• Frequent pre-existing migraine attacks, especially 8 to 14 headache days/month.
• Overuse of acute headache medicines. This can itself sustain near-daily headaches:
  • Simple analgesics such as paracetamol/acetaminophen or NSAIDs: typically 15+ days/month
  • Triptans, opioids, ergot medicines, butalbital-containing or caffeine-combination painkillers: typically 10+ days/month
    The American Migraine Foundation’s medication-overuse guidance explains these thresholds.
• Obesity
• Depression, anxiety, and chronic stress
• Poor sleep, snoring, or obstructive sleep apnea
• High caffeine intake or caffeine withdrawal
• Stressful life events
• Female sex and hormonal influences
• Genetic susceptibility or family history
• Cutaneous allodynia, where normally harmless touch, such as combing hair, becomes painful

1. Osteoarthritis
   • Age-related joint cartilage wear, sometimes following an old injury or years of heavy/repetitive arm use.
   • Causes pain, stiffness, reduced ability to straighten or rotate the elbow, clicking or grating, and sometimes swelling.
   • Risk rises after 45 and osteoarthritis is more common in women. See NHS elbow osteoarthritis information.
2. Tendon problems from overuse
   • Tennis elbow: pain on the outer elbow, often worse with gripping, lifting a kettle, opening jars, or using the wrist.
   • Golfer’s elbow: pain on the inner elbow, often worse with wrist flexion or carrying.
   • These can occur without playing sports and are related to repetitive hand, wrist, or lifting activities.
3. Olecranon bursitis
   • Inflammation of the small fluid sac over the bony tip of the elbow.
   • Produces a noticeable soft swelling, tenderness, and pain. It may follow repeated leaning on the elbows, minor injury, rheumatoid arthritis, or gout.
   • If it is warm, red, rapidly enlarging, or associated with fever, infection must be excluded.
4. Rheumatoid arthritis or another inflammatory arthritis
   • More common in women than men.
   • Often causes persistent swelling and stiffness, especially morning stiffness lasting over 30 minutes. Both elbows or other joints, such as hands and wrists, may be affected.
   • The Arthritis Foundation overview notes that rheumatoid arthritis commonly affects corresponding joints on both sides.
5. Gout or calcium-crystal arthritis
   • Can cause sudden severe pain, redness, warmth, and swelling. Gout can affect the elbow, including the bursa, although it more often begins in the big toe.
6. Nerve compression
   • Compression of the ulnar nerve at the elbow can cause aching near the inner elbow plus tingling or numbness in the little finger and half of the ring finger, sometimes with weak grip.
7. Pain referred from elsewhere
   • Neck arthritis or a pinched nerve in the neck can cause pain that travels into the elbow, arm, or hand.
   • Shoulder problems may also be felt around the upper arm or elbow.
8. Fracture or injury
   • A fall, even one that seemed minor, can cause a fracture in older adults, particularly with osteoporosis.
9. Menopause-related joint aching
   • Falling estrogen levels around perimenopause and menopause can contribute to generalized joint aches, but focal or persistent elbow pain still needs assessment for a local cause. The NHS joint-pain guidance includes menopause among possible contributors to painful joints.

At home for 1 to 2 weeks

• Reduce activities that provoke pain, especially repetitive gripping, lifting, twisting, or leaning on the elbow. Do not completely immobilize it.
• Apply a cold or heat pack wrapped in a towel for 10 to 15 minutes at a time, several times daily. Use whichever helps more.
• Keep gentle movement: slowly bend and straighten the elbow a few times daily within a comfortable range.
• Consider paracetamol/acetaminophen if it is safe for her to take.
• An anti-inflammatory gel such as topical ibuprofen or diclofenac may help tendon or arthritis pain and generally causes fewer whole-body side effects than anti-inflammatory tablets. Do not use if there is an allergy or a clinician has advised against it.
• Oral ibuprofen, naproxen, or similar medicines should only be used after checking with a doctor or pharmacist in an older person, especially if she has kidney disease, stomach ulcer/bleeding, heart disease, high blood pressure, takes blood thinners, or is on certain BP medicines.

According to the likely cause

• Tennis or golfer’s elbow (tendon pain): activity modification, a forearm strap or elbow brace, and physiotherapy-guided stretching and gradual strengthening. Steroid injections can give short-lived relief but may not help long-term and can weaken tendon tissue, so they are not routinely the best first option.
• Osteoarthritis: regular gentle exercise, maintaining arm strength and range of motion, topical anti-inflammatory medication, and physiotherapy. A clinician may consider an X-ray if there is persistent stiffness, deformity, locking, or loss of movement.
• Bursitis, with swelling over the elbow tip: avoid leaning on it, use padding/compression and ice. It should be medically assessed if swollen. Do not massage, puncture, or inject it at home.
• Rheumatoid or inflammatory arthritis: needs medical assessment and blood tests. Treating the inflammation early with specialist medication helps protect joints.
• Ulnar nerve irritation: avoid prolonged elbow bending and resting the elbow on hard surfaces; an elbow pad or night splint can help. Persistent finger numbness or weakness needs review.

Get urgent medical care today if

• the elbow is red, hot, very swollen, or there is fever, chills, or feeling unwell
• pain started after a fall and she cannot move the arm, there is deformity, or severe bruising
• there is new or worsening numbness, hand weakness, or loss of grip
• arm pain occurs with chest pressure, breathlessness, sweating, or nausea.