Pain in the Elbow PDF Print E-mail
Tuesday, 16 February 2010 07:45

The elbow is one of the least injured joints because of its well matched joint surfaces and strong stabilizing ligaments. As a result, the elbow joint can tolerate large forces across it without becoming unstable. However, it can still become damaged due to osteoarthritis or overuse injuries such as tennis elbow (lateral epicondylitis), which can be caused by repetitive activities such as painting, cutting, or raking, as well as sports such as tennis. Wearing proper protective gear and taking precautions against overusing the elbow joint can help prevent elbow joint pain.


Here are some problems that may cause elbow pain:

1. Arthritis of the Elbow - Inflammation of the elbow joint (arthritis) can occur as a result of many systemic forms of arthritis, including rheumatoid arthritis, gouty arthritis, psoriatic arthritis, ankylosing spondylitis, and reactive arthritis (formerly called Reiter's disease). Generally, they are associated with signs of inflammation of the elbow joint, including heat, warmth, swelling, pain, tenderness, and decreased range of motion. Range of motion of the elbow is decreased with arthritis of the elbow because the swollen joint impedes the range of motion. For more information on these conditions, please read the following articles: Rheumatoid Arthritis, Gout, Psoriatic Arthritis, Ankylosing Spondylitis, Reactive Arthritis.

tennis2. Tennis Elbow (Lateral Epicondylitis) - The lateral epicondyle is the outside bony portion of the elbow where large tendons attach to the elbow from the muscles of the forearm. These tendons can be injured, especially with repetitive motions of the forearm, such as using a manual screwdriver, washing windows, or hitting a backhand in tennis play. Tennis elbow results with inflammation of the tendons causing pain over the outside of the elbow, occasionally with warmth and swelling, but always with local tenderness. The elbow maintains its full range of motion, as the inner joint is not affected, and the pain can be particularly noticed toward the end of the day. Repeated twisting motions or activities that strain the tendon typically elicit increased pain. X-rays are usually normal, but can reveal calcium deposits in the tendon or reveal other unforeseen abnormalities of the elbow joint.

The treatment of lateral epicondylitis includes ice packs, resting the involved elbow, and antiinflammatory medications. Antiinflammatory medications typically used include aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) such as naproxen (Naprosyn), diclofenac, and ibuprofen. Bracing the elbow can help. Simple braces for tennis elbow can be found in community pharmacies and athletic goods stores. Local cortisone injections are given for persistent pain. Activity involving the elbow is resumed gradually. Ice application after activity can reduce or prevent recurrent inflammation. Occasionally, supportive straps can prevent reinjury. In severe cases, an orthopedic surgical repair is performed.

3.Olecranon Bursitis- This condition is when the bursa or the tip of our elbow becomes inflammed because of an injury or minor trauma, a result of systemic diseases such as gout or rheumatoid arthritis, or it may be caused by a local infection. Olecranon bursitis is typically associated with swelling over the tip of the elbow, while range of motion of the inner elbow joint is maintained.

first_aid_kit4. Fractures- The bones of the elbow can break (fracture) into the elbow joint or adjacent to the elbow joint. Fractures generally require immobilization and casts and can require orthopedic pinning or open joint surgery. If you have or suspect to have a fracture, call your orthopedic doctor as soon as possible.

rice5. Sprain- A sprain is a stretch or tear injury to a ligament. One or more ligaments can be injured during a sprain. This might occur when the elbow is hyperextended or simply jammed, such as in a "stiffarm" collision. The severity of the injury will depend on the extent of injury to a single ligament (whether the tear is partial or complete) and the number of ligaments involved. Treatment involves rest, ice, immobilization, compression, and antiinflammation medications.

6. Cellulitis- Inflammation of the skin related to infection (cellulitis) commonly occurs as a result of abrasions of the skin. When abrasions or puncture wounds occur, bacteria on the surface of the skin can invade the deeper layers of the skin. This causes inflamed skin characterized by heat, redness, warmth, and swelling. The most common bacteria that cause cellulitis include Staphylococcus and Streptococcus. Patients can have an associated low-grade fever. Cellulitis generally requires antibiotic treatment, either orally or intravenously. Heat application can help in the healing process. Cellulitis can lead to infection of the olecranon bursa, causing olecranon bursitis, as described above.

staphylococcus7. Infected Elbow Joint (Septic Arthritis)- Infection of the elbow joint with bacteria (septic arthritis) is uncommon. It is most often seen in patients with suppressed immune systems or diabetes, those taking cortisone medications, or intravenous drug abusers. The most common bacteria that cause infection of the elbow joint are Staphylococcus and Streptococcus. Septic arthritis of the elbow requires antibiotic treatment and often surgical drainage. It is characterized by swelling, warmth, redness, and pain, with limited range of motion of the elbow joint. Septic arthritis is often associated with fever, sweats, and chills.

8. Tumors- Bone tumors of the elbow joint are rare. Primary bone cancer can occur. It can be painless or associated with pain in the elbow joint. It is usually detectable by x-ray testing. Nuclear medicine bone scanning can also be helpful for detection.scalpel

9. Ulnar Nerve Entrapment- The ulnar nerve is the "funny bone" nerve which travels between the tip of the elbow and the inner elbow bone. At this site it can be "pinched" by normal structures or swollen structures after injury. This pinching is referred to as entrapment. When ulnar nerve entrapment occurs, numbness and tingling of the little and ring finger of the hand may be felt. Pain may occur in the entire forearm, usually the inner side. Hand dexterity can be affected. Sometimes, the numbness is reproduced by elevating the hand. Treatment consists of avoiding repeated trauma or pressure to the elbow area and resting the elbow joint. Occasionally, ice can help. In severe cases, surgical repositioning of the ulnar nerve can be required. This relocates the ulnar nerve to a position where it will not be continually compressed by the surrounding structures.


Article lifted from AAOS © 2009. all rights reserved