An aching elbow that flares up when you lift a coffee cup, shake someone’s hand, or turn a door handle has a way of making its presence felt constantly. Elbow discomfort is easy to dismiss as a minor nuisance, until it starts affecting work, sport and the tasks you do without thinking. Elbow discomfort can become increasingly frustrating when it starts affecting work, sport and the tasks you do without thinking.
Most elbow pain has a clear cause and responds well to the right management. The problem is that the wrong approach, rest and waiting, often settles pain temporarily while leaving the underlying issue unaddressed, which is why so many elbow problems keep coming back.
What Causes Elbow Discomfort?
Tennis Elbow (Lateral Epicondylalgia)
Tennis elbow is the most common cause of outer elbow pain in adults, and despite the name, most people who develop it have never played tennis. It’s an overload condition affecting the tendons that attach the forearm muscles to the outside of the elbow, the tendons that control wrist extension and grip. This type of elbow discomfort can develop gradually and become more noticeable with everyday activities.
It develops gradually from repetitive or sustained use of the forearm muscles: typing, mouse use, gripping tools, lifting, painting, gardening or any task that loads the forearm repeatedly. The tendon undergoes structural changes from accumulated overload, which is why rest alone settles pain temporarily but doesn’t address the problem, and why many people find it comes back the moment they return to normal activity.
Golfer’s Elbow (Medial Epicondylalgia)
Less common than tennis elbow but following the same principle, golfer’s elbow affects the tendons on the inner side of the elbow, where the forearm flexors and pronators attach. It produces pain on the inner elbow and sometimes into the forearm, typically aggravated by gripping and wrist flexion. The name is equally misleading, it affects tradies, gym-goers and desk workers as readily as golfers.
Referred Pain From the Neck
Elbow pain isn’t always elbow pain. Neck joint problems and nerve irritation from the cervical spine can refer symptoms into the forearm and elbow. If elbow symptoms don’t quite follow the usual pattern, or come with numbness, tingling or symptoms into the hand, the neck is worth assessing alongside the elbow. Treating the elbow alone when the neck is the source tends to produce limited results.
Overuse and Load-Related Pain
Beyond specific named conditions, elbow discomfort frequently reflects a load-capacity mismatch, the forearm muscles and tendons being asked to do more than they’re currently conditioned for, whether from a new activity, increased volume of an existing one, or returning to demands after a break.
Typical Symptoms of Elbow Discomfort
Tennis elbow and related conditions typically present as:
- Pain or tenderness on the outer or inner elbow
- Aching that spreads into the forearm
- Pain when gripping, lifting, twisting or using the wrist
- Weakness in grip strength
- Symptoms that build gradually rather than starting suddenly
- Stiffness that is often worse in the morning or after a period of rest
Symptoms of elbow discomfort can range from a background ache that comes and goes to pain severe enough to limit basic daily tasks.
How Elbow Pain Affects Daily Life, Work and Sport
The forearm muscles are involved in almost everything hands do. When they’re irritated and painful, the effects reach further than people expect:
- Work: prolonged typing, mouse use, tool use and lifting all become uncomfortable
- Sport: gripping a racquet, club, bar or ball reproduces pain, which affects performance and often forces time off
- Everyday tasks: turning taps, opening jars, carrying bags, shaking hands, all involve forearm load
The persistence of these demands is part of what makes elbow tendon problems frustrating. Unlike a lower limb injury where you can reduce walking, the forearm is hard to genuinely rest in daily life.
How Physiotherapy Can Help
Physiotherapy for elbow discomfort begins with identifying the source, whether it’s a tendon condition, a load-capacity issue, or a referral from the neck, before deciding on treatment. A physiotherapy plan may include:
- Assessment of the elbow, forearm, wrist and neck
- Education about what’s driving the pain and what the tendon needs to recover
- Progressive loading program, the foundation of tendon rehabilitation, gradually rebuilding the forearm’s capacity to handle demand
- Forearm and wrist strengthening exercises tailored to your work and activity demands
- Load management advice to reduce aggravation while keeping you functional
- Dry needling to address persistent forearm trigger points and muscle tension alongside the loading program
- Remedial massage to ease the muscle tension that builds in the forearm with ongoing overload
For persistent cases where a well-structured loading program over several months hasn’t produced sufficient improvement, shockwave therapy may be considered as part of a broader plan. It is positioned as an adjunct to rehabilitation, not a replacement for it.
Forearm and Wrist Exercises in Recovery
Exercise is central to tendon recovery, tendons adapt to progressive loading, and without it they don’t regain their capacity. Specific forearm and wrist exercises form a graduated part of most elbow rehabilitation programs for elbow discomfort.
The timing and progression of these exercises matters. Starting too heavy or progressing too quickly can aggravate symptoms; too little load means the tendon doesn’t adapt. A physiotherapy-guided program navigates this more effectively than generic exercise lists, particularly in the early and mid-stages of rehabilitation.
When Elbow Pain Needs Assessment
Book an assessment if:
- Elbow or forearm pain has persisted for more than two to three weeks
- Grip strength is noticeably reduced
- Pain is affecting your ability to work, train or manage daily tasks
- Symptoms keep returning in the same pattern despite rest
Seek prompt medical attention if elbow discomfort follows a fall or direct trauma, comes with significant swelling or deformity, or is accompanied by numbness that travels into the hand, as these may indicate a fracture or nerve problem needing urgent assessment.
Elbow Pain Treatment at Next Phase Injury Therapy
At Next Phase Injury Therapy in Yagoona, our physiotherapists see elbow and forearm pain regularly, in tradies, office workers, gym-goers and recreational athletes. Tennis elbow in particular is one of the most common upper limb presentations we assess and manage. We also regularly help people experiencing elbow discomfort related to overuse and tendon problems.
We work with you to:
- Identify what’s actually driving your elbow pain, the tendon, the load, the neck, or a combination
- Build a progressive loading program matched to your work and activity demands
- Support recovery with hands-on treatment where it adds value, and guide you back to full function
That Grip Isn’t Going to Fix Itself
If your elbow discomfort has been stopping you mid-task for weeks, it’s time to find out what’s behind it and get a plan in place.
Book an appointment with Next Phase Injury Therapy in Yagoona. We’re open 8am to 8pm, seven days a week. Yes, even Sundays.
FAQs
What causes tennis elbow?
Tennis elbow is caused by overload of the tendons attaching the forearm muscles to the outside of the elbow, from repetitive or sustained use, typing, gripping tools, lifting, painting or any activity that loads the forearm repeatedly. It’s not limited to tennis players.
Can physiotherapy fix tennis elbow?
Physiotherapy is a well-supported first-line approach for tennis elbow. A progressive loading program guided by a physiotherapist addresses the tendon’s capacity deficit, which is what drives the problem, rather than only settling pain. Many cases improve significantly with structured conservative management.
How long does tennis elbow take to heal?
Tennis elbow is known for taking longer than people expect. Mild cases may improve over six to twelve weeks of consistent rehabilitation; more established cases can take three to six months or longer. Consistency with the loading program matters more than any timeline.
Why does my elbow hurt when I grip things?
Gripping loads the forearm extensor and flexor tendons, which attach at the elbow. When those tendons are irritated or overloaded, gripping reproduces or worsens pain. This is a hallmark feature of tennis and golfer’s elbow.
Can elbow pain come from the neck?
Yes. Cervical nerve root irritation and neck joint problems can refer symptoms into the forearm and elbow. If elbow symptoms don’t follow the usual pattern, or include tingling or numbness into the hand, the neck warrants assessment alongside the elbow.
What is the difference between tennis elbow and golfer’s elbow?
Tennis elbow affects the outer elbow and is driven by the forearm extensor tendons. Golfer’s elbow affects the inner elbow and is driven by the flexor and pronator tendons. Both are overuse tendon conditions managed with similar principles, progressive loading, load management and addressing contributing factors.
References
- Coombes, Brooke K., et al. “A New Integrative Model of Lateral Epicondylalgia.” British Journal of Sports Medicine, vol. 43, no. 4, 2009, pp. 252–258, https://doi.org/10.1136/bjsm.2008.052738.
- Bisset, Leanne, et al. “Mobilisation with Movement and Exercise, Corticosteroid Injection, or Wait and See for Tennis Elbow: Randomised Trial.” BMJ, vol. 333, no. 7575, 2006, p. 939, https://doi.org/10.1136/bmj.38961.584653.AE.
- Bisset, Leanne M., and Bill Vicenzino. “Physiotherapy Management of Lateral Epicondylalgia.” Journal of Physiotherapy, vol. 61, no. 4, 2015, pp. 174–181, https://doi.org/10.1016/j.jphys.2015.07.015.
- Korakakis, Vasileios, et al. “The Effectiveness of Extracorporeal Shockwave Therapy in Common Lower Limb Conditions: A Systematic Review Including Quantification of Patient-Rated Pain Reduction.” British Journal of Sports Medicine, vol. 52, no. 6, 2018, pp. 387–407, https://doi.org/10.1136/bjsports-2016-097347.
- Lin, Ivan, et al. “What Does Best Practice Care for Musculoskeletal Pain Look Like? Eleven Consistent Recommendations from High-Quality Clinical Practice Guidelines: Systematic Review.” British Journal of Sports Medicine, vol. 54, no. 2, 2020, pp. 79–86, https://doi.org/10.1136/bjsports-2018-099878.
Information on this page is general in nature and is not a substitute for individualised advice from a registered health practitioner. Our practitioners are registered with AHPRA.