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Elbow Pain - Location, Common Disorders, Diagnosis, and Treatment

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Elbow pain is a common symptom involving bone, tendons, ligaments, and muscles in the elbow joint that help in various movements of the arm.

Written by

Dr. Deepiha. D

Medically reviewed by

Dr. Ranvir Sachin Tukaram

Published At October 31, 2022
Reviewed AtJuly 17, 2023

Introduction:

The elbow is a joint between the long bones of the arm and the forearm with complex biomechanical features. The elbow can withstand dynamic forces and involve a wide range of motions. Unfortunately, the elbow joint is located in such a position that it is more prone to disorders and trauma, which can induce the onset of pain and discomfort.

The complex structure of the elbow joint makes it tough to determine the cause of elbow pain and discomfort.

What Is the Basic Anatomy of the Elbow Joint?

The elbow is a hinge type of joint between the three long bones; humerus (arm), radius (forearm), and ulna (forearm). The joint is surrounded by cartilage to provide frictionless movement during an action. These bones are confined together by various tendons, ligaments, and muscles. Three primary nerves (radial nerve, ulnar nerve, medial nerve) travel down the arm and cross the elbow joint to reach their innervation area for motor and sensory activity.

What Are the Locations of Pain in the Elbow and Its Causes?

Based on the injury or the disorder, the pain in the elbow can occur on four surfaces; anterior (front), posterior (back), medial (close to the body), and lateral (away from the body). The following are the various conditions responsible for pain in the elbow,

  • Anterior: Osteoarthritis, rheumatoid arthritis, gout, biceps tendinopathy (pain and swelling in associated tendon), anterior capsule strain, and median nerve entrapment.

  • Posterior: Olecranon is a cup-shaped extremity of the bone ulna that covers the end of the humerus, which forms the bony tip of the elbow during bend movements. Most of the posterior elbow pain is due to olecranon fracture, impingement, infection, and inflammation.

Other reasons for posterior elbow pain include osteoarthritis and triceps tendinopathy.

  • Medial: Ulnar nerve entrapment, medial epicondylitis (inflammation of the bony bump of the humerus bone present medially near the elbow joint), ligament sprain or injury, and development of bony spurs.

  • Lateral: Lateral epicondylitis, plica syndrome (condition associated with pain and clicking sound), radial nerve entrapment, and joint instability.

What Are the Common Disorders Associated With Elbow Pain?

Fracture:

Elbow fractures can be three types; single non-displaced, single displaced, and multiple site fractures causing severe pain and discomfort.

Dislocation:

The joint can dislocate in any direction and impairs the normal range of motion. Numbness, tingling feeling, swelling, discoloration, and pain during movement are associated with elbow dislocation.

Both displaced fractures and dislocations are reduced in their correct anatomical positions and require immobilization (eliminate movement) for complete healing.

Bursitis:

Bursae are tiny sacs filled with fluid that lubricates the joints. The sacs can get inflamed and are known as bursitis. The inflammation leads to swelling and pain. Bursitis can be managed with cold compression and antibiotics.

Osteoarthritis:

Osteoarthritis refers to age-related wear and tear of cartilage around the joint that progresses and worsens over time, resulting in joint damage and pain.

Rheumatoid Arthritis:

Rheumatoid arthritis is an autoimmune (immune reaction attacking the body’s normal cells) inflammatory disease where the joint lining becomes swollen and painful.

Tennis Elbow and Golfer's Elbow:

Tennis and golfer’s elbow are common names indicative of lateral and medial epicondylitis, respectively. The condition is characterized by epicondyle inflammation resulting in swelling and pain. Weak muscles, repetitive movements during practice, and strenuous activity are the reason for the above condition. Rest, painkillers, physiotherapy, and massage can alleviate pain.

Nerve Impingements:

One of the major nerves in the arm can get entrapped near the elbow. The compression can give vague pain around the joint and get better with decompressing the nerve from the impinging structure. However, surgery may be required to release the nerve.

Osteochondritis dissecans:

This condition primarily affects the joints where the cartilage around the joints becomes non-vital due to a lack of blood supply, and a small piece of bone gets separated. They result in swelling and pain, which increases during activities.

Pain Associated With Tendons, Ligaments, and Muscles:

Tendinitis (inflammation or irritation of the tendon), ligament tear, and muscle sprains can also lead to elbow pain.

Tumors:

Tumors are sporadic in the elbow region. But any cancerous or non-cancerous lesions around the joint can produce pain.

What Are the Diagnostic Criteria to Look For in an Elbow Pain?

  • The physician carries out various physical examinations and simple tests to check for movements, reflexes, tenderness, swelling, and stiffness.

  • Imaging investigations like X-rays, ultrasound, CT (computed tomography), and MRI (magnetic resonance imaging) can give detailed images of the inner aspect of the elbow to look for changes.

  • Electromyography and nerve conduction studies can assess pain caused by nerve impingement.

  • Laboratory blood tests can be performed to check for complete blood count, autoantibodies, and rheumatoid factors in inflammatory disorders of the elbow.

  • Biopsy in case of bursitis to check for infection.

When to Consult a Physician?

Some minor elbow pains caused by muscle and tendon strain can resolve independently. But for the following situations, one has to check with the physician.

  • Persisting pain that does not improve with cold compress and painkillers.

  • Visual deformity.

  • Inability to move the arm.

  • Infection of the elbow with localized swelling and redness along with fever.

  • Clicking or popping sound while bending or extending the arm. Sometimes the elbow may get locked in a specific position.

  • Children affected with elbow disorders.

How to Manage Elbow Pain?

Conservative treatment for elbow pain includes,

  • Medications (NSAIDs - non-steroidal anti-inflammatory drugs, muscle relaxants, antibiotics).

  • Physiotherapy to ease pain and improve the range of motion.

  • Steroid shots to reduce inflammation.

Surgery is considered the last resort when there is excessive tendon tear and severe impairment in elbow movement.

Conclusion:

Elbow pain can be debilitating and affects one’s daily routine activity. However, painful elbow conditions usually get well by conservative treatment, and the movements can be restored with an intense rehabilitation program. Identifying the reason for pain and a prompt treatment plan can help to recover soon from pain and discomfort.

Stretching and strengthening exercises, warming up during sports, elbow pads, and avoiding repetitive strenuous activity can prevent elbow problems and pain.

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Dr. Ranvir Sachin Tukaram
Dr. Ranvir Sachin Tukaram

Orthopedician and Traumatology

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