Referred Pain (Elbow)
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What is referred pain?
Referred pain is a term given to pain that is felt in one region of your body although it originates from another. This is commonly seen in clinical practice.
There are several structures in the body that, when injured, may cause the patient to experience pain in the elbow. This can occur even though there may be nothing wrong with the elbow itself.
Causes of referred pain to the elbow
The neck, upper back and shoulder are some of the most common areas of the body that, when injured, may cause referred pain to the elbow (figure 1).
Figure 1 – Areas of the body that may cause pain in the elbow
In addition, increased neural tension (tight nerves) may also contribute to the development of symptoms. Some of the more common conditions which may cause these symptoms include:
Signs and symptoms of referred pain to the elbow
Patients with elbow pain that is referred from another source may or may not experience symptoms from the originating source. Patients typically experience a dull ache in the elbow that is poorly localized and may vary in severity or location. They may also experience pain or stiffness in other locations in the body such as the neck, upper back, shoulder, arm or forearm. Occasionally pain may also be felt in the wrist or hand. These symptoms are usually experienced on the same side of the body as the elbow pain, although sometimes, the opposite side or both sides may be affected. Occasionally patients may also experience pins and needles or numbness in the affected arm. This most commonly affects the hand and can sometimes affect the other arm or both arms.
Patients with referred pain to the elbow normally experience restricted movement and abnormalities on assessment (such as tenderness on palpation) in the specific region of the body causing the pain. Local assessment of the elbow may demonstrate no significant abnormalities although patients may experience tenderness on firmly touching the elbow region. In long standing cases of elbow pain that is referred form another source, patients may develop muscle tightness in the muscles of the elbow.
Diagnosis of referred pain to the elbow
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose pain that is referred to the elbow and the underlying cause of symptoms. Further investigations such as X-rays, MRI or CT scans are often required to assist with diagnosis.
Treatment for referred pain to the elbow
Treatment for patients with elbow pain that is referred from another source varies greatly depending on the cause. Accurate diagnosis from a physiotherapist or doctor is therefore required to determine the most appropriate treatment. Treatment of the underlying cause of symptoms should result in improvement in the elbow pain.
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