Elbow Pain - Causes

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What injuries can cause elbow pain, and what are symptoms and signs of the causes of elbow pain?

Tendinitis (or tendonitis)

  • Lateral epicondylitis (tennis elbow): 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 then leads to inflammation of the tendons, causing pain over the outside of the elbow, occasionally with warmth and swelling but always with local tenderness. The elbow maintains its full range of motion, as the inner joint is not affected, and the pain can be particularly noticed toward the end of the day. Repeated twisting motions or activities that strain the tendon typically elicit increased pain. These include lifting and throwing. X-rays are usually normal, but if chronic tendinitis has occurred, X-rays can reveal calcium deposits in the tendon or reveal other unforeseen abnormalities of the elbow joint.

    The treatment of lateral epicondylitis may include ice packs, resting the involved elbow, and anti-inflammatory medications. Anti-inflammatory medications typically used include aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn), diclofenac (Voltaren), and ibuprofen (Motrin). Bracing the elbow can help. Simple braces for tennis elbow can be found in community pharmacies and athletic goods stores. Local cortisone injections are given for persistent pain. Activity involving the elbow is resumed gradually. Ice application after activity can reduce or prevent recurrent inflammation. Occasionally, supportive straps can prevent reinjury. In severe cases, an orthopedic surgical repair is performed.
  • Medial epicondylitis (golfer's elbow): 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 indicate calcifications of the tendons if the tendinitis has persisted for extended periods of time.

    The usual treatment involves combinations of ice packs, resting the elbow, and medications including aspirin and other NSAIDs. With severe inflammation, local corticosteroid (cortisone) injections are sometimes given. Using a strap can prevent reinjury. After a gradual rehabilitation exercise program, return to usual activity is best accompanied by ice applications after use. This helps to avoid recurrent inflammation.

Olecranon bursitis

Olecranon bursitis (inflammation of the bursa at the tip of the elbow) can occur from injury or minor trauma as a result of systemic diseases such as gout or rheumatoid arthritis, or it 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.

Fractures

The bones of the elbow can break (fracture) into the elbow joint or adjacent to the elbow joint. Typically, elbow fracture causes sharp pain in the elbow, and X-ray imaging is used to make a diagnosis. Fractures generally require immobilization and casts and can require orthopedic surgery, involving pinning or open joint procedures.

Sprain

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 medications.

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See what others are saying

Comment from: Shawn, 45-54 Female (Patient) Published: January 08

I work in the automotive industry and have had carpal tunnel surgery on both hands as well as trigger finger tendon release. I have started having issues with my right elbow and continued pain in my right wrist. Unfortunately, it was 16 months from the time I initiated my injury claim before I had my surgery, therefore, my right hand, wrist and elbow are pretty well toast plus I am right handed. I am still suffering from pain even when I am not working. It is difficult to pick up the smallest items.

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Comment from: Mikel, 35-44 Male (Patient) Published: January 14

Currently, I have a very hot elbow, which is very painful. It was inflamed, both by size, and by temperature. I did not have a fever, but am being treated for 2 possible causes. Since the emergency room could not do a "biopsy" of fluid, they had to assume that I had cellulitis as a primary diagnosis. Secondary diagnosis was gouty arthritis. I want others to note that the X-ray "was clean" as one emergency room worker had put it. I also did not have elevated white blood cells (per CBC test). My current medication, indomethacin, given by the emergency room, is not talking the swelling down. I am also on Lupin, for the same exact amount of time as the Indomethacin. I have arthritis in other parts of my body, but nothing got to be as hot as my elbow. As I went into the emergency room, I felt a "needle pricking" like it broke off and stuck in nerve area (inside arm) at the elbow. Now I can tell that I do feel sharp pains when moving my arm, when not immobilized in a sling. I am still "puffed up" with the swelling, but little discoloration. I also have to mention that I had no trauma to the arm or elbow areas. My TENS unit helps a little, but does not diagnose exactly what this is, or cure the actual problem.

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