Elbow pain is one of those problems that can look small, but feel huge. A sore elbow can make everyday tasks extremely annoying, like turning a doorknob, picking up a kettle, using a mouse, lifting kids, training at the gym, or playing tennis and golf.
A big reason elbow pain lingers and is slow to recover is that many cases are tendon-related. Tendon problems dislike sudden spikes in gripping, lifting, twisting, or repetitive work, and they often need a gradual rebuild rather than a quick rest-only approach. Tendons are slow to heal and need time to adapt. NSW Health uses the term elbow tendinopathy for these conditions and notes that it can take months to fully resolve.
At PhysioCentral, we assess and treat elbow pain for people in Miranda and across the Sutherland Shire. The goal is simple: work out what is driving your symptoms, calm the flare-up, and rebuild strength and load tolerance. As strength goes up, pain goes down. Increasing strength will also prevent any recurrence.
Table of contents
- Overview: elbow pain and why it can be stubborn
- Quick self-check: where is your elbow pain?
- Common causes of elbow pain
- Symptoms that matter (what your symptoms may suggest)
- When to get it checked (red flags)
- Do I need an X-ray or scan?
- What helps in the first week (and what to avoid)
- How we assess elbow pain at PhysioCentral
- Physiotherapy treatment that helps
- Rehab plan: Mobility → Flexibility → Strength (our phased approach)
- Return to gym, sport, and work (simple readiness checklist)
- FAQs about elbow pain
- Book an appointment in Miranda (PhysioCentral)
Overview: elbow pain and why it can be stubborn
Most elbow pain falls into a few broad pain patterns:
- Outer elbow tendon pain (tennis elbow, lateral epicondylalgia)
- Inner elbow tendon pain (golfer’s elbow, medial epicondylalgia)
- Back of elbow swelling/lump (olecranon bursitis)
- Nerve irritation (often tingling into the ring and little finger)
- Less commonly, joint irritation, arthritis, or tendon issues around the biceps or triceps
Tendons can be slow to calm down because they respond best to the right amount of load, progressed gradually. Healthdirect notes that tennis elbow often improves, but recovery can be slow, sometimes 6 to 12 months.
We beg to differ. With the right treatment and rehab protocol, this generally accepted timeline can be shortened dramatically.
Quick self-check: where is your elbow pain?
Outer elbow pain
Most commonly linked with tennis elbow (lateral epicondylitis), which often hurts with gripping, twisting, lifting, or shaking hands. A tendon attachment injury that leads to chronic inflammation.
Clues:
- Sore on the outside bony point of the elbow
- Worse with gripping, lifting with palm down, or turning things
- Forearm feels weak or easily fatigued
Inner elbow pain
Often linked with golfer’s elbow (medial epicondylitis), typically aggravated by gripping, wrist flexion, and repetitive work. Another injury that can occur right where the a tendon attaches to the bone.
Clues:
- Sore on the inner bony point of the elbow
- Pain with gripping, carrying, pulling, or certain gym exercises
- Sometimes tingling can travel into the ring and little finger
Back of elbow swelling or a “lump”
A common cause is olecranon bursitis, which can look like a swollen bump right at the bony point of the elbow.
A bursa is a small, fluid-filled sac that sits between tendons and bone, acting as a cushion to protect the tendon from rubbing against the bone; ‘itis’ simply means inflammation.
Clues:
- Visible swelling, sometimes tender
- Often aggravated by leaning on the elbow
- Can become easily infected, and needs checking if hot and red, or you feel unwell
Numbness, tingling, pins and needles in the hand
This can point to nerve irritation rather than a simple tendon overload. Sometimes accompanied by pain in the forearm muscles close to the elbow. If symptoms are spreading or worsening, it is worth getting it checked out.
Common causes of elbow pain
Tennis elbow (lateral epicondylalgia)
Tennis elbow is commonly caused by repetitive use of the wrist and forearm muscles, often from work tasks, gym, racquet sports, tools, or prolonged computer use. Worse with ‘palm down’ activities.
Golfer’s elbow (medial epicondylalgia)
Golfer’s elbow is similar, but on the inner elbow, and relates to repeated stress through the wrist and finger flexors. Worse with ‘palm up’ activities.
Elbow bursitis (olecranon bursitis)
A swollen, tender lump at the back or point of the elbow is a common presentation.
Tendinopathy vs tendinitis
NSW Health notes that tendinopathy tends to develop over time and often is not primarily an inflammation problem, while tendinitis may be more sudden and inflamed.
Ultimately, although treated differently initially, both require a similar treatment rehab protocol to get over it as quickly as possible. And, more importantly, to prevent it from recurring.
Symptoms that matter (what your symptoms may suggest)
- Grip weakness or forearm fatigue: common in tennis elbow patterns
- Pain that spreads into the forearm: common with elbow tendinopathy – a chronic breakdown in tendon strength and integrity
- Night pain: can occur in tennis elbow, and arthritic change
- Swelling or a clear lump: bursitis
- Numbness or tingling into fingers: consider nerve irritation
When to get it checked (red flags)
Seek medical assessment promptly if:
- Your elbow is hot and inflamed and you have a fever
- You’ve had a fall, or injured it and can’t bend your elbow, your elbow looks deformed, or you suspect a fracture
- Pain is worsening, you have abnormal swelling, or you develop redness and heat in the area
- You have increasing numbness, tingling, or weakness in the hand
Do I need an X-ray or scan?
Not everyone needs imaging straight away. Scans are usually used to rule out other causes or clarify the picture when symptoms are severe or not improving.
A simple rule of thumb: If you can’t place any weight through it (like pushing up from a chair), or move the joint through more than half its normal range – we recommend getting an X-ray
Also:
- X-rays may be used to rule out a fracture, or even arthritis
- Ultrasound (most common for simple presentations) or MRI may be used to assess tendon damage or rule out other soft tissue injuries
- EMG (Electromyography) may be used to rule out nerve compression when symptoms suggest it
If you’re unsure, an assessment by one of our physios will clear things up for you.
What helps in the first week (and what to avoid)
Early wins usually come from calming the flare without fully shutting down the arm and avoiding all movement.
- Stay active and don’t immobilise the elbow
- Avoid tasks that provoke pain above a manageable level
- Avoid, and at least minimise lifting, or repetitive tasks, with the hand in a face-down position early on with outer elbow pain, and face-up with inner elbow pain
- Apply ice for pain relief (20mins at a time, 3 times per day)
How we assess elbow pain at PhysioCentral
A good elbow assessment is not just “where does it hurt.” We look for what is driving the overload and what’s changed to spark off the problem.
Your assessment may include:
- Your symptom pattern (what triggers it, morning vs evening, work and sport loads)
- Grip strength and forearm capacity (because weakness is common in these conditions)
- Movement testing of elbow, shoulder, and neck (because the elbow symptoms are often linked with issues ‘higher up the chain’)
- Specific resistance and strength testing that reproduce lateral (outer) or medial (inner) tendon pain patterns
- Screening for nerve irritation, and upper limb nerve tension tests, if symptoms suggest it
- A clear plan for what to do at home between visits
Physiotherapy treatment that helps
Treatment depends on what we find, but commonly includes:
- Load management coaching (what to reduce now, what to keep)
- Hands-on treatment if stiffness or muscle guarding is contributing
- Taping or bracing advice when appropriate (short term support can help)
- Progressive strengthening to rebuild tendon capacity
- Technique advice for work tasks, gym, tennis, golf, or tool use
Other treatment:
We’ll also occasionally recommend considering a cortisone injection if we think it’s appropriate in chronic cases. A cortisone injection is a powerful anti-inflammatory injected right to the spot. It can provide pain relief but, most importantly, reduce pain enough for you to perform the rehabilitation program to increase tendon strength – which provides the cure.
For those of you whose symptoms are worsened with desk work. And may be associated with neck and shoulder issues – we recommend an ergonomic assessment to ensure you have the best setup.
Rehab plan: Mobility → Flexibility → Strength (our phased approach)
Phase 1: Mobility
Goal: keep the elbow and wrist moving comfortably and reduce protective muscle spasm.
In this phase we focus on:
- Restoring comfortable elbow, wrist, and forearm movement
- relieving any other contributory issues stemming from the shoulder and neck
- Keeping the arm active without poking the hornet’s nest by providing you with a home exercise and pain-relieving program, from day 1
- Getting you back to normal daily tasks without a lingering flare
Progress looks like:
- Less pain with basic tasks (kettle, mouse, door handles)
- Symptoms settle within 24 hours after normal activity
Phase 2: Flexibility
Goal: reduce the “tight forearm” feeling and improve comfort through full range of elbow movement.
In this phase we focus on:
- more vigorous treatment as sensitivity allows
- an upgrade on the rehab program to prepare the muscles and tendons for the final phase of restrengthening
- Gradual exposure to the positions you have been avoiding (without causing big spikes of pain)
Progress looks like:
- Less morning stiffness and less intense pain
- Better tolerance to longer computer or work blocks
Phase 3: Strength
Goal: rebuild load tolerance for the complete cure.
In this phase we focus on:
- A progressive strengthening and endurance program for the neck, shoulder, and forearm (it’s all related)
- Return to heavier gripping, lifting, and sport-specific loads
Progress looks like:
- Stronger grip without flare
- You can return to gym or sport loads gradually, predictably and with confidence
Return to gym, sport, and work (simple readiness checklist)
You are usually ready to build back when:
- Daily tasks no longer trigger a 24–48 hour flare
- Grip strength is improving
- You can do your rehab strength work with manageable discomfort
- Sport or gym drills can be reintroduced gradually without a symptom spike
If it is a work-related overload (trades, tools, repetitive grip), we also plan the return in a way that matches the actual tasks, not just “rest until it feels good.”
FAQs about elbow pain
How long does tennis elbow take to settle?
It often improves, but it can be slow. Typical soft tissue injuries take 6-8 weeks to heal.
Substitute the word ‘months’ for ‘weeks’ when referring to tendons, though. Improvement is often noticeable in the 2-4 week range, and they gradually improve from there as the structures around the elbow begin to strengthen. This one requires patience.
Is elbow pain always inflammation?
Not always. Many cases of tendinopathy are not primarily inflamed; they’re more a breakdown or weakening of the tendon’s structure, which is why the rehab focus is usually on load progression rather than anti-inflammatory drugs.
Should I stop using my arm completely?
Usually no. Unless you suspect a fracture, of course. Stay active and avoid immobilising the elbow, and avoid movements that cause significant pain.
Do I need a brace?
A properly fitted brace can reduce strain in some cases, especially early on, but it is usually an adjunct, not the main solution. They should only be used short term, and only during tasks that you know cause intense pain.
What if I have tingling into my fingers?
That can indicate nerve involvement and warrants assessment, especially if it is worsening or spreading. It’s often just due to protective muscular spasm along the nerve pathway – anywhere from the neck down. Temporary and sometimes part of the pattern of involvement we see with elbow problems.
Can also be due to Carpal Tunnel Syndrome stemming from the wrist.
When should I worry about a swollen lump at the back of the elbow?
A lump can be olecranon bursitis. If it is hot, very painful, red, or you feel unwell, get checked promptly, as they’re prone to becoming infected, and you may need antibiotics.
Do I need imaging?
We usually only need an X-ray after a recent trauma. Ultrasound, MRI, or EMG may be used further down the track if symptoms aren’t settling at a typical pace, or to fine-tune the diagnosis with overlapping symptoms.
Book an appointment in Miranda
If elbow pain is affecting your work, training, sleep, or simple daily tasks, we can help.
PhysioCentral is based in Miranda and supports patients across the Sutherland Shire. We’ll assess what is driving your symptoms and guide you through a practical plan to settle it and keep it settled.