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Learn more about elbow pain: introduction

Arm pain is common and usually caused by an injury or fall. It can often be managed with rest and over-the-counter painkillers.

If your arm has suddenly started hurting but you don't think the cause is serious, try caring for it at home by:

  • holding an ice pack (a pack of frozen peas in a tea towel works well) to your arm for 15-20 minutes every few hours for the first couple of days
  • taking over-the-counter painkillers, such as paracetamol or ibuprofen, to relieve the pain and any inflammation
  • resting the arm and keeping it raised for as long as possible (try resting it on cushions) to help reduce any swelling and pain

See your GP if your arm pain doesn't improve after several days, or if there's increasing redness, swelling or pain.

When to get immediate medical help

See your GP immediately if:

  • your arm pain is brought on by exercise and relieved with rest; it may be a sign of angina (restricted blood supply to the heart)
  • you think you may have a broken arm (but aren't sure)
  • your arm becomes red, hot and swollen over a period of a few hours, and you start to feel generally unwell and develop a high temperature; you may have an infection  

Call 999 for an ambulance if:

  • the pain has come on suddenly and your chest feels like it's being squeezed (you may be having a heart attack or stroke)
  • you have obviously broken your arm (it looks the wrong shape)

Read on to get a better idea of what might be wrong with your arm, but don't use this information to diagnose yourself – always see your GP for a proper diagnosis.

Shoulder pain is covered separately.

Common causes of arm pain

The most common causes of arm pain are:

These are discussed below.

Simple sprain

If you think your pain has been caused by doing more activity than you're used to, you may have just sprained your arm. This means the arm tissues have been stretched, twisted or torn, but aren't permanently damaged.

Read about sprains and strains.

Avoid exercising the arm and care for it at home using painkillers and an ice pack (see the advice above) until the pain goes away.

Tennis elbow or golfer's elbow

Tennis elbow and golfer's elbow are conditions that cause pain around the outside or inside of the elbow. They often occur after strenuous overuse of the muscles and tendons near the elbow joint (for example, after playing tennis or golf).

The pain caused by tennis elbow or golfer's elbow can last for several weeks or months, but will eventually get better.

Bursitis

Repetitive movement of the arm can cause a build-up of fluid over the elbow joint, known as olecranon bursitis (the olecranon is the bony tip of the elbow). This results in pain and swelling.

Most cases of bursitis can be successfully treated with painkillers at home, but some cases will be complicated by infections and may need antibiotics (this is more common after sustaining a scratch or penetrating injury to the arm).

The pain will usually improve within a few weeks, although the swelling may take longer to completely disappear.

Squashed or trapped nerve

Sometimes, the general "wear and tear" that occurs in the joints and bones of the spine as a person gets older can cause the nerves in the spinal cord to become squashed or trapped. This can cause pain that radiates from the neck to the arms, and sometimes also pins and needles.

This type of wear and tear is known as spinal arthritis or cervical spondylosis.

Arm pain caused by cervical spondylosis varies from person to person, but it's typical to have good days and bad days. In most cases, symptoms can be controlled using over-the-counter medication, such as ibuprofen or paracetamol, and exercise. 

Read more about treating cervical spondylosis.

A trapped nerve can also occur in the arm itself. This can sometimes occur in the wrist (carpal tunnel syndrome) or in the elbow (cubital tunnel syndrome). Pain and tingling in your arm and hand that isn't associated with neck pain may be caused by these conditions.

Angina

Angina is a heart condition caused when the blood supply to the muscles of the heart is restricted. It usually occurs when the arteries supplying the heart become hardened and narrowed.

Angina usually causes a dull, heavy or tight pain in the chest that can sometimes spread to the left arm, neck, jaw or back. The pain is usually triggered by physical activity or stress and often only lasts for a few minutes.

However, sometimes angina may only be felt as pain in the arm. This is why it's important to see your GP as soon as possible if your arm pain comes on after exercise and is relieved with rest. Angina is a serious warning sign that you have an increased risk of more serious conditions, such as a heart attack or stroke. Learn more about the symptoms of angina.

Repetitive strain injury

Repetitive strain injury may be diagnosed if your arm or elbow pain seems to be caused by a repetitive task and then fades when the task is stopped. It often occurs in people who work with computers or carry out repetitive manual work.

Sometimes, the pain is caused by an underlying problem, such as bursitis or tendonitis.

Read more about repetitive strain injury.

Less common causes of arm pain

Less commonly, arm pain may be caused by one of the following conditions or injuries:

  • de Quervain's tenosynovitis – inflammation of the tendons on the inside of the wrist (read about tendonitis and tenosynovitis)
  • cervical rib – where you have an extra rib above your normal top rib, which may cause pain, tingling or numbness in the arm
  • inflammation of the nerves in the arm (known as 'brachial and ulnar neuritis') – this may occur after shingles
  • damage to the nerves connecting the spine and the arm (a 'brachial plexus injury') – this can be caused by over-stretching the arm or shoulder and most often occurs during contact sports or a motor vehicle accident
  • arthritis of the elbow – which can cause the elbow joint to become inflamed (swollen, warm and painful) and feel stiff
  • a broken arm, usually caused by a fall onto an outstretched arm

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Learn more about elbow pain: tennis elbow

Tennis elbow is a condition that causes pain around the outside of the elbow.

It's clinically known as lateral epicondylitis.

It often occurs after strenuous overuse of the muscles and tendons of the forearm, near the elbow joint.

You may notice pain:

  • on the outside of your upper forearm, just below the bend of your elbow
  • when lifting or bending your arm
  • when gripping small objects, such as a pen
  • when twisting your forearm, such as turning a door handle or opening a jar

You may also find it difficult to fully extend your arm.

Read more about the symptoms of tennis elbow.

What causes tennis elbow?

The elbow joint is surrounded by muscles that move your elbow, wrist and fingers. The tendons in your elbow join the bones and muscles together, and control the muscles of your forearm.

Tennis elbow is usually caused by overusing the muscles attached to your elbow and used to straighten your wrist. If the muscles and tendons are strained, tiny tears and inflammation can develop near the bony lump (the lateral epicondyle) on the outside of your elbow.

As the name suggests, tennis elbow is sometimes caused by playing tennis. However, it is often caused by other activities that place repeated stress on the elbow joint, such as decorating or playing the violin.

Pain that occurs on the inner side of the elbow is often known as golfer's elbow.

Read more about the causes of tennis elbow.

When to see your GP

If your elbow pain is caused by a strenuous or repetitive activity, you should avoid the activity until your symptoms improve. 

Visit your GP if the pain in your elbow persists, despite resting it for a few days. They will check for swelling and tenderness, and carry out some simple tests, such as asking you to extend your fingers and flex your wrist with your elbow extended.

Further tests, such as an ultrasound scan or a magnetic resonance imaging (MRI) scan will only be needed if it is thought that your pain is being caused by nerve damage.

Treating tennis elbow

Tennis elbow is a self-limiting condition, which means it will eventually get better without treatment.

However, there are treatments that can be used to improve your symptoms and speed up your recovery.

It's important that you rest your injured arm and stop doing the activity that's causing the problem.

Holding a cold compress, such as a bag of frozen peas wrapped in a towel, against your elbow for a few minutes several times a day can help ease the pain.

Taking painkillers, such as paracetamol, may help reduce mild pain caused by tennis elbow. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can also be used to help reduce inflammation.

Physiotherapy may be recommended in more severe and persistent cases. Massaging and manipulating the affected area may help relieve the pain and stiffness, and improve the range of movement in your arm.

Surgery may be used as a last resort to remove the damaged part of the tendon.

Most cases of tennis elbow last between six months and two years. However, in about nine out of 10 cases, a full recovery is made within a year.

Read more about how tennis elbow is treated.

Preventing tennis elbow

It's not always easy to avoid getting tennis elbow, although not putting too much stress on the muscles and tendons surrounding your elbow will help prevent the condition getting worse.

If your tennis elbow is caused by an activity that involves placing repeated strain on your elbow joint, such as tennis, changing your technique may alleviate the problem.

Read more advice about preventing tennis elbow

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Learn more about elbow pain: broken arm

A broken (fractured) arm or wrist needs to be treated as soon as possible. It typically takes a month or two to heal.

Symptoms

What to do

Treatment

Recovery

Symptoms of a broken arm or wrist

Signs of a broken arm or wrist include:

  • severe pain and tenderness
  • bruising and swelling
  • difficulty moving the hand or arm
  • the wrist or arm being an odd shape
  • a snap or grinding noise at the time of injury
  • bleeding (if the bone has damaged the skin) – sometimes the bone may poke through the skin
  • tingling and numbness

Because of the shock and pain of breaking your arm, you may also feel faint, dizzy or sick.

It can be hard to tell the difference between a minor break and a sprain. It's best to assume it's a fracture until it has been checked by a doctor or nurse.

What to do if your arm or wrist is broken

If you think you or someone else has a broken arm or wrist:

  • go to your nearest accident and emergency (A&E) department or call 999 for an ambulance if it's a bad break – minor fractures can often be treated at a local minor injuries unit
  • avoid moving the affected arm as much as possible – it may help to support it in a sling that goes under the arm and around the neck; find out how to make an arm sling
  • stop any bleeding by applying pressure to the wound with a clean pad or dressing if possible
  • apply an ice pack (such as a bag of frozen peas wrapped in a tea towel) to the injured area if one is easily available
  • don't eat or drink anything in case you need surgery to fix the bone when you get to hospital

If your child has injured their arm or wrist, try to get someone else to drive so you can support and comfort them.

Treatment for a broken arm or wrist

When you arrive at the hospital, you'll be given painkillers and a support (splint) may be fixed to your arm to secure it in position.

An X-ray will be carried out to check whether your arm or wrist is broken and how severe the break is.

For a minor fracture:

  • a plaster cast or removable splint will usually be applied – sometimes this may be done a few days later, to allow any swelling to go down first (a splint can be left on until a cast is fitted)
  • you may be given a sling to support your arm
  • you'll be given painkillers to take home and told how to look after your cast
  • you'll probably be asked to attend follow-up appointments to check how your arm or wrist is healing

For more serious fractures:

  • a doctor may try to realign the broken bones with their hands – this will usually be done while you're awake, but your arm will be numbed and you may be given medicine to relax you 
  • surgery may be carried out to realign the bones – this will often involve putting wires, plates, screws or rods inside your arm, but sometimes a temporary external frame may be used
  • a plaster cast will usually be applied to your arm before you go home
  • you'll be asked to attend follow-up appointments to check how your arm or wrist is healing

Recovering from a broken arm or wrist

Your cast will need to stay on until the broken bone has healed. This usually takes a month or two, but can take longer if the break was severe.

While your arm is in a cast:

  • avoid putting weight or strain on the arm – don't stop moving it completely, but avoid activities such as carrying anything heavy, driving and sports
  • keep the cast dry and keep your arm raised (for example, on pillows) whenever possible – read more about how to care for a plaster cast
  • do some gentle exercises and stretches to reduce stiffness – your doctor or a physiotherapist will advise you about this; see an NHS leaflet on getting your hand moving after a wrist fracture (PDF, 170kb) for examples of exercises to try
  • get medical advice if you notice changes in your skin colour, unusual sensations in your arm or wrist, signs of infection (redness, swelling or smelly discharge), severe or continuous pain, or problems with your cast (it's too loose, too tight or cracked)

Speak to your doctor about when you can return to work and normal activities. They will probably suggest gradually increasing how much you use your arm and hand over a few weeks or months.

Your arm or wrist may be stiff and weak after the cast is removed. A physiotherapist can help with these problems, although sometimes they can last several months or more.

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Learn more about elbow pain: treatment

Most sprains and strains can be managed at home using over-the-counter painkillers to ease any pain.

If the injury is minor, you can look after yourself by using "PRICE therapy" and "avoiding HARM". These are described below.

PRICE therapy

PRICE stands for:

  • Protection  protect the affected area from further injury by using a support or, in the case of an ankle injury, wearing shoes that enclose and support your feet, such as lace-ups.
  • Rest  stop the activity that caused the injury and rest the affected joint or muscle. Avoid activity for the first 48 to 72 hours after injuring yourself. Your GP may recommend you use crutches.
  • Ice  for the first 48 to 72 hours after the injury; apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day. Don't leave the ice on while you're asleep, and don't allow the ice to touch your skin directly because it could cause a cold burn.
  • Compression  compress or bandage the injured area to limit any swelling and movement that could damage it further. You can use a simple elastic bandage or an elasticated tubular bandage available from a pharmacy. It should be wrapped snuggly around the affected area, but not so tightly that it restricts blood flow. Remove the bandage before you go to sleep.
  • Elevation  keep the injured area raised and supported on a pillow to help reduce swelling. If your leg is injured, avoid long periods of time where your leg isn't raised.

Avoiding HARM

For the first 72 hours after a sprain or muscle strain, you should avoid HARM. This means you should avoid:

  • Heat  such as hot baths, saunas or heat packs.
  • Alcohol  drinking alcohol will increase bleeding and swelling, and slow healing.
  • Running  or any other form of exercise that could cause more damage.
  • Massage  which may increase bleeding and swelling.

Moving sprained joints

Most healthcare professionals recommend you don't stop using a sprained joint. The injury will heal quicker if you begin to move the joint as soon as you're able to do so without experiencing significant pain.

Your doctor may be able to teach you a number of exercises that will help you improve the joint's functionality.

If you have a severe ankle sprain, you may be advised not to use it for a while, or even have it put into a cast for a week or so.

Immobilising strained muscles

Depending on your injury, the advice for muscle strains can vary. You may be advised to keep your injured muscle still for the first few days. Your doctor may recommend using a brace, cast or splint to help keep it as still as possible.

The aim of immobilising the muscle is to allow it to start healing, so you can move it without tearing or pulling it again in the same place. After a few days, you'll probably be advised to start using the muscle again.

Treating pain

Paracetamol is usually recommended for painful sprains or strains. If it doesn't help, you may need an additional stronger painkiller  such as codeine  that's only available on prescription.

Your GP may also prescribe a non-steroidal anti-inflammatory drug (NSAID) cream or gel, such as ibuprofen or ketoprofen, to help treat pain. Gently apply the cream or gel to the injured area and wash your hands immediately afterwards.

Ketoprofen can make your skin sensitive to light (photophobia). You should avoid exposing treated areas of skin to direct sunlight or artificial sources of light, such as sunlamps or sun beds, during treatment and for two weeks afterwards.

Oral NSAIDs, such as ibuprofen tablets, can also help reduce swelling and inflammation. However, they shouldn't be used in the first 48 hours after the injury because they may delay healing.

Physiotherapy

For more severe injuries, particularly muscle strains, your doctor may consider referring you for physiotherapy.

Physiotherapy aims to restore movement and function to an injured area of the body. The physiotherapist may show you exercises to help improve the range of motion and return normal function to the injured area.

This may reduce your risk of experiencing long-term problems or injuring the area again.

Recovery

The length of time it takes to recover from a sprain or strain depends on how severe it is. 

Generally, after an ankle sprain you'll probably be able to walk a week or two after the injury. You may be able to use your ankle fully after six to eight weeks, and you'll probably be able to return to sporting activities after eight to 12 weeks.

For muscle strains, the time it can take to recover can vary considerably. Some people recover within a few weeks, whereas others may not be able to return to their normal activities for several months.

Some people may experience continued problems, such as pain, intermittent swelling or instability, for months, or even years, after the original sprain or strain.

Contact your GP if your injury doesn't improve as expected or your symptoms get worse. They may consider referring you to an orthopaedic specialist for further assessment and treatment.


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