Why Elbow Pain Is Often Misunderstood
The elbow is a deceptively complex joint — it is actually three joints in one, consisting of the humeroulnar, humeroradial, and proximal radioulnar articulations. Pain at or around the elbow can originate from any of these joints, from the tendons that cross the joint, from the bursae, from the nerves that pass through the cubital tunnel, or from referred pain from the cervical spine or shoulder. Getting the diagnosis right is essential to getting the treatment right.
At Pittsburgh Physical Medicine, elbow complaints are systematically evaluated to identify the primary pain generator before treatment begins.
Common Elbow Conditions We Treat
Lateral Epicondylitis (Tennis Elbow)
The most common elbow condition we see, lateral epicondylitis involves degeneration of the common extensor tendon at the lateral (outer) epicondyle of the humerus. Despite the name, most patients have never played tennis. Repetitive wrist extension and grip loading are the primary drivers. Pain is located on the outer elbow and worsens with gripping, lifting, and wrist extension.
Medial Epicondylitis (Golfer's Elbow)
Medial epicondylitis involves the common flexor-pronator tendon at the medial (inner) epicondyle. Pain is located on the inner elbow and worsens with wrist flexion and forearm pronation. It is common in golfers, baseball pitchers, climbers, and manual laborers.
Cubital Tunnel Syndrome
Compression of the ulnar nerve at the cubital tunnel (the groove on the inner elbow) causes numbness and tingling in the ring and little fingers, weakness of intrinsic hand muscles, and a deep aching pain on the inner elbow. It is the second most common nerve entrapment in the upper extremity after carpal tunnel syndrome.
Olecranon Bursitis
Inflammation of the olecranon bursa — the fluid-filled sac at the point of the elbow — causes a visible swelling and tenderness at the elbow tip. It can result from direct trauma, repetitive pressure (leaning on the elbow), or systemic inflammatory conditions.
Distal Biceps Tendinopathy
Degeneration or partial tearing of the distal biceps tendon at its insertion on the radial tuberosity causes deep anterior elbow pain with forearm supination and elbow flexion under load.
Referred pain: It is worth noting that cervical nerve root compression at C6 or C7 frequently refers pain to the elbow and forearm, mimicking lateral or medial epicondylitis. We always screen the cervical spine during elbow evaluations.
Treatment at Pittsburgh Physical Medicine
Graston Technique (IASTM)
For epicondylitis and tendinopathy, Graston technique is one of the most effective interventions available. It breaks down collagen cross-links within degenerative tendon tissue, stimulates new collagen synthesis, and reduces adhesions in the surrounding musculature.
Shockwave Therapy
ESWT has strong evidence for lateral epicondylitis — particularly chronic cases that have failed other conservative treatments. It stimulates the body's healing cascade within the tendon without surgery or injection.
Physical Therapy
Eccentric loading protocols for epicondylitis, nerve gliding exercises for cubital tunnel syndrome, and progressive strengthening programs are designed by Dr. Crockatt, DPT, based on a precise biomechanical assessment.
Suffering from Elbow Injuries and Disorders?
Our team at Pittsburgh Physical Medicine treats this condition with chiropractic care, physical therapy, and soft tissue techniques — under one roof in East Liberty, Pittsburgh.
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