Elbow Pain

Your elbow joint allows you to throw, lift, swing, hug, and so many other movements. You can do all this because it is not a simple joint. And that means there are lots of things that can go wrong with it.

Your elbow joint is formed by the ends of 3 bones coming together. The upper arm bone is called the Humerus, and the 2 lower forearm bones are called the Radius and Ulna.

Each bone has smooth cartilage on the ends, to allow smooth gliding of the joint and to absorb shocks. The bones are tied together with tough connective tissue called ligaments. Tendons connect your muscles to the bone and allow you to move your elbow in different ways.

If there is any injury to any of these, you may experience elbow pain.

Why does my elbow hurt?

Injuries:

Fractures

A fracture if when you have broken a bone. This may have occurred if you had a bad fall for instance. Even if you can still move your elbow afterward, don’t be fooled. If there is a lot of bruising, swelling or it just doesn’t feel right, do consult your doctor and get an X-ray done. A fracture may need to be fixed with metal implants such as a plate and screws.

Dislocation

A dislocation is when the bones forming the elbow joint are knocked out of alignment. This commonly occurs if you have fallen and broken the fall on your outstretched hand. A dislocation should be reduced (put back into the correct alignment) as soon as possible.

Sprains and strains

When muscles or tendons get over-stretched or partially torn it is called a strain. With ligaments it is called a sprain. These might occur when you overdo it during exercises or trying to lift heavy things. They are commonly treated with plenty of rest, ice, compression and anti-inflammatory medications. After the pain and swelling had reduced, you will need stretching and strengthening exercises.

Wear and tear problems

Repetitive actions can cause damage over time to your elbow. These may occur with sports, or at your work place.

Tennis elbow and Golfer’s Elbow

These are both types of tendonitis, meaning you have damage to the tendons around the elbow. This is commonly due to overuse through repetitive movements or excessive force. Despite the name, you may still get tennis or golfer’s elbow even if you do not play tennis or golf!

Common symptoms include pain in the side of the elbow, as well as weakened grip strength. The pain may be exacerbated by twisting movements or using strong grip (example: opening a jar)

Tennis elbow and Golfer’s elbow are treated with anti-inflammatory medications. An elbow brace may help with recovery. Once the pain has settled, you will need to do stretching and strengthening exercises to restore strength and flexibility.

In some cases that do not respond adequately to first line treatment, the doctor may offer anti-inflammatory injections to help with healing of the Tennis or Golfer’s elbow. Injections include steroid injections as well as Platelet-rich Plasma (PRP) injections.

Your doctor may also recommend Extra-corporeal ShockWave Therapy (ESWT). This modality of treatment uses high-energy waves; which are transmitted to the target organ through the skin. These waves can stimulate healing, as well as modulate the pain receptors in the area, leading to a reduction in symptoms.

Bursitis

Bursa are small sacs with fluid in them. They are normally to help skin slide over bone. They may become inflamed with repetitive motion, or being rubbed against. The bursa will become swollen and painful (Bursitis).

Bursitis usually settles with a course of anti-inflammatory medication. Some patients may require steroid injections (link to H&L). Excision of a bursa is occasionally done for recalcitrant cases.

Other conditions:

Arthritis

Arthritis means joint inflammation.

Rheumatoid arthritis is a condition where your own immune system attacks the tissues in your joints. This can cause swelling, pain and damage to your elbow joints.

Osteoarthritis is a degenerative condition where your cartilage is worn out and breaks down over time, resulting in a reduction in the joint space. Bone spurs (osteophytes) may develop around the joint also. Common symptoms are pain, stiffness, and joint crepitus (crackling sounds or sensation in your joint).

Gout

Uric acid is a waste product from your body’s metabolism. When excessive amount of this uric acid builds up and deposits as crystals in your joints, you may have an attack of Gout.

Gout attacks can be very painful and the elbow is usually red, hot and swollen. Over long term, uric acid deposits in the elbow may build up and form what is called a Gouty Tophus.