which articulates with the trochlea of the humerus. This allows the ulna to glide round the end of the humerus and enables the elbow to flex and extend. The distal (wrist) end of the ulna is similar to the head of the radius and enables wrist rotation.