Usually tennis or golfer's elbow, about as common in women as in menStrong evidence
In a small UK population study (24 women with each condition), 0.7% of women and 0.8% of men had tennis elbow at the time, and 0.7% of women and 0.4% of men golfer's elbow. In Finland, how common tennis elbow was "did not differ between men and women", and the UK care pathway says it "affects women and men equally".
In one US county, new diagnoses each year were much the same in women and men overall (3.5 and 3.3 per 1,000), and the same was true of French workers. Women in English general practice consulted about the elbow a little less often than men, unlike most other parts of the body.
Sources 1, 2, 3, 4, 5, 6
A midlife problem, in women and men alikeStrong evidence
In the UK and Finland, tennis and golfer's elbow were commonest at 45 to 54 in both sexes. In one US county, new diagnoses peaked at 40 to 49, a little higher in women than in men at that age (10.2 against 7.8 per 1,000 a year), and the average age at diagnosis was 47 in both. The NHS says tennis elbow is most common between 35 and 54.
Sources 1, 2, 4, 7
Gripping, twisting and lifting, at work and at homeStrong evidence
Forceful and repetitive arm work together went with 5.6 times the odds of tennis elbow in Finland, and the same work raised new cases by about 3 times in both women and men in a French study of workers. Tools over 1 kg, lifting heavy loads often and over 2 hours a day of repetitive movements raise the odds, and bending and straightening the elbow for over an hour a day went with tennis and golfer's elbow in the UK study.
The NHS names typing, using a mouse, sewing, screwdrivers and playing instruments, and an NHS leaflet adds DIY and housework. Most people who get tennis elbow don't play tennis.
Sources 2, 8, 5, 9, 10, 1, 7, 11
Babies and caring: the same movements, but no studyEmerging evidence
No study has measured lifting babies, childcare, housework or caring as a cause of elbow pain. Holding a baby with the elbow bent for long spells, lifting a car seat or a toddler with the palms down, and wringing and lifting at home use the same gripping, lifting and bending that the work studies link with tennis and golfer's elbow, so the grip and lifting steps in this guide apply (our reasoning, not evidence).
Two surveys of breastfeeding women reported arm and shoulder pain without giving figures for the elbow. In 216 women in Turkey, rocking the baby to sleep in the arms went with worse arm, shoulder and hand function, and in 471 mothers in Arabic-speaking countries, using arm and back support went with less pain.
Sources 12, 13
The menopause hasn't been shown to cause itEmerging evidence
Tennis and golfer's elbow peak at the same ages in men, and no study has linked menopausal status with them. In one US records study, women taking hormone replacement therapy (HRT) had more coded tennis elbow (27.8% against 22.7%), probably because they saw doctors more, so it can't show cause. Oestrogen's effects on tendons have been studied mainly in the laboratory.
The NHS lists muscle aches and joint pains among menopause symptoms; those are general aches, which our joint pain in the menopause guide covers. A sore spot on the elbow that hurts when you grip is the tendon, at any age.
Sources 4, 1, 14, 15, 16, 17, 18
Breast cancer tablets can affect tendons and nervesStrong evidence
Aromatase inhibitors (anastrozole, letrozole or exemestane), which lower oestrogen further after breast cancer, can cause carpal tunnel syndrome and trigger finger, at up to 10 times the rate seen with tamoxifen, in a review of 19 studies. The NHS asks you to call a doctor or NHS 111 if the joints or tendons in your arms feel weak, painful or swollen, and not to stop the tablets without advice.
Sources 19, 20
Tingling fingers are more often the wrist than the elbowStrong evidence
In UK general practice, carpal tunnel syndrome at the wrist was diagnosed in about 193 women and 88 men per 100,000 a year, most often in women aged 45 to 54. The ulnar nerve at the elbow is somewhat less common in women: in one Italian area, nerve tests confirmed it in 17.2 women and 32.7 men per 100,000 a year.
Ulnar nerve symptoms are tingling in the ring and little fingers, worse leaning on the elbow or with it bent. Constant numbness, weakness or visible wasting of the hand needs referral, urgently if it is permanent, UK hand surgeons and an NHS service say.
Sources 21, 22, 23, 24
Arthritis at the elbow in women: more often rheumatoid than wearStrong evidence
Osteoarthritis that starts in the elbow mainly affects middle-aged men who have done heavy manual work; otherwise it usually follows an old injury. Rheumatoid arthritis is about twice as common in women (0.93% against 0.40% of UK adults) and often reaches the elbow over the years; in one German clinic, ultrasound found fluid in the elbow in 55% of people with rheumatoid arthritis.
The National Institute for Health and Care Excellence (NICE) asks GPs to refer suspected rheumatoid arthritis to a specialist, urgently if more than one joint is affected, the small joints of the hands or feet are involved, or it has lasted 3 months or more.
Sources 25, 26, 27, 28, 29, 30, 31
Some causes are more common in menEmerging evidence
A swollen bursa on the point of the elbow is more common in men and with age. Torn biceps tendons at the front of the elbow are rare (about 1.2 per 100,000 people a year) and happen "rarely in women"; in one series of 13 women, most tears were partial and half came on gradually, sometimes with a lump, rather than with a sudden pop.
Sources 32, 33, 34, 35, 36
Pregnancy: no study of the elbowStrong evidence
No study has looked at elbow pain in pregnancy. The arm problems of pregnancy with evidence behind them are at the wrist: carpal tunnel syndrome, which "sometimes gets better by itself in a few months, particularly if you have it because you're pregnant", the NHS says, and pain on the thumb side of the wrist (De Quervain's), common after the birth.
Sources 37, 38
The heart: arm pain is as common in women's heart attacks as men'sStrong evidence
In 27 studies of heart attacks and unstable angina, left arm or shoulder pain was reported by 38% of women and 37% of men; women more often had pain between the shoulder blades, sickness and breathlessness, and chest pain was still the commonest symptom. The NHS asks you to call 999 for arm pain that comes on suddenly with pressure, heaviness or squeezing across your chest, and heart pain can spread to either arm. Women sometimes have the less well-known symptoms rather than chest pain, the British Heart Foundation says.
Sources 39, 40, 41, 42
When a scan or test helpsStrong evidence
Tennis and golfer's elbow are diagnosed from what you describe and an examination: "Plain radiographs of the elbow are not essential", the UK care pathway says, and scans are rarely needed without a fall or an injury, an NHS leaflet adds.
Tests answer specific questions: an X-ray after a fall when the elbow won't fully straighten, as about half of those have a fracture; nerve tests for a nerve problem in specialist care; blood tests and X-rays of the hands and feet for suspected rheumatoid arthritis, without delaying the referral; fluid drawn from a swollen bursa or joint when infection or gout is possible; and an electrocardiogram (ECG) and blood tests for a suspected heart attack.
Sources 3, 11, 43, 23, 31, 33, 44
How it usually goesStrong evidence
In the no-treatment and placebo groups of 24 trials, 89% of people with tennis elbow were much better or recovered at a year, the share still unimproved halving every 2.5 to 3 months, and how long it had lasted before didn't change the odds. "It can take between 6 and 24 months to settle", an NHS leaflet says. In one US county, it came back within 2 years in about 1 in 12 people.
Golfer's elbow follows a similar course, on thinner evidence, and early ulnar nerve symptoms often settle with changes of position. No one can promise a timescale.
Sources 45, 46, 11, 4, 47, 23
