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Elbow pain

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Elbow specialist examining a male patients elbowElbow pain can be caused by various factors, depending on the location of the pain. Usually, minor cases of elbow pain go away on their own. However, more severe cases may require injections or other small surgical procedures to the elbow.

In this article, we offer an overview of the most common causes and symptoms of elbow pain and tips for preventing it.

We also look at some self-management techniques and review the treatment options offered at The Alexandra Hospital — a Circle Health Group hospital in Manchester. 

The elbow is a hinged joint. To understand the many potential causes of elbow pain and where they might occur in the elbow, we need to look at how this joint works.

The elbow joint is made of three bones:

  • The humerus
  • The ulna
  • The radius

Cartilage covers the ends of these bones, giving them a rubbery surface that allows them to glide over each other. The bones are held together with ligaments. Together, the ligaments form the joint capsule, which is a sac filled with fluid that lubricates the elbow joint.

Elbow muscles and tendons

Your elbow also has tendons in it, which attach the muscles to the bone. There are two main tendons in your elbow:

  • The biceps tendon attaches the biceps muscle (or the muscle on the front of your arm) to the elbow bones
  • The triceps tendon attaches the triceps muscle (or the muscle on the back of your arm) to the elbow bones

The humerus bone is attached to the muscles in your forearm in two main places:

  • The lateral epicondyle — this is the bony bump that you can feel on the outside of your arm, just above the elbow
  • The medial epicondyle — the bump on the inside of your arm that you can feel just above the elbow

Elbow nerves

There are also three main nerves that start at the shoulder and cross the elbow on their way down. These are:

  • The ulnar nerve
  • The medial nerve
  • The radial nerve

Dr Mohammad Waseem, Consultant Orthopaedic Surgeon at Circle Health Group’s The Alexandra Hospital, shares some of the more common causes of elbow pain.

Golfer’s elbow

This is the most common cause of elbow pain, explains Dr Waseem. It is also called medial epicondylitis because it occurs when the medial epicondyle, a tendon that makes the wrist bend towards the palm, is inflamed.

It is caused by overuse of the muscles that help your fingers and wrist bend. This overuse causes inflammation in the bony part inside your elbow.

Symptoms include pain when you bend your elbow or try to grip things, or when you bend your wrist or try to make a fist. Overall, only about 1% of the population has golfer’s elbow, and the condition tends to affect people between 40 and 60 years old.

Tennis elbow, or lateral epicondylitis

Despite the name, this common condition doesn’t only affect tennis players, but it can also affect anyone whose forearm muscles have been strained. This condition is caused by the inflammation of the tendons that run between your wrist and your elbow.

Symptoms include a weak grip, pain, and a burning sensation along your forearm and elbow.

The condition “doesn't always come with tennis, but with rotational movements,” explains Dr Waseem, so you may find that using doorknobs, for example, is very difficult.

Tennis elbow may be caused by improper tennis-playing technique or other repeated activities, such as painting with a brush or roller, using a chainsaw, and other repeated hand motions common for musicians, dentists, or carpenters.

Saturday night palsy, or radial nerve compression

This condition tends to occur when you have slept for a long time in an awkward position, compressing the radial nerve. This nerve compression may cause a tingling sensation, numbness, weakness, or pain.

You may compress your radial nerve if you fall asleep or are immobilised for a long time after consuming large amounts of alcohol, if you have fallen asleep with your hand on a chair, or if someone else has fallen asleep on your arm for a long time.

Triceps tendonitis

The medial head of the triceps can push the nerve out of its natural position, Dr Waseem explains, when you have done too much exercise. Triceps tendonitis results from repeated stress to the tendon, such as when you lift weights or use a hammer repeatedly.

Symptoms of this condition include a tender, swollen, and painful elbow. You may also have difficulty straightening your elbow.

Elbow fracture

Also called an olecranon fracture, an elbow fracture occurs when the end of the ulna — the bone whose pointy end you can feel when you flex your elbow — is fractured. Symptoms include pain and tenderness to the touch, swelling and bruising around the area, and the inability to extend the elbow.

You can also have a radial head fracture, where the radial bone is injured. The symptoms here are similar to the ones from tennis elbow, explains Dr Waseem. Using a sling usually helps the healing process. However, if the fracture is displaced or open, surgery may be necessary.

Elbow arthritis

Elbow arthritis condition is more common in older people. It is caused by wear and tear of the elbow cartilage, or can occur as a result of overuse or injury.

Symptoms include pain when bending the arm, a grinding or popping sensation in the elbow joint, swelling, and stiffness.

Osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis can all cause elbow pain. 

The most common causes that may lead to pain between the elbow and the shoulder are:

  • Triceps tendonitis. This inflammation of the tendons causes pain between the back of the elbow and the shoulder.
  • Olecranon bursitis. This condition occurs when the bony tip of your elbow gets inflamed, causing pain and swelling. In turn, bursitis in this area can be caused by other inflammatory conditions such as gout, psoriatic arthropathy, or rheumatoid arthritis.
  • Bursitis and tendonitis at the end of the biceps, where the biceps muscle attaches to the radius bone through the tendon. This condition may cause pain between the front of the elbow and the shoulder. Swelling also occurs.

Other causes of elbow pain may occur between the elbow and the wrist. Radial tunnel syndrome, for example, is a rare condition that affects the radial nerve, which helps you extend and lift your wrists.

To lower the risk of developing elbow pain, make sure you:

  • Warm up and cool down appropriately before engaging in physical activity
  • Use good technique and equipment when playing sports or engaging in other physical activity
  • Do muscle-strengthening exercises in a safe manner, such as the ones prescribed by a physiotherapist
  • Avoid repetitive tasks that put excessive pressure on muscles of the forearm or that involve the use of fingers, wrists, and forearms
  • Avoid poor posture
  • Avoid sleeping in awkward positions

Following the above tips can help to prevent elbow pain.

Usually, you can manage minor elbow pains by yourself. Most of the time, rest and painkillers are enough to make the pain go away completely, says Dr Waseem.

Stretching exercises, soft tissue massage, and applying ice to the affected area can also help. Using a brace or elbow support can stabilise your elbow and give your muscles and tendons time to heal.

“If the cause of elbow pain is tendonitis related or bursitis related, you can get better with taking a course of ibuprofen, by applying ibuprofen gel, or doing physiotherapy,” adds Dr Waseem.

He explains that these treatments and self-management techniques will work if your pain is between 0 and 3, for example, on a pain scale from 0 to 10.

Most of these minor elbow pains tend to go away by themselves between two and six weeks.

If the pain persists after six weeks, you should seek medical advice, says Dr Waseem.

If you reach the point where the pain is 3–6 on the pain scale, you have a more serious injury, and the pain lasts for more than two weeks, you should seek medical advice.

“As far as anything above the 6 to 10 [pain threshold], you would seek advice anyway because the pain will be very severe,” says Dr Waseem.

He stresses the importance of seeing a consultant promptly because conditions such as tennis elbow, golfer’s elbow, or triceps injuries can worsen and cause more damage over time.

When you do decide to see a consultant for your elbow pain, they may ask you a series of questions. They might like to know:

  • Your age
  • What you do for work
  • What activities you do in your spare time — if you go to the gym, lift weights, play sports, or even play musical instruments, all of these activities may affect your elbow pain
  • If you are taking any medication regularly — for instance, statins may cause muscle pain, and some antibiotics may cause muscle injuries
  • Your medical history
  • How much alcohol you consume
  • If you smoke or have smoked — smoking leads to a lack of oxygen in your muscles, which may affect recovery

After asking you several questions, you will move on to imaging investigations. These depend on the suspected cause of elbow pain.

For example, things like tennis and golfer’s elbow will not need an X-ray, notes Dr Waseem. Instead, ultrasound scans are the quickest and easiest way to diagnose these conditions.

If the consultant suspects another underlying cause, such as arthritis, they may then ask for X-rays or MRI scans.

Elbow-pain-and-arthritisThere are many treatment options for elbow pain at The Alexandra Hospital in Manchester, ranging from non-invasive treatments to surgery.

The general course of treatment is to start with gels, tablets, and physiotherapy.

The next stage may be injections, such as platelet-rich plasma (PRP) or hyaluronic acid injections. These are a quick and convenient fix, especially for tendonitis. The injections are offered on-site and can take about 15 minutes to administer, explains Dr Waseem.

Dr Waseem cautions against the use of steroid injections for elbow pain, which have recently been shown to damage the tendons.

If the above treatments do not work, techniques such as percutaneous tennis elbow release can be performed under local anaesthetic. In this procedure, the tendon is released and lengthened, removing the pressure and therefore the pain in the elbow.

Other surgical procedures for elbow conditions include:

When you choose to go private with Circle Health Group, you can expect:

  • Flexible appointment times and locations to fit your routine
  • The freedom to choose which hospital and consultant suit your needs
  • Personalised, consultant-led treatment plans tailored to your individual needs
  • Comfortable and safe private facilities maintained by expert multidisciplinary teams
  • Support by the same compassionate clinical team from beginning to end
  • Affordable, fixed-price packages with aftercare included
  • Flexible payment options to help you spread the cost of your care

If you would like to learn more about this procedure, book your appointment online today or call a member of our team directly on 0141 300 5009.

Cost is an important part of your treatment journey, and a key factor when deciding whether to choose private healthcare services.

The Alexandra Hospital offers fixed price packages that include an initial consultation, treatment, and aftercare.

There are several ways you can pay for your private healthcare:

Like all Circle Health Group hospitals, The Alexandra Hospital also offers flexible payment options. Paying in instalments can make healthcare more affordable than you might think. 

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