Elbow pain often gets lumped together as "tennis elbow" or "golfer's elbow" but there are half a dozen conditions with distinct patterns. Here's a practical guide to the most common ones we see.
Outside of the elbow — tennis elbow
Lateral epicondylalgia. Pain on the outer bony point, worse with gripping and wrist extension. Common in office workers, tradespeople, and lifters — not just tennis players. Responds well to shockwave, loading progression, and grip modification.
Inside of the elbow — golfer's elbow
Medial epicondylalgia. Pain on the inner bony point, worse with gripping and wrist flexion. Deadlifters, pull-up enthusiasts, and manual labourers are common patients.
Front of the elbow
Biceps tendinopathy or distal biceps strain. Deep aching pain, worse with resisted elbow flexion or supination. Often from heavy curling or a sudden loading event.
Back of the elbow
Triceps tendinopathy or olecranon bursitis. Pain at the back of the elbow or a visible swelling over the bony point. Triceps issues come from overhead pressing; bursitis from prolonged pressure or a bump.
Deep inside
Ulnar collateral ligament sprain — common in throwers (baseball, cricket). Pain on the inner elbow with valgus load.
Distal biceps rupture — sudden pop with heavy lifting, immediate weakness, visible deformity. Surgical urgency in most cases.
With numbness or tingling
Cubital tunnel syndrome — ulnar nerve compression at the elbow. Tingling in the ring and little fingers, worse with elbow flexion or leaning on the elbow.
How to figure out which one you have
Location of pain is the first clue. Aggravating movements narrow it down further. But most elbow patterns need a careful exam to identify — we test the specific tendons, ligaments, and nerves that could be involved.
Universal principles
- Most elbow tendon problems are degenerative, not inflammatory — anti-inflammatories help symptoms briefly but don't heal the tissue
- Progressive loading is the durable fix
- Modifying the driving activity is essential — treatment without addressing what's overloading the elbow rarely holds
- Shockwave has strong evidence for chronic tendinopathies
Come in for an assessment — elbow pain has a small list of causes and once we identify yours, treatment is straightforward.