Lateral Elbow Pain
The most common cause for pain on the outer part of the elbow is Tennis elbow. Tennis elbow is an overuse injury of the tendons from your forearm and wrist muscles. Although its name suggests that this is a tennis injury, anyone can develop this overuse tendinopathy. If often occurs as a result of repetitive wrist and forearm activities, whether from work, sport, hobbies, or a weekend DIY project.
Pain usually develops over time, only after the provoking activity. As the condition progresses, you may start having pain at night and find that the strength in your hand becomes weaker.
Initial treatment of tennis elbow aims to reduce pain and inflammation of the tendon, followed by regaining elbow movement and function. We will guide you on how to modify daily activities to reduce pain. Hands-on treatment may include ultrasound, laser, electrotherapy, manual elbow mobilisation techniques, massage and myofascial release, taping, dry needling and specific exercises and/or stretches. In severe, chronic cases, we may suggest a brace.
Other less common causes of pain on the outer aspect of the elbow includes ligament injuries, which can occur with throwing activities, nerve injuries or joint instability.
Nerve injuries may happen with repetitive forearm movements such as with carpenters or mechanics. Pain typically comes on gradually and is poorly localised. There may be associated muscle weakness. Nerve injuries take longer to heal. To treat nerve injuries, we first have to alleviate the pain. We can perform neural and joint mobilisations to relieve pressure off the nerve. Ultimately, a rehabilitation program must be followed to regain full, pain-free elbow function.
Medial Elbow Pain
As with lateral elbow pain, pain on the inner aspect of the elbow is usually also caused by overload of the tendons. This type of injury is also called Golfer’s Elbow, but can happen to anyone who uses their wrist or elbow a lot. With repetitive, or unaccustomed movements, the tendons that insert on the inner bony structures of the elbow become irritated and inflamed, and pull on their bony insertions. This ultimately causes pain and perhaps swelling. Your grip strength will also most likely be weakened.
Our initial treatment will aim to relieve your pain and reduce any existing inflammation. There are various treatment modalities we can use to achieve this, including ultrasound, laser, massage, or dry needling. Activity modification is vital, and we will guide you on how to avoid exacerbating activities and how to adapt to others. We may tape your elbow to relieve pressure on sensitive structures, and in some cases, suggest a brace.
Once the acute pain and swelling have been treated, rehabilitation must follow, which will include specific exercises and/or stretches. Firstly we aim to restore your full, pain-free elbow and wrist movements. Finally, we will strengthen the muscles of your arm and improve their endurance. If your work, sport or hobby requires repetitive wrist or elbow movements, we will assess your functional movements, use of equipment or technique. If we see that you have a faulty movement pattern or technique, we can help to address this to prevent recurring injuries.
Occasionally, Tennis or Golfers Elbow injuries require surgery. Rehabilitation after surgery is very important. Rehabilitation will follow the same principles as mentioned above.
Another less common problem that may cause medial elbow pain is a ligament injury. Ligament injuries often happen with traumatic incidents e.g. falls, forceful throwing or pulling on the joint. Treatment of ligament injuries will follow the same principles of symptoms management, protection of the joint, regaining movement and recovery of function.
Pain at the Back of Your Elbow
If you have hyperextension of your elbow and do repetitive throwing activities such as javelin or other sporting activities, there could be impingement of soft tissues, or entrapment of a nerve, at the back of your elbow. This will cause pain or discomfort localised at the back of your elbow, usually without swelling. You may only experience pain when you straighten your arm. It is important to take some time to rest and avoid aggravating activities. During this time, we can help you manage any existing pain, as well as help, stabilise your elbow joint by means of taping. Thereafter, we help you regain elbow stability by working out a strengthening program for you.
Another cause of pain at the back of your elbow may be tendinopathy of your triceps muscle. People who have to extend their elbow against some resistance, such as weight lifters, people working with heavy machinery, etc. are more at risk for this type of injury. Treatment will consist of relative rest, ice, ultrasound, and other electrotherapy modalities to reduce pain and swelling.
If you have tenderness in your muscles and connective tissue in your arm, we can reduce this by massage, myofascial release, dry needling, and stretching.
In older people, pain at the back of their elbow may be a result of arthritis. As for any arthritic joint, pain management is the first step. We use various treatment techniques to manage your pain, including ultrasound, electrotherapy, massage, gentle joint mobilisations, and heat application. It is common to have some muscle tension around arthritic joints since the muscles aim to protect the injured area. By releasing any muscle tension, we can further relieve your pain.
A rare cause of pain at the back of the elbow is bursitis. Scholars elbow is a term referring to bursitis that develops as a result of prolonged pressure on the elbow, such as when you lean on a table on your elbows. Elbow bursitis can be septic, meaning there is an active infection in the fluid-filled sack protecting the back part of your elbow joint. Septic bursitis will present with pain, swelling, and redness around the elbow joint, and you may also have a fever. When elbow bursitis is aseptic, i.e. without an infection, you may simply present with a spongy, non-painful lump at the back of your elbow. Bursitis can be treated with ice, compression, and avoidance of aggravating activities. If we see that you have an infection, we will refer you to a doctor, since you will then need antibiotics.
Pain at the Front of Your Elbow
Pain here usually indicates a biceps tendon injury that occurs with repeated elbow activities, mostly those that are performed against resistance e.g. bicep curls. Pain typically comes on gradually over time. To treat your biceps tendinopathy, we will guide and advise you on relative rest, the use of ice, and how to adapt daily activities to avoid aggravating the injury. Pain management can be done with ultrasound, electrotherapeutic treatments, and massage. We also use taping to offload the sensitive tendon. Once the pain has subsided, you will need to regain movement in your elbow and gradually build up strength in your biceps muscle. Together, we will develop a rehabilitation program to help you achieve the full function of your elbow and biceps again.
In older people, arthritis of the elbow can cause pain at the front of the joint. Arthritis treatment is based on pain management, reducing joint stiffness and maintaining or improving joint movement and function.
Occasionally, traumatic incidents will result in elbow fractures or dislocations. If you require surgery, we can help you with your recovery afterwards.
Conditions We Treat
Jaw and TMJ Disorders
Chest Pain/ lung problems
Elbow & Arm Pain
Thoracic / upper back Pain
Lower back Pain
Wrist,hand and finger Pain
Lower leg Pain