Summary
Causes
- Tennis Elbow
(Lateral Epicondylitis) - Dislocated Elbow
- Radial Head Fractures
- Golfers Elbow
- Bursitis (Joint Inflammation)
- Olecranon Fracture
- Cupital Tunnel Syndrome
- Sprain, Strains and other Soft Tissue Injuries
- Broken Arm
- Rheumatoid Arthritis
Elbow pain often results after repetitive strain injury. Many hobbies like playing tennis or golf and many sports require repetitive arm movements which can strain the tendons around the elbow and result in pain.
Occasionally elbow pain can happen because of wear and tear (arthritis) but in general the elbow joint is much less prone to wear and tear damage than any other joints.
Some of the more common causes that can result in pain to the elbow include tennis elbow, golfers elbow, bursitis, dislocated elbow, broken bones around the elbow, osteoarthritis, rheumatoid arthritis, trapped nerve etc.
Tennis Elbow ( Lateral Epicondylitis )
Tennis elbow is a painful condition which happens when the tendons on the outside of your elbow; usually secondary to repetitive movements gets strained and becomes painful.
As the name suggests it can happen in people who play tennis along with plumbers, painters, carpenters and butchers.
Patients will normally feel pain where the tendons of your forearm muscles attach to a bony bump on the outside of your elbow. Pain can travel into your forearm and wrist.
Main stay of treatment for tennis elbow is muscle stretching and strengthening exercises for which you will be referred to a physiotherapist. Occasionally steroid injections or platelet rich plasma injections are used. Very occasionally keyhole surgery is done to relieve the symptoms.
Dislocated Elbow
This happens when the bones that make up the elbow joint are forced out of alignment. This can happen during sports or a fall on an outstretched arm. Shoulder and elbow joints are the two most common joints that get dislocated in adults. In children, elbow is the most common joint that gets dislocated.
In toddlers if they are lifted or swung by their forearms, elbow may dislocate known as a pulled elbow or nursemaids elbow.
If it happens you will experience pain and you will not be able to move the joint, a toddler will avoid using the arm.
If this happens you must see your doctor immediately. Bones can be realigned i.e. joint can be reduced by a simple manoeuvre in accident and emergency or in a clinic.
Radial Head Fractures
Radius is one the two bones on your forearm. Radial head is essentially the knobbly end of the bone where it meets your elbow.
In case of a fracture you will notice pain, bruising, swelling and inability to rotate your forearm.
Golfers Elbow
Golfers elbow is similar to tennis elbow but in this condition, pain happens on the inside of the elbow. It will happen because of the repetitive strain injury to the tendons of your forearm muscles which attach on a bony bump on the inside of your elbow.
Like tennis elbow most patients will respond to muscle strengthening and stretching exercises. Very occasionally this is managed with steroid injections and even rarely with an operative procedure.
Bursitis (Joint Inflammation)
Bursa is a fluid filled sac that cushions your elbow. Bursa can become irritable in people that lay onto their elbows or with certain jobs which involves laying onto elbows. Bursa becomes irritable and a swelling comes up behind the elbow. In most cases bursitis will go away by simply avoiding irritation to it. Occasionally, you will have to seek medical attention where the fluid is drained and a steroid injection is injected into the bursa. Very occasionally this bursal sac has to be surgically removed.
If you have bursitis the joint may feel achy, stiff and hurts when you move it. You will have to consult your doctor if there is excessive swelling, redness, associated fever etc.
Elbow Arthroscopy
Is a keyhole surgery which involves tiny cuts around your elbow. The surgeon will insert a small camera called an arthroscope into your elbow joint. The camera displays pictures on the screen which the surgeon will use to guide surgical instruments and deal with conditions like tennis elbow, removal of loose bodies, debridement of arthritis etc.
Olecranon Fracture
Olecranon is the bony tip of the elbow. It can break easily if there is a direct blow to the elbow or a fall. If the bones displace then you may need an operative fixation.
Otherwise this can be managed in a plaster for a few weeks followed by physiotherapy.
Cubital Tunnel Syndrome (Ulnar Nerve Entrapment behind the Elbow Joint)
In this condition you will experience pins, needles and numbness to the ring and the little finger. This happens because a nerve gets entrapped behind the inside of your elbow. If the symptoms are persistent you will need to seek medical attention where your doctor will take medical history, do an examination to your elbow and hand and then order a nerve test. Mild symptoms can be managed with a splint and steroid injections. Severe symptoms will need a surgical release to the nerve.
Sprain, Strains and other Soft Tissue Injuries
Elbow joint is surrounded by muscles, tendons and the bones are attached to each other through cord like structures known as ligaments. Injuries to these soft tissues can happen during sports, exercises or from repetitive strain.
More often than not they can be managed non-operatively with physiotherapy, splints and steroid injections.
Broken Arm
Broken arm can involve one of the three bones in your arm- the radius, Ulna or the humerus. It happens most commonly secondary to a fall on an outstretched hand. If it happens seek medical attention as it is important to treat a fracture as soon as possible for good healing, function and strength.
Treatment will depend on the severity of the injury. A simple break can be treated with a sling and analgesia. However, if the bones are displaced; they may need an operative fixation which will involve realigning the broken bones and then holding it with plates and screws or nails or wires.
Rheumatoid Arthritis
It is a chronic inflammatory disorder that starts to affect your finger and hand joints and then go on to involve other big joints in your body. It happens when the immune system in your body mistakenly attacks your own body tissues. It affects the lining of your joints which results in the destruction of the lining (cartilage). This results in arthritis where the involved bones rub on each other. You may notice pain, swelling and limited movements.
These days the modern medications can in most of the cases, dramatically reduce the severity and control the progression of the disease. Very occasionally you may need a surgical intervention.
In the upper limb it can affect shoulder, elbow, hand and wrist and can result in pain, swelling, deformity, loss of function etc.
Your doctor will take a detailed history and examine the relevant joints. Mainstay of treatment will be to make daily changes to your life and to make adjustments to your home situation. You will be seen by a physiotherapist and an occupational therapist and a rheumatology doctor who will manage this with medications.
Occasionally, if the joint is swollen, deformed, painful and you have got loss of function you will need surgical intervention.
BMI Chelsfield Park Hospital
Bucks Cross Road Chelsfield ORPINGTON BR6 7RG
01689 877855
BMI The Blackheath Hospital
40-42 Lee Terrace Blackheath LONDON SE3 9UD
020 8318 7722
BMI The Sloane Hospital
125 Albemarle Road BECKENHAM BR3 5HS
020 8466 4000
Princess Royal University Hospital
Farnborough Common ORPINGTON BR6 8ND
01689 863223