Elbow pain in Vienna
The elbow makes itself felt when you grip, when you prop yourself up or when you lift. Sometimes it starts gradually after weeks at a desk, sometimes suddenly after a fall. In my practice at the Orthozentrum Döbling I establish which structure is causing the symptoms.
In short
Elbow pain is a leading symptom, not a diagnosis. Behind it there are usually irritated tendon insertions on the outer or inner side, a loss of movement from scarring or osteoarthritis, instability, a fracture after a fall or a compressed nerve. Where the pain is located and which movement triggers it narrows down the cause. I assess the symptoms through the consultation, the clinical examination and ultrasound. The findings determine the course: I usually treat irritated tendon insertions and early osteoarthritis conservatively; with a completely torn tendon, an unstable dislocation or a displaced fracture, on the other hand, I raise surgery at an early stage.
Possible causes of elbow pain
At the elbow, the humerus, the ulna and the radius meet. Tendon insertions, collateral ligaments and nerves run close beneath the skin here. What takes us further is the question of which side hurts and which movement triggers the pain.
Pain on the outer side when gripping
A tender spot on the outer bony prominence and pain when gripping firmly suggest epicondylitis lateralis (tennis elbow), an irritation of the tendon insertion of the wrist extensors. Keyboards and tools trigger it as often as racket sports. More on this on the page about the treatment of tennis elbow and golfer's elbow.
Pain on the inner side when bending
If the pain is on the inner side and pulls when you bend the wrist or throw, it is usually epicondylitis medialis (golfer's elbow), an irritation of the flexor tendon insertions. The ulnar nerve runs right next to them; I therefore always check whether the nerve is involved.
The arm can no longer be fully straightened
If full extension or flexion is lacking, or if the joint locks during movement, possible causes are scarring after an injury, osteoarthritis of the elbow and loose bodies. What can be done for a stiff elbow depends on whether the capsule, bone or cartilage is limiting the movement.
Symptoms after a fall or a dislocation
A fall onto the outstretched hand transmits the force into the elbow: swelling, tenderness on the outer side and painful rotation of the forearm are consistent with a radial head fracture. If the joint was dislocated, stiffness and a feeling of unsteadiness often remain — see the pages on elbow dislocation and elbow instability.
Numbness in the ring and little finger
Tingling, a furry feeling in the fingers and a weakening grip, often at night or with the arm bent, suggest cubital tunnel syndrome, the compression of the ulnar nerve at the elbow. If, on the other hand, the thumb, index and middle finger fall asleep, this points to carpal tunnel syndrome.
Sudden loss of strength when lifting
An audible tear while lifting a load, bruising in the crook of the elbow and loss of strength when turning the forearm outwards point to a tear of the distal biceps tendon; the details are on the page about the distal biceps tendon. Less often the triceps tendon tears, usually in strength sports — more on this on the page about the triceps tendon rupture.
How I make the diagnosis
It begins with a conversation about onset, triggers, occupation and sport. Then I examine you clinically: I palpate the tendon insertions, the joint lines and the ulnar nerve, measure the range of movement in comparison with the other side and test the collateral ligaments. Ultrasound is available in my practice; it shows the tendons, any effusion and the nerve in motion. Where needed, I arrange an X-ray or an MRI outside the practice, and for nerve symptoms a neurological nerve conduction study. The page on the elbow specialist in Vienna gives an overview.
When a prompt assessment matters
Do not wait if there is a visible deformity after a fall, if the joint can hardly be moved, if there is a sudden loss of strength with an audible tear, increasing numbness, or redness, warmth and fever. I also see acute cases outside regular consultation hours.
Treatment: the findings decide
What is treated is the cause. With irritated tendon insertions, I first change the strain that triggers them: grip, tools, training volume. Physiotherapy to build up the forearm muscles is added; it takes place in-house at the Orthozentrum Döbling. In the practice I have shockwave therapy in focused and radial form, ultrasound-guided injection, magnetic field therapy and PRP therapy at my disposal. With a loss of movement, movement therapy takes priority. The situation is different with a freshly torn tendon, an unstable dislocation or a displaced fracture: here I raise surgery at an early stage rather than first exhausting the conservative route. In every case, the aim is to relieve the pain and to restore the function of the elbow.
When an operation is necessary
If the symptoms persist, or if the findings show damage that will not heal on its own, I discuss the surgical route with you. Much can be addressed through elbow arthroscopy: arthrolysis (release of scar tissue), removal of obstructing bony prominences and removal of loose bodies. I use open surgery for ligament reconstruction, release of the ulnar nerve and fractures. I carry out necessary procedures at the ATOMOS Klinik Währing, the Privatklinik Döbling or the Rudolfinerhaus, and I accompany you from planning through the procedure to aftercare. Whether an operation makes sense depends on the findings — it is discussed and decided together once all the results are available.
Frequently asked
Common questions about elbow pain
An examination makes sense if the pain persists for weeks, returns with every strain or if extension is diminishing. You should have the following assessed promptly: a deformity after a fall, a sudden loss of strength with an audible tear, increasing numbness in the fingers, and redness, warmth and fever.
Usually epicondylitis lateralis (tennis elbow): the tendon insertion of the wrist extensors at the outer bony prominence is irritated. Typical signs are a palpable tender spot and pain when gripping firmly. Less often, loose bodies, cartilage damage or an irritated tendon at the radial head are behind it. Examination and ultrasound narrow this down.
A loss of extension develops when the joint capsule scars after an injury, when bony outgrowths strike against each other or when a loose body becomes trapped. An effusion also blocks full extension. Because the elbow is prone to stiffness, I investigate a persistent loss of movement rather than simply watching it.
Tingling or numbness in the ring and little finger points to compression of the ulnar nerve at the elbow, known as cubital tunnel syndrome. It often becomes noticeable at night or when the arm is bent for a long time; later, loss of strength in the hand follows. If the thumb, index and middle finger fall asleep, the narrowing is more likely to be in the carpal tunnel.
That depends on the cause. For irritated tendon insertions I use shockwave therapy, ultrasound-guided injection, magnetic field therapy and PRP therapy, together with physiotherapy and an adjustment of the strain. With stiffness, movement therapy takes priority; with nerve symptoms, the focus is on relieving pressure on the nerve.
When the findings call for it or when conservative treatment is not enough. This applies, for example, to a displaced fracture, a torn tendon, recurrent instability, a compressed nerve or stiffness caused by scarring. Much of this I treat arthroscopically, some of it with open surgery. The findings, your age and your occupation are all taken into account.
My practice is a private practice, in Austria a Wahlarztordination. I do not settle directly with any public health insurer; you receive an invoice and submit it to your insurer — on request I take care of the submission for you. For an operation, direct settlement with a supplementary private insurance is possible.
Dr. med. Martin Eigenschink
Specialist in Orthopaedics and Traumatology · Specialist in elbow, shoulder and hand surgery
Surgical and conservative treatment of the elbow, shoulder and hand, preferably minimally invasive. Practice at the Orthozentrum Döbling, 1190 Vienna. More about my background
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Medical notice: The contents of this page serve as general information. They do not replace a medical examination, diagnosis or individual advice. Medicine is a constantly evolving field — despite careful research, no guarantee can be given that the content is fully up to date.