Pain guide · Elbow pain
Elbow pain is less common in later life than knee, hip or shoulder pain, and it is rarely serious. Tennis elbow still happens in your 60s and 70s, though less often than in midlife; a stiff elbow that won't fully straighten is usually arthritis after an old break or years of heavy work; a soft swelling on the point of the elbow is usually bursitis from leaning on it; and tingling in the ring and little fingers is usually the ulnar nerve, which is worth checking early. After a fall, an elbow that won't straighten may be broken, and many older people's elbow fractures do well without an operation.
This guide starts with the warning signs: arm pain that comes on suddenly with pressure, heaviness or squeezing across your chest needs 999, an injury that changes the elbow's shape or numbs the hand needs accident and emergency (A&E), and a hot, red, swollen elbow needs help the same day, even without a fever. Then it sorts the causes by where it hurts, covers grip, leaning, walking aids, falls and bone checks, says when to see a general practitioner (GP) or contact the National Health Service's 111 line (NHS 111), and gives a three-stage plan with 3D demos.
Exercise is for pain that has been checked or is clearly mild and settling.
Location narrows the likely causes; it does not diagnose.
Usually tennis elbow, which is less common after 70 but still happens. Our tennis elbow guide has the full plan.
Read: Tennis elbow →The inner elbow, tender over the bony bump, worse gripping and bending the wristUsually golfer's elbow, managed like tennis elbow. Our golfer's elbow guide covers it.
Read: Golfer's elbow →A stiff elbow that won't fully straighten or bend, aching at the ends of movement, sometimes catching or lockingUsually arthritis or stiffness after an old break, years of heavy work or rheumatoid arthritis. Our elbow arthritis guide covers it.
Read: Elbow arthritis and stiffness →A soft swelling on the point of the elbow after leaning on it or a knockUsually olecranon bursitis. Painful, hot skin over it can mean infection, as the warning signs say. Our elbow bursitis guide covers it.
Read: Elbow bursitis →Tingling in the ring and little fingers, worse leaning on the elbow or with it bentUsually the ulnar nerve at the elbow (cubital tunnel). Numbness all the time or a weak, clumsy hand needs a GP soon. Our ulnar nerve guide covers it.
Read: Ulnar nerve entrapment →After a fall, an elbow you can't fully straighten, or one that is swollen and bruisedPossibly a broken elbow, more common in older women after a simple fall. Get help as the warning signs say. Our broken elbow guide covers recovery.
Read: Broken elbow →After a fall, the elbow looks out of place or won't movePossibly a dislocation: call 999 or go to A&E, and don't try to put it back. Our dislocated elbow guide covers recovery.
Read: Dislocated elbow →Possibly an infected bursa or joint, or gout: get help the same day, as the warning signs say.
Possibly a heart attack: call 999, as the warning signs say. Elbow pain that is worse when you grip and tender over the bone, with none of these signs, points to the elbow.
A trapped nerve in the neck can be felt at the elbow, even without neck pain. Our pinched nerve guide covers it.
Read: Pinched nerve in the neck →Pain and stiffness in both shoulders and the hips, worst in the morningPossibly polymyalgia rheumatica, which affects the shoulders and hips rather than the elbows: see a GP, as the warning signs say. Our shoulder pain in older adults guide covers it.
Read: Shoulder pain in older adults →A pop at the front of the elbow while lifting, then bruising and a bulge in the upper armPossibly a torn biceps tendon, mostly in men in their 40s and 50s. Our biceps tendon guide covers it.
Read: Front of the elbow (biceps tendon) →Elbow pain at night, or that wakes youOur elbow pain at night guide sorts the causes.
Read: Elbow pain at night →The whole arm, or you're not sure where it startsOur arm pain guide maps the arm from the shoulder to the hand, including the heart.
Read: Arm pain →Elbow pain in a man in midlife: manual work, tools or liftingOur elbow pain in men guide covers the 40s and 50s.
Read: Elbow pain in men →Elbow pain in a woman in midlife: work, caring or the menopauseOur elbow pain in women guide covers the 40s and 50s.
Read: Elbow pain in women →In 12 English general practices, people consulted about the elbow most at 45 to 64, and less after 65: 42 women in 10,000 aged 65 to 74 consulted in a year, against 667 for the knee. From 65, men consulted about the elbow about 2 to 2.7 times as often as women. "Elbow and arm pain is not usually a sign of anything serious", the NHS says, and NHS inform lists "normal age-related changes" among the causes.
In one US county, new cases of tennis elbow per 1,000 people a year were 9.0 at 40 to 49, 6.9 at 50 to 59, 3.4 at 60 to 69 and 1.2 at 70 and over, much the same in men and women. So at 70 and over it is less common but not rare, and arthritis, the neck and the nerve deserve more thought.
Most tennis elbow gets better: 89% of people in the no-treatment and placebo groups of 24 trials were much better at a year. In 349 primary care patients, age didn't predict a worse outcome, but neck pain at the same time did. NHS Lothian says it "can take between 6 and 24 months to settle".
"Osteoarthritis is not very common in the elbow unless you've injured it in the past, for example if you've previously broken a bone", Arthritis UK says. One review, drawing on older studies, puts arthritis that starts in the elbow itself at 2% to 3% of people, mostly men, often after years of heavy manual work. Rheumatoid arthritis reaches the elbow in a third to over half of people with it after 10 years, as another review reports.
The typical signs are pain at the ends of movement, slowly losing the last bit of straightening, and sometimes catching or locking from "loose pieces of cartilage or bone"; the nerve to the little finger can be squeezed too. The National Institute for Health and Care Excellence (NICE) diagnoses osteoarthritis without an X-ray from 45 when the pain comes with activity and morning stiffness lasts 30 minutes or less.
Leaning on the point of the elbow on hard surfaces, "such as a tabletop or the armrest in a car", sets off bursitis over months; a knock or a graze can infect it; gout and rheumatoid arthritis can cause it. In 10,301 Israeli cases it was linked with being male, raised cholesterol and smoking, but only about 1 in 6 cases were 65 or over, so it isn't clearly more common in later life.
Infected bursae were more often tender (88% against 36%), red, warm and after a wound, but only 38% had a fever, so a normal temperature doesn't rule out infection. A bursitis that keeps coming back needs checking, as rarely something else looks like it. Gout can also leave hard lumps (tophi) on the elbows, the NHS says.
The ulnar nerve squeezed at the elbow (cubital tunnel syndrome) affected about 25 people per 100,000 a year in Siena, Italy (men 32.7, women 17.2), rising with age. In UK general practice, new cases peaked at 55 to 64 and fell slowly after, more often in men at every age, so the age pattern differs between studies. Leaning on the inner elbow or keeping it bent (the phone, driving, sleeping with the arm tucked up) brings it on, and arthritis or an old injury can narrow the tunnel.
In specialist referral clinics, older people more often already had wasting of the small hand muscles at their first visit: in 121 people in Japan, age was the only factor independently linked with it. After surgery for severe cases in 25 people over 70, feeling, strength and function improved, but only 2 arms recovered fully. One NHS referral guide treats permanent numbness or wasting as urgent.
After an injury, about half of people who couldn't fully straighten the elbow had a fracture, and full straightening made one unlikely in adults. Breaks just above the elbow are "bimodal" by age and most often follow a simple fall; in Finnish women 60 and over, they rose from 1970 to 1998 and then fell. Breaks at the point of the elbow (olecranon) were 62% in women, at a median age of 70.
These behave like fractures from thin bones: 14% of people with an olecranon fracture had another osteoporotic fracture within 5 years, and in women 50 and over a broken radial head went with osteoporosis. NICE counts an elbow fracture from a fall from standing height at 50 or over as a fragility fracture, which means a fracture risk check, though not an automatic bone scan.
Arm pain that "has come on suddenly and it occurs with pressure, heaviness or squeezing across your chest" can be a heart attack, the NHS says; angina comes and goes with exercise, stress or cold and eases with rest, and is more likely in men from 45 and women from 55. In 20,881 people with heart attacks or unstable angina, 8.4% had no chest pain.
The neck can cause elbow pain "even when you don't feel pain in your neck" (NHS inform); a trapped nerve in the neck peaks at 50 to 54 and usually settles. Polymyalgia rheumatica affects the shoulders and hips, not the elbows. A blood clot in the arm is rare, but its symptoms "can sometimes happen in your arm".
An X-ray matters after a fall when the elbow won't fully straighten; if it does straighten, people who skip an X-ray should come back if it hasn't settled in 7 to 10 days. Osteoarthritis needs no X-ray to diagnose from 45 with typical symptoms, and tennis elbow needs none either, though an X-ray shows loose pieces when locking or surgery is being considered.
Fluid drawn from a hot bursa or joint decides between infection, gout and crystals. Nerve tests matter before ulnar nerve surgery or when the picture is unclear: 76% of people with typical symptoms had normal tests. Suspected rheumatoid arthritis needs blood tests, which shouldn't delay referral, and a broken elbow from a fall at 50 or over needs a fracture risk check.
"In many cases, new pain or a flare-up of long-standing elbow problems should begin to settle within 6 weeks", NHS inform says. Elbow arthritis is "oftentimes slowly progressive and relatively well tolerated". Bursitis "should go away in a few weeks" (the NHS), though it "can take a year or two" (NHS Lothian). Mild ulnar nerve symptoms usually go fully; strength returns slowly after surgery for severe ones. A broken point of the elbow heals in "around six to eight weeks", sometimes with some lasting stiffness. No one can promise a timescale.
The UK care pathway says "Patients should be offered physiotherapy", "Corticosteroid injection should not be used" and shockwave "should not be used", with referral after 12 to 24 weeks without improvement. The UK consensus doses are holds of up to 60 s, 5 times, once a day, then lifting and lowering in 3 sets of 10 to 15 once a day. These come from mixed-age programmes; no trial has been done in older adults.
NICE offers exercise to everyone with osteoarthritis, warning that "joint pain may increase when they start", a gel anti-inflammatory for joints other than the knee, and steroid injections only for "short-term relief (2 to 10 weeks)". No exercise trial has been done for the elbow, so this is borrowed from other joints. Keyhole surgery can remove spurs and loose pieces; elbow replacements are mostly done for fractures in older people and for rheumatoid arthritis (in the US, 54% and 22%, against 11% for osteoarthritis).
In 90 people with uninfected bursitis (average age 46), a compression bandage with an anti-inflammatory settled 83% by 4 weeks, as many as draining (65%) or draining with a steroid (85%). NHS Ayrshire & Arran says draining "is not usually recommended as this can introduce infection and the fluid often comes back". An infected bursa needs antibiotics, "usually taken for at least 7 days". The trial was in younger, mostly male people.
In 70 people with mild or moderate symptoms, 89.5% improved at 6 months with advice on avoiding leaning and long bending; "Night splints and nerve gliding exercises did not add favourably". Surgery is for severe cases or ones that don't respond, mainly to stop the weakness getting worse; the two usual operations probably do about as well as each other. Over 70, recovery after surgery for severe cases is long and rarely complete.
For displaced breaks at the point of the elbow from 75, a trial of 60 people found no clear difference in arm function at a year between surgery and "a sling for comfort and early movement as tolerated"; a smaller trial of 19 stopped early because 9 of the 11 operated on had complications. For broken elbows above the joint over 65, a replacement gave better early scores than plates and screws, but not at 2 years, in one trial of 42. Your fracture team decides with you.
Across 108 trials of older people living at home, exercise cut the rate of falls by 23% and the number of people falling by 15% (high certainty). The NHS asks older adults to do strength and balance work at least twice a week, and NICE offers a full falls assessment after a fall that needed treatment.
For the tendon exercises, mild discomfort is fine: no more than about 3 to 4 out of 10, settling within an hour and no worse the next morning. If it is worse, go lighter next time rather than stopping. These are our elbow guides' editorial numbers. The UK consensus allows pain "to a level that the individual patient deems acceptable to them", and NHS inform allows up to 5 out of 10, "no worse the morning after you've exercised". Across 7 trials of long-lasting pain, exercise that allowed some pain did no worse than pain-free exercise.
For a stiff, arthritic elbow, NICE says pain may rise a little when you start, and Arthritis UK says "stop if you get any joint pain that doesn't go away quickly". Tingling is the exception: stop any position that brings on pins and needles in the ring and little fingers. A changed shape after a fall, a hot, swollen elbow or arm pain with chest pressure aren't pain-rule questions: they are warning signs.
Start at the first stage. Each move opens a full guide with a 3D demo.
About the first 2 weeks, daily. Take the pressure off the point of the elbow, change your grip and move gently. Choose the outer-elbow (wrist-lifting) or inner-elbow (wrist-bending) holds to match where it hurts. No trial has tested a plan for elbow pain in older adults; the doses come from the UK tennis elbow consensus, NHS inform, Arthritis UK, a 2026 NHS fracture leaflet and the move pages, as named. After a fracture, start only when your fracture team says; with tingling, our ulnar nerve guide's position changes come first; with a hot, swollen elbow, nothing here applies until it has been checked.
3D demoElbow bend and straighten (elbow range of motion)Beginner · No equipment10 slow repetitions, up to 4 times a day; once it moves comfortably, hold each end for 15 to 30 s, up to 10 times · The move page's dose, with Arthritis UK's holds. Help from the other hand should be gentle, never forceful. With tingling in the ring and little fingers, skip long holds at full bend, as the move page says
Harder: Dumbbell biceps curl
3D demoWrist & forearm flowBeginner · No equipmentTurn the palm up and down: 2 to 3 at a time, building to sets of 8, up to 2 sets of 15, 2 to 3 times a day · NHS inform's palm up, palm down exercise and its pacing
Easier: Wrist circles · Harder: Wrist flexor stretch
3D demoReverse wrist curlBeginner · A dumbbell + A bench or boxFor the outer elbow: hold a light weight still with the wrist level for up to 60 s, 5 times, once a day · The UK consensus dose for holds. The move page says hold it still if lifting hurts
Easier: Wrist-extensor eccentrics · Harder: Plate pinch
3D demoWrist curlsBeginner · A dumbbellFor the inner elbow: the same holds, palm up · The UK consensus dose, borrowed for golfer's elbow (editorial)
Easier: Wrist-extensor eccentrics · Harder: Plate pinch
3D demoBall squeezeBeginner · Other / check instructionsSqueeze a soft ball as hard as you can without pain, hold 5 s, 10 times · A 2026 NHS fracture leaflet's dose. With tennis elbow, squeeze only as firmly as you can without increasing pain, as the move page says
Easier: Tendon glides (hand tendon gliding exercises) · Harder: Band finger extension
3D demoShoulder rollsBeginner · No equipment10 to 15 slow circles each way, once or twice through · The move page's dose (editorial). Keeping the shoulder moving matters after a fracture or a sling
Move on when: The elbow moves a little further than when you started, and it is no worse the next morning.
About weeks 2 to 8: the forearm moves once a day, the arm moves 2 or 3 times a week.
3D demoWrist-extensor eccentricsBeginner · A dumbbellFor the outer elbow: 3 sets of 10 to 15, once a day, lowering slowly · The UK consensus dose
Harder: Wrist curls
3D demoDumbbell forearm rotationBeginner · A dumbbell + A bench or boxWith a light weight such as a tin of beans: 30 turns in all, resting after every 10 · Arthritis UK's wrist turn with a weight
Easier: Wrist-extensor eccentrics · Harder: Plate pinch
3D demoDumbbell biceps curlBeginner · A dumbbell2 to 3 sets of 10 to 15, light, through your full comfortable range · Arthritis UK does the elbow bend with a light weight; the sets are editorial, as in our elbow arthritis guide
Easier: Seated dumbbell curl · Harder: Incline inner biceps curl
3D demoDumbbell triceps kickbackBeginner · A dumbbell2 to 3 sets of 10 to 15, light, to full straightening · Editorial, as in our elbow arthritis guide: it works straightening, which a stiff elbow loses first
3D demoBand rowBeginner · A band + An anchor point3 sets of 10 to 15, stopping 2 to 3 reps short of failure · The move page's dose (editorial)
3D demoWall push-upBeginner · A wall2 sets of 10, hands on the wall, the point of the elbow kept off it · Editorial, as in our elbow arthritis and bursitis guides
Harder: Push-up
Move on when: Every set passes the pain rule, and your range is holding or improving week to week.
From about week 8: 2 or 3 sessions a week, then keep going. Gardening, DIY, carrying shopping and sport come back a little more each week (our suggestion), with strength and balance at least twice a week, as the NHS asks for older adults.
3D demoSit to stand from a chairBeginner · A bench or box5 slow repetitions, building to 10, pushing through the palms on the armrests or with the arms crossed, never the point of the elbow · Editorial, as in our older adults' guides
Easier: Sit to stand, pushing on the thighs · Harder: Bodyweight squat
3D demoIncline push-upBeginner · A bench or box2 to 3 sets of 8 to 12 at a worktop · Editorial, as in our elbow arthritis guide. Use a higher surface if the wrists or shoulders complain, as the move page says
Easier: Wall push-up · Harder: Push-up
3D demoChest-supported dumbbell rowBeginner · A dumbbell + A bench or box3 sets of 8 to 12 · Editorial
3D demoHammer curlBeginner · A dumbbell2 to 3 sets of 8 to 12, with the thumb-up grip this guide teaches · Editorial, as in our elbow guides
Easier: Seated dumbbell curl · Harder: Alternating hammer curl
3D demoFarmer's carryIntermediate · A dumbbell + A kettlebell2 to 3 walks of 20 to 30 m, light · Editorial: practice for shopping bags close to your sides
Harder: Suitcase carry
3D demoSingle-leg standBeginner · A wallHold 5 to 10 s, 3 times each side, fingertips on a counter, building towards 30 s · Editorial, as in our ankle pain in older adults guide. After a fall, stay within reach of support with someone nearby, as the move page says
Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix
Move on when: Our suggestion: your usual week of jobs, hobbies and getting about passes the pain rule. Keep the range moves a few times a week, and strength and balance twice a week, for good.
Our 3D figure can't show these. They come from NHS Lothian, Arthritis UK, the NHS, the American Academy of Orthopaedic Surgeons (AAOS) and the British Society for Surgery of the Hand (BSSH), except where marked as our suggestion.
These come from NHS trusts and the NHS, except where marked as our suggestion.
These come from a 2026 NHS fracture leaflet for a broken point of the elbow treated without an operation, and NICE. Your fracture clinic's plan comes first.
| Habit or position | Why it matters | Instead |
|---|---|---|
| Resting the arm completely | NHS inform and Arthritis UK say keep it moving; long rest stiffens the joint. | Gentle bending and straightening.Try: Elbow bend and straighten (elbow range of motion) |
| Leaning on the point of the elbow: tables, car armrests, chair arms | It sets off bursitis and keeps it going. | Padding, an elbow pad, and pushing up with your palms. |
| Forearm planks or kneeling on your elbows with bursitis | It presses on the swollen bursa. | Hands on a wall or worktop.Try: Wall push-up |
| Long spells with the elbow bent: the phone, or sleeping with the arm tucked up | It squeezes the ulnar nerve. | A headset, and a towel round the elbow at night. |
| Gripping hard with the palm down: kettles, heavy pans, stiff jars | It loads the outer elbow tendons most. | Palm-up or two-handed lifts, and lighter, thicker handles.Try: Hammer curl |
| A steroid injection for tennis elbow | The UK care pathway says it should not be used. | The consensus loading exercises.Try: Wrist-extensor eccentrics |
| Forcing a stiff elbow straight | Help from the other hand should be gentle, never forceful. | Slow holds at the end of your range.Try: Elbow bend and straighten (elbow range of motion) |
| Waiting to see whether a hot, red, swollen elbow settles | An infection doesn't always cause a fever. | Same-day help: an urgent GP appointment or NHS 111. |
| Carrying on with numbness all the time or a weakening hand | Older people often already have nerve damage when first seen, and strength returns slowly after late surgery. | See a GP and ask about referral. |
Wrist mobility and forearm strength for desk work, climbing, push-ups and handstands.
10 minBeginner7 movesA wall, A dumbbellA 30-minute joint-friendly circuit built like the GLA:D and ESCAPE-pain programmes: a gentle warm-up, chair, step and band strength moves, balance, then stretches.
30 minBeginner14 movesA bench or box, A stepA 20-minute seated workout for older adults who cannot stand for long: marching, leg and arm strength, posture, and sit-to-stands that lead back to standing.
20 minBeginner11 movesA bench or box, Something with weightA 40-minute strength and balance session for over-65s, built from the Otago home programme and NHS exercises, using a chair, a counter and a step.
40 minBeginner18 movesA bench or box, Something with weightBalance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.
10 minBeginner7 movesA wall, A bench or boxA 25-minute session for healthy joints: slow circles to take every joint through its range, then a strength circuit for hips, knees, ankles, shoulders and grip.
25 minBeginner13 movesA wall, A bench or boxUsually tennis or golfer's elbow, arthritis or stiffness after an old injury, a swelling on the point of the elbow (bursitis), or the ulnar nerve; after a fall, a fracture. It is rarely serious, and the map on this page sorts the causes by where it hurts.
Yes: it is most common in the 40s and 50s, but still affects about 3 in 1,000 people a year in their 60s and about 1 in 1,000 over 70. Most people get better within a year, and age doesn't seem to slow recovery.
A stiff elbow that won't fully straighten, aches at the ends of movement and sometimes catches can be arthritis, usually after an old break, years of heavy work or rheumatoid arthritis. Exercise and staying active help, and a GP can usually tell without a scan.
A soft swelling on the point of the elbow is usually bursitis, often from leaning on it. If the skin is painful, hot or red, or you feel unwell, get an urgent GP appointment or contact NHS 111 the same day, as it can be infected even without a fever.
Usually not: most settle with padding, ice and painkillers, and draining can bring infection while the fluid often comes back. A GP may still take a sample to check for infection or gout.
Usually the ulnar nerve at the elbow, squeezed by leaning or long bending. A towel round the elbow at night and a headset for calls help mild cases. Numbness all the time, a weak or clumsy hand, or a thin muscle between the thumb and index finger needs a GP soon, because nerve damage recovers slowly in later life.
It can be: call 999 for arm pain that comes on suddenly with pressure, heaviness or squeezing across the chest. Arm pain that comes with exercise and goes with rest needs NHS 111 the same day. Elbow pain that is worse when you grip and tender over the bone points to the elbow.
If you can't fully straighten it, it may be: about half of people in that situation have a fracture, so contact NHS 111, or go to A&E if it has changed shape or the hand is numb. If you can straighten it fully, a break is unlikely, but get it checked if it isn't better in 7 to 10 days.
Not always: for many breaks at the point of the elbow from 75, a sling and early movement did about as well as surgery at a year. Your fracture team decides with you, and a bone health check is worth asking about.
Rest it from pressure and the jobs that hurt, not from movement: keeping the elbow moving is part of recovery, and long rest stiffens it. The first stage of the plan shows how.
No study has looked at this. A stick set at your wrist crease, with a slight bend at the elbow, is the usual advice, and a physiotherapist can check the height and grip if your elbow aches.
Call 999 for arm pain with chest pressure or signs of a stroke, and go to A&E for an injury with a changed shape or a numb hand. Get same-day help for a hot, swollen elbow, and see a GP for pain that isn't better after a few weeks, a swelling that lasts more than 2 weeks, or numb fingers. In the US, call 911 where this page says 999.
Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.
