Pain on the inside of the elbow when lifting, gripping, or flexing the wrist is a common complaint, often signaling an issue in the forearm’s muscle-tendon unit. This discomfort, which can range from a dull ache to a sharp sensation, is typically centered around the bony prominence on the inner side of the elbow. The pain is frequently aggravated by activities that require forceful grasping, carrying, or bending the wrist toward the palm against resistance. Understanding the primary cause of this pain pattern is the first step toward finding relief and safely returning to normal activity.
Understanding Medial Epicondylitis
The most frequent source of pain on the inside of the elbow is medial epicondylitis, often called Golfer’s Elbow. This condition involves the common flexor tendon, where several forearm muscles converge and attach to the medial epicondyle, the bony bump on the inner side of the elbow. These muscles, including the flexor carpi radialis and the pronator teres, are responsible for bending the wrist and turning the forearm palm-down.
The injury mechanism is typically degeneration resulting from chronic, repetitive strain, rather than an acute tear. Activities involving repeated forceful wrist flexion and gripping, such as weightlifting or using hand tools, cause micro-tears in the tendon fibers. Over time, this trauma leads to structural changes in the tendon, a process known as tendinosis.
The primary symptom is tenderness and pain located just below the medial epicondyle, the tendon’s point of origin. This pain is often exacerbated by resisting wrist flexion, such as when carrying a heavy suitcase or pulling a bar during a lift. Patients may also notice stiffness in the elbow, particularly upon waking, and a decrease in grip strength. The discomfort may radiate downward along the inner side of the forearm toward the wrist.
Other Causes of Inner Elbow Discomfort
While medial epicondylitis is the most common diagnosis, inner elbow pain can also stem from other issues. Ulnar nerve entrapment, known as Cubital Tunnel Syndrome, involves the compression of the ulnar nerve as it passes through a tunnel on the back of the medial epicondyle. Unlike tendon pain, this condition causes neurological symptoms, specifically numbness and tingling that affects the ring and pinky fingers.
The Ulnar Collateral Ligament (UCL) provides stability to the elbow joint against outward-bending forces. UCL injuries, ranging from a strain to a complete tear, are typically acute and common in overhead or throwing athletes due to intense stress placed on the elbow. In contrast to the gradual onset of epicondylitis, a UCL injury often presents as sudden, sharp pain accompanied by a feeling of instability during a forceful action.
Immediate Steps for Pain Relief
Initial management of medial elbow pain focuses on reducing strain on the injured tendon. The first step is activity modification, which involves identifying and avoiding movements that trigger pain, such as heavy gripping or forceful wrist flexion. Temporarily changing the grip used during weightlifting or reducing the load allows the affected tissues to rest.
Applying ice to the tender area for 15 to 20 minutes several times a day helps manage acute pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can also temporarily manage pain. Gentle stretching of the wrist flexor muscles is beneficial; this involves extending the affected arm, palm up, and using the opposite hand to pull the fingers downward toward the body. Stop the stretch immediately if it increases pain.
A counterforce forearm brace or strap, worn just below the elbow, is another helpful self-care measure. This device compresses the forearm muscles, shifting tension away from the tendon origin at the medial epicondyle. This reduction in strain can provide immediate pain relief during necessary activities.
Professional Treatment and Rehabilitation
If pain persists despite conservative home management for several weeks, or if weakness and numbness are present, consult a healthcare professional. Physical therapy (PT) is the primary structured treatment for chronic tendon issues. Rehabilitation focuses on a progressive loading program, emphasizing eccentric exercises.
Eccentric exercises involve the controlled lengthening of the muscle under tension, such as slowly resisting the downward motion of the wrist while holding a light weight. This specific training helps the tendon adapt to load, improving its strength and resilience.
Medical Interventions
Medical interventions are typically reserved for cases that do not respond to physical therapy and rest. Corticosteroid injections may offer short-term pain relief, but they are not recommended as a long-term solution.
A newer, regenerative approach is Platelet-Rich Plasma (PRP) therapy, which involves injecting a concentration of the patient’s own platelets into the injured tendon. PRP is thought to promote healing by delivering growth factors directly to the damaged tissue. Evidence suggests PRP may be superior to corticosteroids in providing sustained functional improvement. Surgery is considered a last resort for chronic cases that fail to improve after six to twelve months of comprehensive non-surgical treatment.