Physical discomfort in the elbow joint or in the muscles, tendons, and ligaments that support it. Elbow pain can have causes that are not due to an underlying disease. Examples include prolonged pressure or leaning on elbows, trying a new exercise such as tennis, local trauma, office work, sprains, or strains.
What is Elbow Pain?
Elbow pain involves any kind of pain or discomfort in the elbow joint of your arm. Anyone can experience elbow pain. Elbow pain is caused by an injury, including a blow to the elbow or inflammation of the elbow joint.
Often, an injury or inflammation of the elbow results from a sports injury or repetitive use injury. In mild cases, elbow pain can result from wear and tear on your elbow joint. Severe cases of elbow pain can result from a broken bone. Other less common causes of elbow pain include skin growths, such as cysts or tumors, or an infection in the elbow.
Treatment for elbow pain depends on the cause. In mild cases, resting the elbow and using home treatments, such as cold compresses and over-the-counter pain relievers, may be adequate. In severe cases, elbow pain may require physical therapy, prescription drugs, or even surgery.
Seek medical attention immediately if you experience elbow pain associated with a broken bone, paralysis or numbness of the limb below the elbow, or excessive bleeding. If your elbow pain persists or worries you, see a doctor right away.
There are several causes of elbow pain, many of which are triggered by repetitive activities or injuries.
Lateral epicondylitis, also called tennis elbow, is the most common cause of elbow pain and refers to inflammation of the tendon that attaches the elbow bone to the muscles in the forearm used to extend the wrist and fingers. People who repeatedly use their forearm muscles, such as tennis players, weightlifters, painters, and plumbers, are especially prone to developing lateral epicondylitis.
Typically, elbow pain from lateral epicondylitis is burning, comes on gradually, and gets worse with activities that involve the use of the extensor muscles of the forearm such as turning a wrench, mixing the paste when doing the cooking, or holding a tennis racket. Difficulty gripping objects is another potential symptom of lateral epicondylitis.
Similar to lateral epicondylitis, medial epicondylitis causes discomfort around the joint. However, the symptoms of medial epicondylitis are on the inner side of the elbow and are caused by inflammation of the tendon that connects the elbow bone to the muscles in the forearm used to flex the wrist and fingers. A repetitive and powerful grip (for example, from a golf club, racquet, or heavy tool) is often what triggers medial epicondylitis. Forearm weakness can also occur.
The olecranon bursa is a fluid-filled sac between the tip of the elbow bone and the skin. When a patient has olecranon bursitis, they were swelling and tenderness behind the joint over the bony prominence called the olecranon. If the swelling becomes large enough, a person may not fully move their elbow.
Acute olecranon bursitis develops because of gout, infection, or trauma to the elbow. With an infected bursa, redness, and warmth develops on the tip of the elbow. Some people develop a fever.
Chronic bursitis, the disease that develops slowly over time, is usually caused by repeated overuse (eg, prolonged pressure on the elbows) or inflammatory arthritis (such as polyarthritis rheumatoid).
Tendonitis of the Biceps and Triceps
The biceps tendon is a tough fibrous tissue that connects the biceps muscle at the front of the elbow bone, while the triceps tendon connects the triceps muscle at the back of the elbow bone.
Bicep tendonitis is most often caused by repetitive muscle activity of the biceps (for example, lifting heavy boxes) and causes painful pain in front of the elbow. In contrast, triceps tendonitis (less common than biceps tendonitis) causes pain in the back of the elbow and is most commonly caused by people who repeatedly extend their elbow against resistance (eg, weight lifters).
If a tendon in the biceps or triceps ruptures, sudden severe pain, accompanied by a sensation of clicking or popping, may be felt. Swelling and bruising can also occur near the elbow and forearm, and a visible lump can develop on the upper arm.
Cubital Tunnel Syndrome
Cubital Tunnel Syndrome:
Your ulnar nerve passes from your neck to your hand. Sometimes the nerve compresses when it wraps around the inside of the elbow. This condition is called cubital tunnel syndrome. Besides painful pain inside the elbow, cubital tunnel syndrome often causes numbness and tingling in the little finger and ring finger area. Sometimes people report shooting pain along the forearm, and a poor grip.
Radial Tunnel Syndrome
Radial tunnel syndrome is a rare condition that results from radial nerve compression. The radial nerve travels along the arm and controls the triceps muscle and wrist extensor muscles. Most often, this diagnosis is considered in people who engage in a repetitive rotation of the muscles of the forearm. Besides a vague localized pain in the forearm that comes on gradually, a person with radial tunnel syndrome may experience numbness on the back of the hand that may extend to the back of the forearm.
Fractures can occur around the elbow after injuries such as a fall on the elbow or an outstretched hand, or a direct blow to the elbow, such as from a car accident. The most common elbow fractures are olecranon fractures and radial head fractures. Symptoms of an elbow fracture include sudden and severe pain in the elbow and forearm, accompanied by swelling, possible numbness and tingling in the hand, or an inability to straighten the arm.
Elbow dislocation is not common and usually occurs when a person falls on an outstretched hand. When the hand contacts the ground, the force of the fall is transmitted to the elbow, which can spin or twist it out of its socket. The elbow bones, the upper arm bone (humerus), and two forearm bones (radius and ulna) are separated from their normal alignment.
Besides severe elbow pain, a dislocation often causes visible elbow deformity, swelling, and bruising around the joint.
Some people also experience numbness and tingling in the hand.
- Most elbow problems can be diagnosed and treated with a simple exam, and you are unlikely to need any special tests.
- Your doctor may suggest that you have an x-ray, which may show any new bone growth, any loose pieces of bone, or arthritis.
- Rarely, an ultrasound or magnetic resonance imaging (MRI) may be needed to rule out or confirm a diagnosis.
- During an ultrasound, a small device is placed on the skin. Sound waves create an image of a part of the interior of the body.
- A person having an MRI will need to lie down in a large tube, and the magnetic fields and radio waves produce detailed images of the inside of the body.
- You may need a nerve conduction test if you have problems with your nerves. Small electrodes are placed on your skin to stimulate the nerves. This will measure the speed at which messages are sent through the nerve, and the length of the delay will give a sense of how tight the nerve is.
Depending on the extent and severity of elbow pain, patients may see an orthopedic surgeon to diagnose and manage elbow pain.
Minor strains and sprains are usually treated with ice packs, compression, and rest, and elevation, and medication. Some clinicians may recommend an ultrasound, electrical stimulation, and friction massage.
Elbow pain from fractures or a stress fracture is usually best managed by an orthopedist and usually requires rest and often external support, such as a cast, splint, or sling. Severe trauma to the elbow may require surgical repair, usually performed by an orthopedic surgeon.
Other causes of elbow pain require specific treatment. For example, cellulitis or elbow abscesses usually require antibiotics or drainage to treat elbow pain. Other problems such as elbow pain caused by rheumatoid arthritis may require a variety of treatments which may include NSAIDs, corticosteroids, anti-rheumatic drugs, or even surgery.
Some patients may benefit from physical therapy or the use of braces or splints. Assistive devices can help reduce pain when the elbow joint produces pain when it is straightened.
When to visit a Doctor?
Seek emergency care if you have:
- An obvious deformity in your elbow
- A protruding bone
Call your physician immediately if you have:
- Severe pain, swelling, and bruising around the joint.
- Difficulty moving your elbow normally, using your arm, or turning your arm from the palm down and vice versa.
Schedule an office visit if you have:
- Elbow pain that doesn't improve after home care.
- Pain that occurs even when you are not using your arm.
- Increased redness, swelling, or pain in the injured area.
Ways to reduce the risk of elbow pain include:
Always warm-up and cool down completely when exercising.
Make sure you use good technique and the right equipment when playing your chosen sport.
Do strengthening exercises with hand weights, your physiotherapist can prescribe the correct exercises.
Avoid or modify work tasks that place excessive strain on the forearm muscles or that include the use of fingers, wrists, and forearms during repetitive work involving strong movements, uncomfortable postures, and a lack of rest.