Elbow pain is assessed around the load your arm needs to tolerate.

A load-related condition of the common forearm extensor tendon on the outside of the elbow, most often near the extensor carpi radialis brevis origin. “Epicondylitis” is commonly used, although the process is not necessarily inflammatory.

• Pain or burning on the outside of the elbow
• Pain with gripping, lifting, shaking hands or turning a tool
• Pain with resisted wrist or middle-finger extension
• Pain-related reduction in grip strength

A load-related condition of the common flexor-pronator origin on the inside of the elbow. It may occur with manual work, racket sports, throwing or strength training.

• Pain and tenderness at the medial epicondyle
• Pain with gripping, resisted wrist flexion or pronation
• Pain that may extend into the medial forearm
• Ring- and little-finger numbness suggests associated ulnar nerve involvement

A load-related problem affecting the biceps tendon near its attachment to the radius. It must be distinguished from a partial or complete tear.

• Pain at the front of the elbow
• Pain with resisted elbow flexion or turning the palm upward
• Tenderness near the distal tendon
• Reduced tolerance for pulling, lifting weights or manual work

A partial or complete tear of the biceps tendon from the radius, usually during a sudden load that forces the elbow straight. A complete rupture needs prompt orthopaedic assessment.

• A pop and immediate pain at the front of the elbow
• Swelling and bruising around the elbow or forearm
• Altered biceps contour or a palpable gap
• Marked weakness in supination and, to a lesser extent, flexion

Overload or tearing of the triceps tendon where it attaches to the olecranon. Rupture may follow a fall, forceful pushing or sudden loading.

• Posterior elbow pain with pushing or extension
• Tenderness at the tip of the olecranon
• Swelling, bruising or a pop with acute injury
• Weakness or inability to straighten the elbow against gravity with a complete rupture

A sprain or tear of the primary medial stabiliser against valgus stress. It commonly follows repeated throwing load but can also occur after acute trauma.

• Medial elbow pain during throwing
• Loss of throwing velocity, control or tolerance
• A pop with acute injury
• Pain or instability with valgus stress; ulnar nerve irritation may coexist

Injury to the lateral ligaments that may allow abnormal rotation and displacement of the elbow. It can follow dislocation, a fall or previous procedures.

• Lateral elbow pain
• Giving way, catching or shifting when pushing up from a chair
• Apprehension while bearing weight through an outstretched hand
• Painful clicking during extension and supination

Complete or partial separation of the elbow joint surfaces, usually after a fall onto an outstretched hand. It may involve ligament tears, fractures, nerves or blood vessels and is an emergency injury.

• Severe pain, deformity and inability to move the elbow
• Swelling and bruising after trauma
• A feeling that the elbow shifts out of place with subluxation
• A cold or discoloured hand, weak pulse, numbness or weakness requires emergency care

Degenerative change in joint cartilage and bone related to age, previous trauma or repeated loading. Osteophytes and loose bodies may develop.

• Gradually developing pain and stiffness
• Loss of full extension or flexion
• Grinding, catching or mechanical locking
• Difficulty with work, sport or activities requiring forearm rotation

Injury to subchondral bone and cartilage at the capitellum, most often in adolescents exposed to repeated throwing or gymnastics loading. An unstable fragment may become a loose body.

• Lateral pain during throwing or upper-limb weight-bearing
• Swelling and progressive loss of extension
• Clicking, catching or locking
• Reduced performance in a young athlete

Fluid accumulation and inflammation in the bursa over the tip of the elbow after repeated pressure, impact, gout or infection. Septic and non-septic bursitis must be distinguished.

• Visible sac-like swelling behind the elbow
• Pain or tenderness when leaning on the elbow
• Movement may remain relatively preserved in uncomplicated cases
• Redness, warmth, a wound or fever suggests infection and needs medical assessment

Elbow-joint inflammation caused by rheumatological disease, crystal deposition (as in gout), or infection. Septic arthritis is a medical emergency.

• Pain, swelling, warmth and restricted movement
• Sudden severe onset in crystal or septic arthritis
• Fever, chills or feeling unwell with infection
• Other affected joints and prolonged morning stiffness in inflammatory disease

Compression or irritation of the ulnar nerve at the elbow, often aggravated by prolonged flexion or pressure over the inner elbow.

• Numbness and tingling in the little finger and ulnar half of the ring finger
• Symptoms worsening with sustained elbow flexion or at night
• Pain along the inner elbow
• Reduced grip, finger coordination or hand-muscle wasting in advanced cases

Irritation or compression of the deep radial nerve in the proximal forearm. Radial tunnel syndrome primarily causes pain; motor involvement of the posterior interosseous nerve causes weakness.

• Deep lateral elbow pain, usually below the epicondyle
• Pain with resisted supination or middle-finger extension
• Numbness is usually absent in radial tunnel syndrome
• Weak finger or wrist extension when the motor branch is involved

Irritation of the median nerve as it passes through the anterior elbow and proximal forearm. It must be distinguished from carpal tunnel syndrome and cervical radiculopathy.

• Pain in the front of the forearm
• Numbness or tingling in the thumb, index, middle and part of the ring finger
• Symptoms aggravated by repeated pronation or manual work
• Weakness of median-innervated muscles with more severe compression

A fracture near the elbow, usually after a fall onto an outstretched hand. Ligament or interosseous-membrane injury may coexist, so the forearm and wrist also need assessment.

• Lateral elbow pain and swelling after trauma
• Pain with pronation and supination
• Restricted or mechanically blocked elbow movement
• Wrist or forearm pain suggests a combined injury

A fracture of the posterior ulna or lower humerus, usually after a fall or direct impact. It may compromise the extensor mechanism, nerves or circulation.

• Severe pain, swelling and bruising after trauma
• Deformity or marked focal bony tenderness
• Inability to straighten the elbow or use the arm
• Numbness, weakness, a cold hand or weak pulse requires emergency care

A fracture of one or both forearm bones caused by direct trauma, a fall or a rotational mechanism. Bone alignment, the elbow and wrist joints, nerves and circulation must be assessed.

• Severe pain and swelling along the forearm
• Deformity, shortening or abnormal position
• Pain and inability to rotate the forearm
• An open wound, numbness or circulatory change requires emergency care

A dangerous rise in pressure within a muscle compartment, usually after fracture, crushing or bleeding. Acute compartment syndrome can damage muscles and nerves and is a surgical emergency.

• Pain out of proportion that continues to worsen
• Pain with passive stretching of the fingers
• A tense, firm and swollen forearm
• Progressive numbness or weakness; a present pulse does not exclude the condition

Pain may be felt in the elbow or forearm even when the source is the neck, shoulder, wrist or a nerve elsewhere along the limb. Examination should link the symptom pattern to its possible source.

• Pain accompanied by neck or shoulder symptoms
• Numbness, tingling or weakness not matching a local structure
• Symptoms changing more with neck than elbow movement
• Persistent unexplained pain or systemic symptoms require medical assessment