Why do I have pain on the outside of my elbow?
Help I have elbow pain!
Does the below sound like you?
The outside of my elbow hurts when I grip and lift things with my hand
Grip feels weak
Straightening or bending my elbow hurts
Repetitive gripping or holding objects causes pain
Wrist movements cause pain in the elbow
Straightening fingers with resistance causes pain in the elbow
Computer use hurts the outside of my elbow
Elbow pain affects many people! Whether you work in the trades, along a production line, or sit at a computer in an office, having a sore elbow is a common injury. If your elbow is hurting, this blog will help you understand the potential causes for elbow pain.
5 Reasons for Elbow Pain
1. Tennis elbow
Other names for this injury: tendinitis or tendinosis of the extensor tendons, lateral epicondylalgia
This diagram helps visualize the tendons connecting onto the lateral epicondyle which are inflamed and irritated.
You may have heard a lot about tennis elbow before, but it is important to know it doesn’t just affect tennis players. Whether your job requires repetitive gripping or typing, many people can develop this condition. It is an inflammatory process where the tendons on the top of your forearms are irritated. The site of pain is usually at the insertion of the tendon onto bone known as the lateral epicondyle and/or along the forearm near the insertion of tendons. With continued repetitive use, it can cause degeneration of the tendon which is then classified as a tendinosis – this means you may experience constant pain that can range from mild to severe.
2. Cervical radiculopathy
Other names for this injury: pinched nerve in the neck, cervical nerve root compression at C6
Nerves! They travel from your neck, through your shoulder, past your forearm and into your hand. To determine if this is the cause of your elbow pain, your neck and shoulder may need to be assessed by your physiotherapist. The chances of your neck being the source of your elbow pain is 44% according to this study. Nerves travel from your neck to form a network that provide strength to the muscles and sensation to the skin along your arm. If you’re experiencing burning, tingling, or weakness at your arm, forearm, and/or hand, you may be dealing with a pinched nerve in your neck. Your physiotherapist can find out whether the neck is involved with your injury by completing screening tests. At Break Free, we are all trained to ensure that we check all other possible sources of your injury thoroughly.
3. Muscular strain of the wrist extensors
Sometimes the muscles of the forearm are pulled too far causing strain on the belly of the forearm muscles. This results in damage to the muscle fibres causing pain and inflammation. This will commonly happen with a sports injury due to a collision. Your physiotherapist will be able to find out what exercises would be appropriate to heal from this type of injury.
4. Arthritis
Do not be alarmed by the “a” word. Sometimes with repetitive overuse and age, we can develop age-related changes in the joints of our elbow. Clients will often believe that the diagnosis of arthritis means that their injury is irreversible and they will always be in pain. Contrary to that belief, exercise can help remedy pain through the appropriate stretches and guidance of a cardiovascular program from your physiotherapist.
5. Posterior interosseus nerve syndrome
The nerves again! There is a nerve that travels through the supinator muscle and it can become compressed. It’s usually associated with repetitive strain with gripping, twisting, and extending the wrist. You may notice a decrease of strength in your wrist and fingers, numbness and/or tingling. It’s important to talk to your physiotherapist about all the symptoms you are feeling, including any burning, tingling or numbness. This is to help us figure out where the source of your pain is coming from.
Common Causes of Elbow Pain
Repetitive manual labour
Repetitive gripping over an extended period of time can often be associated with elbow pain. Without proper rest in between periods of gripping, the forearm muscles are overused. Other potential causes could be the use of power tools that produce vibration resulting in increased use of muscle activity of the forearm to stabilize the wrist, or tasks that use fine motor skills with small instruments in an enclosed space.
Professions who suffer with elbow pain from manual labour:
Auto Mechanics
Painters
Plumbers
Butchers and chefs
Carpenters
Cleaners
Construction workers
Factory Line Workers
Dentists
Dental Hygienists
Dental Assistants
Consistent Computer Use
Do you work at your computer all day? People who use a keyboard and mouse to type and click frequently can develop significant elbow pain.
Ergonomics is a fancy word that describes the science of making work safe. In the case of office work, it’s related to your posture and how things are set up in your workspace. Your posture can affect how much strain is put on specific muscles in your forearm. Changing seat height, adding arm rests, and ensuring your wrists aren’t bent too far one way can help prevent these types of injuries. The position of your neck can also put increased pressure on nerves which can result in elbow pain with typing. If your wrists are not in a good position, repetitive clicking and typing can cause repetitive strain on specific muscles.
Sports
Gripping a racquet can cause a high level of stress on your forearms. Single handed strokes often create more force of the extensor muscles resulting in strain of the tendon. Wrist movements to create more spin on the ball are used often in tennis resulting in an increase of torque through the forearm muscles.
In some cases, a collision injury can result in the strain of forearm muscles, tendons, and nerves. Blunt force trauma from a ball can also affect your forearm resulting in pain, bruising, sensitivity to touch and in some rare cases tingling/weakness.
What can physio do to help?
Physiotherapists are the first line of defense in musculoskeletal injuries. We are well trained to ensure that we assess all possible sources of pain and help you understand your injury. Here are some of the many ways in which physiotherapists can help you with your injury.
1. Accurate assessment and diagnosis of your injury
Your physiotherapist at Break Free Physiotherapy is trained to ask the right questions to figure out what has happened with your elbow. By asking key questions, your physiotherapist is able to pinpoint where their focus should be in the objective testing to help determine what your injury is. During the objective testing, your physiotherapist knows which tests to use to determine what part of your forearm/elbow is injured. At Break Free Physiotherapy, we are trained to also determine if there are other sources that could be affecting your forearm/elbow.
2. Checking the neck!
At Break Free Physiotherapy, we are skilled in finding the true cause of your injury. The neck can be a cause of elbow pain because of the nerves that travel from your neck to the forearm. Physiotherapists at Break Free are trained to complete a thorough screening process for your neck to determine if it is related to your elbow. There are special tests such as reflexes, strength, range of motion, nerve tension, and sensation that can help determine if your neck is involved.
3. The right treatment for your injury
None of the fluff and only the good stuff! We do not promote the use of modalities at our clinic unless it is necessary to help with your injury. We provide the exact stretch or exercise you need based on our thorough examination. No cookie cutter exercises or one treatment fits all approach.
4. Bracing or taping
Your forearm muscles or tendons need a break from repetitive use! In some cases, your physiotherapist may recommend a specific brace or taping technique to help relieve pain. If a tendon in your forearm is inflamed, a brace can help offload the tendon to allow your tendon to heal. This will allow the exercises provided to become more effective.
5. Changing how you do things
Perhaps there is a posture that is aggravating your forearm/elbow. Or there might be a better way to grip something. It could be related to your ergonomics at work at your office station. Your physiotherapist will ask very specific questions to help you understand what factors may be contributing to your injury. Education around how you modify certain activities will help lead to healing in your forearm.
6. Acupuncture or Dry Needling
For those more chronic and stubborn injuries, some of our physiotherapists are trained in acupuncture or dry needling. These modalities are used in more stubborn cases, where there is a lot of central sensitization. This means that your body may be interpreting pain differently which can sometimes complicate your road to recovery. Acupuncture and dry needling can help decrease central sensitization, help you feel better, and allow for exercises to become more effective.
7. Medications
We collaborate with your family doctor when required. If things still are not improving, we may talk to your doctor (with your permission of course) to see if any medications could be prescribed. A short period of the right medication may help decrease pain so you can participate in strengthening of your forearm injury.
Our goal is to help you get back to doing what you love. Physiotherapy’s aim is to decrease the chance of surgery and improve your chances of recovering naturally. We hope to give you peace of mind by sharing our knowledge of the body with you so you can feel more at ease. Book with one of our physiotherapists today by clicking here.
Corey Kim
Co-Owner and Physiotherapist
Hey, my name is Corey, and I’m a co-owner of Break Free Physiotherapy and Wellness. I was born in Seoul, South Korea but grew up in London, Ontario. I finished both my Bachelor of Arts in Kinesiology and Master of Physical Therapy degrees at Western University. I’m passionate about helping people find pain relief through movement and believe in self-empowerment by sharing knowledge of the human body and its ability to heal. [full bio]
