Elbow Pain With Gripping or Lifting: Tennis Elbow vs. Golfer’s Elbow vs. Nerve Entrapment

Elbow pain that appears when gripping objects, lifting groceries, shaking hands, opening jars, or using tools is a surprisingly common complaint. For some people, the pain begins as mild soreness but gradually worsens until even simple tasks such as holding a coffee cup or typing on a keyboard become uncomfortable.

Three conditions account for a large proportion of elbow pain related to gripping or lifting: tennis elbow, golfer’s elbow, and nerve entrapment around the elbow. While these conditions may feel similar at first, they involve different structures of the elbow and require different approaches to treatment.

Understanding the differences between these causes of elbow pain can help patients seek the right care early and prevent chronic pain or long-term functional limitations.

The elbow is a complex joint that connects the upper arm bone (humerus) to the two forearm bones (radius and ulna). Several muscles, tendons, and nerves pass around the elbow to control wrist movement, hand grip, and finger motion.

When you grip, twist, or lift objects, the muscles of the forearm generate force through tendons that attach around the elbow. These tendons are responsible for movements such as bending the wrist, extending the wrist, rotating the forearm, and stabilizing the hand during gripping tasks.

Repetitive strain, sudden overload, or compression of nearby nerves can cause inflammation or injury in this area. As a result, activities that activate the forearm muscles—especially gripping or lifting—can trigger pain.

Common causes of elbow pain during gripping include:

• Overuse injuries of forearm tendons
• Degeneration of tendon fibers from repetitive strain
• Compression of nerves near the elbow
• Muscle imbalances or poor ergonomics
• Repetitive occupational movements

Two of the most common tendon conditions affecting the elbow are tennis elbow and golfer’s elbow, while nerve entrapment can also produce similar symptoms.

Tennis elbow, medically called lateral epicondylitis, is one of the most common causes of pain on the outer side of the elbow. Despite the name, most people who develop this condition have never played tennis.

The problem occurs when the tendons that extend the wrist become irritated or damaged where they attach to the outer part of the elbow. Repetitive strain can cause small microscopic tears in these tendons, leading to pain and weakness.

People with tennis elbow usually notice pain on the outside of the elbow that worsens with gripping or lifting. The discomfort may begin gradually and become more intense over time.

Common symptoms include:

• Pain on the outer side of the elbow
• Pain when gripping objects or shaking hands
• Weak grip strength
• Pain when lifting objects with the palm facing downward
• Difficulty opening jars or turning door handles

Many patients also experience tenderness when pressing on the bony prominence on the outer elbow.

The pain can sometimes radiate down the forearm, especially during activities that involve wrist extension.

Although tennis players can develop this condition, it is frequently seen in people who perform repetitive arm movements.

Examples include:

• Computer use with repetitive mouse movements
• Painting or carpentry
• Plumbing or mechanical work
• Frequent lifting of objects
• Gardening or pruning

These repetitive motions place strain on the wrist extensor muscles that attach near the outer elbow.

How Tennis Elbow Develops

Research suggests that tennis elbow is often caused by tendon degeneration rather than acute inflammation. Repetitive stress can damage collagen fibers within the tendon, leading to a weakened tendon structure and persistent pain (1).

Over time, the tendon becomes less able to tolerate mechanical stress, making everyday movements painful.

Golfer’s elbow, medically called medial epicondylitis, affects the tendons on the inner side of the elbow. These tendons connect the muscles responsible for wrist flexion and forearm rotation.

Although the name suggests it occurs in golfers, this condition frequently affects people who perform repetitive wrist flexion or gripping activities.

Golfer’s elbow produces pain on the inner side of the elbow that may extend into the forearm.

Typical symptoms include:

• Pain on the inside of the elbow
• Tenderness near the inner elbow bone
• Pain during gripping or lifting
• Pain when bending the wrist or turning the forearm
• Weak grip strength

Some individuals also notice stiffness in the elbow or discomfort when making a fist.

Several occupational and recreational activities may trigger this condition.

Common risk factors include:

• Repetitive lifting with the palm facing upward
• Swinging sports equipment such as golf clubs or baseball bats
• Throwing sports
• Weightlifting
• Using hand tools that require gripping

Frequent wrist flexion and forearm rotation can strain the tendons on the inner elbow, leading to microtears and degeneration.

Differences Between Tennis Elbow and Golfer’s Elbow

Although both conditions involve tendon injuries near the elbow, the location of pain helps distinguish them.

Tennis elbow causes pain on the outer elbow, while golfer’s elbow causes pain on the inner elbow.

The movements that trigger pain may also differ slightly. Tennis elbow is commonly aggravated by wrist extension and gripping with the palm facing downward, while golfer’s elbow is often triggered by wrist flexion or gripping with the palm facing upward.

Not all elbow pain during gripping is caused by tendon injuries. Nerve compression around the elbow can also produce pain, weakness, or unusual sensations in the arm and hand.

Two nerves commonly affected near the elbow are the ulnar nerve and the radial nerve.

The ulnar nerve travels along the inner side of the elbow through a narrow passage known as the cubital tunnel. This nerve is responsible for sensation in the ring finger and little finger, as well as controlling certain hand muscles.

When the ulnar nerve becomes compressed or irritated, it can produce symptoms that mimic golfer’s elbow.

Symptoms of Ulnar Nerve Compression

People with ulnar nerve entrapment may experience:

• Tingling or numbness in the ring and little fingers
• Pain along the inner elbow
• Weak grip strength
• Difficulty with fine hand movements
• Increased symptoms when bending the elbow for long periods

Many people notice a “pins and needles” sensation when the elbow is bent for extended periods, such as while talking on the phone or sleeping.

Chronic compression can lead to muscle weakness in the hand.

Another nerve that can become compressed near the elbow is the radial nerve. Compression of this nerve may occur in a condition sometimes referred to as radial tunnel syndrome.

Radial nerve irritation may cause pain on the outer side of the elbow that resembles tennis elbow.

However, unlike tendon injuries, nerve entrapment may produce deeper aching pain and sometimes burning sensations in the forearm.

Symptoms can include:

• Pain on the outer elbow or forearm
• Pain that worsens with forearm rotation
• Weakness during wrist or finger extension
• Aching discomfort extending down the forearm

Because symptoms overlap with tennis elbow, nerve entrapment can sometimes be misdiagnosed.

A careful medical evaluation is essential to identify the underlying cause of elbow pain during gripping or lifting.

Doctors usually begin with a detailed history of symptoms and activities that trigger pain. The location of tenderness and the type of movements that reproduce pain can provide important clues.

Physical examination may involve tests that stress specific tendons or nerves around the elbow.

For example:

• Pain with resisted wrist extension may indicate tennis elbow.
• Pain with resisted wrist flexion may suggest golfer’s elbow.
• Tingling or numbness in the fingers may point toward nerve entrapment.

In some cases, imaging studies may be used.

Ultrasound and magnetic resonance imaging can help visualize tendon damage or inflammation. Nerve conduction studies may be used if nerve compression is suspected (2).

The treatment approach depends on the underlying cause of the pain. Fortunately, many cases improve with conservative management.

Reducing activities that aggravate the elbow is often the first step.

Patients may need to temporarily limit repetitive gripping, heavy lifting, or forceful wrist movements.

Ergonomic adjustments in the workplace can also help reduce strain on the elbow.

Physical therapy plays a major role in treating both tennis elbow and golfer’s elbow.

Exercises designed to strengthen the forearm muscles and improve tendon resilience can gradually restore function.

Eccentric strengthening exercises are particularly helpful for tendon injuries (3).

Stretching exercises may also improve flexibility and reduce tension around the elbow.

Forearm braces or straps can reduce stress on the affected tendons during activity.

These devices distribute force away from the tendon attachment at the elbow, allowing the injured tissue to heal.

Nonsteroidal anti-inflammatory medications may help relieve pain during the early stages of injury.

However, since many tendon injuries involve degeneration rather than inflammation, medication alone is usually not sufficient.

When nerve entrapment is present, avoiding prolonged elbow bending and pressure on the elbow can help reduce symptoms.

Night splints may sometimes be recommended to keep the elbow in a more neutral position during sleep.

In certain cases, physicians may recommend injection therapies.

.Options may include:

• Corticosteroid injections
• Platelet-rich plasma injections
• Other regenerative therapies

These treatments aim to reduce pain and promote tendon healing.

Surgery is rarely required but may be considered if symptoms persist despite months of conservative treatment.

Surgical procedures may involve removing damaged tendon tissue or relieving pressure on compressed nerves.

Many cases of elbow pain related to gripping can be prevented with proper conditioning and ergonomic practices.

Helpful strategies include:

• Strengthening forearm muscles regularly
• Using proper technique during sports or lifting
• Avoiding sudden increases in repetitive activity
• Using ergonomically designed tools
• Taking regular breaks during repetitive tasks

Early treatment of mild symptoms can also prevent more severe tendon damage.

People should seek medical evaluation if elbow pain:

• Persists for several weeks
• Interferes with daily activities
• Is associated with numbness or tingling in the hand
• Causes significant weakness in the arm

Early diagnosis improves the chances of recovery and helps prevent long-term complications.

Elbow pain that worsens with gripping or lifting is often caused by tennis elbow, golfer’s elbow, or nerve entrapment around the elbow. Although these conditions may produce similar symptoms, the underlying causes and treatment approaches differ.

Pain on the outer elbow is commonly associated with tennis elbow, while pain on the inner elbow may suggest golfer’s elbow or ulnar nerve compression. Nerve entrapment may also produce numbness, tingling, or weakness in the hand.

Accurate diagnosis and early treatment are important for restoring function and preventing chronic elbow pain. With appropriate activity modification, strengthening exercises, and medical care when needed, most individuals can recover and return to normal activities without long-term limitations.

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