23 Apr Tendon vs Nerve Pain in Upper Limb Injuries

Understanding whether your pain is coming from a tendon or a nerve is key to getting the right treatment. While both can affect the upper limb, they present very differently.

This guide will help you recognise the difference, understand common injuries, and know
when to seek professional care.

The difference between a tendon and a nerve

Tendons are strong, fibrous tissues that connect muscles to bones. They play a critical role in movement by transmitting the force generated by muscles to create joint motion.

Nerves are responsible for transmitting signals between your brain, spinal cord, and the rest of your body. They control both movement (motor function) and sensation (feeling).

How Do Tendon Injuries Present?

Tendon injuries are usually caused by overload, repetitive strain, or sudden trauma. Pain is typically localised, meaning you can point directly to where it hurts.

Common Tendon Injuries

Rupture (Complete Tear)

• Sudden, severe injury
• Often accompanied by a “popping” sound
• Immediate loss of movement
• Swelling and bruising
• Requires urgent medical attention (often surgical)

Partial Tear

Avulsion Injury

• Tendon pulls away from the bone
• Often caused by trauma
• Significant weakness or inability to move the joint
• Pain, swelling, and bruising

Tendinopathy (Overuse Injury)

• Gradual onset from repetitive activity
• Dull, aching pain
• Stiffness, especially after rest
• Pain with movement or loading

Managing Tendon Pain

• Short-term rest or immobilisation
• Gradual return to movement
• Strengthening and tendon-loading exercises
• Activity modification
• Taping or bracing if needed

When to See a Therapist for Tendon Pain

• Pain persists despite rest
• Swelling or stiffness limits movement
• Weakness affects daily tasks
• Sudden loss of function or severe injury

Symptoms may travel along a path rather than stay in one spot.

Common Nerve Conditions

Carpal Tunnel Syndrome (Median Nerve)

• Tingling in thumb, index, and middle and ring fingers
• Numbness, especially at night
• Weak grip strength

Read more about Carpal Tunnel Syndrome HERE

Helpful strategies:

Radial Nerve Palsy

• Difficulty lifting the wrist (“wrist drop”)
• Weakness in finger extension
• Burning or tingling on the back of the hand

Watch our video: Radial Nerve Palsy Rehabilitation

Helpful strategies:

• Splinting to support wrist position
• Gentle movement exercises
• Activity modification
• Soft tissue work

Cubital Tunnel Syndrome

• Tingling in ring and little fingers
• Numbness in hand and elbow
• Reduced grip and pinch strength

Concerned about your grip strength? Read more HERE

Helpful strategies:

• Avoid prolonged elbow bending
• Night splinting
• Ulnar nerve gliding exercises
• Strengthening and conditioning

When to Seek Help for Nerve Pain

• Symptoms occur daily or worsen over time
• Persistent numbness or tingling
• Noticeable weakness or loss of coordination
• Symptoms interfere with sleep or daily activities

In Summary

Tendon and nerve injuries can feel similar at first, but recognising the differences is essential for effective treatment. Early intervention can prevent long-term issues and help you return to normal function faster.

Key differences: Tendon Vs Nerve Pain

Tendon Pain = Localised to one area, aching or sharp with movement, worse with loading & strength limited by pain

Nerve pain = Travels along a path, tingling, burning, or numb, may occur at rest or night & true muscle weakness