The elbow is the joint where three long bones meet in the middle portion of the arm. The bone of the upper arm (humerus) meets the inner bone of the forearm (ulna) and the outer bone of the forearm (radius) to form a hinge joint. The radius and ulna also meet in the elbow to allow for rotation of the forearm.
If you have elbow pain, a number of factors could be the cause. Overuse and sports injuries cause many elbow conditions: golfers, baseball pitchers, tennis players, and boxers often experience elbow pain and disorders.
Elbow disorders may involve arm muscles, elbow ligaments, tendons, and bones in the arm. The treatments for elbow disorders depend on the underlying cause of the pain.
CONDITIONS & SYMPTOMS
Common conditions and symptoms the doctors at IPM see and treat are the following:
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 is caused by inflammation of the tendons. Usually, the pain is on the outside of the elbow and might be accompanied by warmth and swelling. The elbow maintains its full range of motion, as the inner joint is not affected, and the pain is usually more noticeable toward the end of the day. Repeated twisting motions or activities that strain the tendon typically cause more pain. X-rays are usually normal, but can reveal calcium deposits in the tendon or other abnormalities of the elbow joint.
Medial epicondylitis is inflammation at the point where the tendons of the forearm attach to the bony prominence of the inner elbow. As an example, this tendon can become strained in a golf swing, but many other repetitive motions can injure the tendon. Golfer’s elbow is characterized by local pain and tenderness over the inner elbow. The range of motion of the elbow is preserved because the inner joint of the elbow is not affected. Those activities which require twisting or straining the forearm tendon can elicit pain and worsen the condition. X-rays for epicondylitis are usually normal but can show calcifications of the tendons if the tendinitis has persisted for long periods of time.
Olecranon bursitis is inflammation of the bursa at the tip of the elbow and can occur from injury or minor trauma, as a result of systemic diseases such as gout or rheumatoid arthritis, or can be due to 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
The bones of the elbow can break or 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.
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 anti-inflammation drugs.
Treatments for the Elbow
The treatment of elbow pain includes:
- Ice packs
- Resting the involved elbow
- Aspirin and anti-inflammatory medications like naproxen (Naprosyn), diclofenac (Voltaren), and ibuprofen (Motrin)
- Bracing the elbow or using a strap can prevent reinjury (found in community pharmacies and athletic stores)
- Local cortisone injections are given for persistent pain
- Gradual rehabilitation exercise programs
- Cellulitis requires antibiotic treatment, either orally or intravenously
- Septic arthritis of the elbow requires antibiotic treatment and often surgical drainage
- In severe cases, surgery might be recommended