Elbow pain is usually not a very serious condition. But just like pain in any other part of the body, it can get very frustrating. You use your upper limbs for many movements that make up your daily activities. Most of these movements involve the elbow joint. As a result, pain in the elbow can make performing your daily activities a very difficult task.
Causes of Elbow Pain
The most common cause of elbow pain is overuse (1). If you regularly partake in sports, jobs, hobbies, etc that require constant and repetitive movement of the elbow joints, you are more likely to develop elbow pain. These are the most common causes of elbow pain:
- – Fracture
A fall on the upper limb, especially the elbow can result in a fracture of the elbow joints and the surrounding bony areas (3). Other sources of trauma (such as Road Traffic Accidents, blunt force, etc) to the upper limb could also result in a fracture of the elbow. Pain alongside swelling, redness, and an increase in temperature are common symptoms of such fractures. A common fracture of the elbow is an olecranon fracture. Tiny cracks in bones around the elbow (stress fractures) (10) can also result in elbow pain.
- – Bursitis
Bursitis simply means inflammation of the bursa (4). A bursa is a sac-like cavity in the joint which contains a fluid. The sac together with its encompassing fluid serves as a cushion between the bones, muscles, and tendons surrounding your joint. Excessive use of the elbow joint leads to inflammation of the bursa
- – Golfer’s Elbow
This condition is caused by overusing the elbow in a constant wrist or fingers-clenched position and making repeated motions similar to a golfer’s strike (5). Golf elbow pain is caused by inflammation of the tendons of your forearm which attach to the inner bump of your elbow. This results in elbow pain into forearm.
- – Tennis Elbow
This is similar to a golfer’s elbow and is one of the most talked about causes of elbow pain. Unlike a golfer’s elbow, inflammation is at the tendon that attaches to the outer bump of your elbow (12). Do not be deceived by its name, this cause of burning elbow pain is not limited to just tennis players. You are likely to develop a tennis elbow if you constantly make similar movements to a tennis player. Carpenters, plumbers, painters, and butchers are at risk of having tennis elbow. The tennis elbow is also called lateral epicondylitis. In addition to pain at the elbow, tennis elbow is also characterized by elbow pain extension from the outer part of the elbow to the wrist and forearm. If you have tennis elbow, you might also observe that you have a weak grip. You might also experience elbow pain after lifting, and increased pain (15) when using tools, opening bottles or jars, squeezing objects, and shaking hands. One classical feature of tennis elbow is burning elbow pain and elbow pain after lifting heavy objects.
- – Osteoarthritis
Osteoarthritis simply means the degeneration of the articular surface of a joint. Osteoarthritis at the elbow is not very common (compared to weight-bearing joints like the knees, hips, and ankles) but is still a possible cause of pain at the elbow joint (6). Professions, athletes, and hobbyists that make constant repetitive use of the elbow are more prone to elbow osteoarthritis. Other risk factors are old age and other diseases that reduce bone density. A history of trauma, fracture, osteomalacia (bone softness), and osteomyelitis (bone infection) at the elbow predisposes you to elbow osteoarthritis.
- – Cubital Tunnel Syndrome
Cubital tunnel syndrome is characterized by the compression of the ulnar nerve at the elbow and forearm to elbow pain. The ulnar nerve is one of the three most important nerves that enter the forearm and supplies innervation to the forearm, wrist, hand, and fingers (13). Cubital tunnel syndrome is also referred to as ulnar nerve entrapment. In addition to the forearm to elbow pain, there is also pain at the inner side of the elbow. Another common symptom of cubital tunnel syndrome is paraesthesia (numbness and tingling sensations) along the inner side of the forearm and also at the fourth and fifth fingers.
- – Osteochondritis Dissecans
This joint condition is caused by little or no supply of blood to the bone of the joint (7). This causes the cartilage and bone to lose strength and stability which results in reduced movement at the joint and also pain. It usually occurs after an injured elbow joint or very intense activity performed over several months.
- – Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune disorder where the immune system mistakes the body for a foreign harmful substance and then fights it (8). This can affect a lot of systems and organs in the body and the extent of this damage varies from person to person.
- – Sprain
Spraining ligaments around the elbow can be very painful. Spraining a ligament means getting a tear or stretch in a ligament (9). Sprains are usually caused by sudden excessive movement at a joint that results in stretching a ligament beyond its normal limits. Severe sprains usually result in excessive tears that may require surgery to repair.
- – Dislocation
Just like fractures, dislocating any of the bones that make up the elbow joints also results in great pain. Fractures and dislocation at the elbow joint should be immediately reported to the hospital as they usually require urgent medical care. A common dislocation at the elbow joint is posterior elbow dislocation. This occurs when the ulna and radius (the two bones that make up the forearm) are forcefully displaced behind the humerus (the bone of the upper arm). This is the most common type of dislocation in children below the age of 10 years.
In addition to the causes listed above, elbow pain can also be caused by other types of arthritis (such as septic arthritis, gout, and reactive arthritis), and tendinitis (11). Tendinitis of the triceps results in tricep near elbow pain.
Complications of Elbow Pain
Usually, when you have elbow pain, the elbow joint does not suffer alone. Elbow pain, especially when prolonged, can result in several other things beyond the pain. Underlisted is some common complications of elbow pain:
- – Reduced Range of Motion
Pain at the elbow causes you to not move your elbow adequately to avoid the pain. This temporary reduction in the range of motion at the elbow joint could result in a semi-permanent loss of motion if the pain is prolonged.
- – Muscle weakness
The strength of muscles reduces when not in adequate use over a long period. Pain at the elbow leads to reduced use of the muscles of the upper limb especially the biceps, brachialis, brachioradialis, and triceps that control the elbow joint.
- – Reduced ability to perform activities of daily living
The elbow joint is very crucial to the performance of simple daily tasks such as grooming, toileting, feeding, and even our occupations. Pain at the elbow immensely affects our ability to perform these tasks. This limitation usually results in reduced quality of life.
Managing Elbow Pain
The management of pain at the elbow joint is dependent on the cause of such pain and the severity of the cause. You can manage some elbow pains at home. For others, you need a team of health professionals to get the right care.
Diagnosing elbow pain means finding out the cause of your pain. Your doctor or physical therapist will help find the cause of your elbow pain through a series of objective and subjective assessments such as:
- – Medical History / History of Elbow Pain
You will be asked various questions revolving around the severity and history of your pain. You will also be asked questions on the type and frequency of the physical activities you have been undergoing in the preceding days, weeks, and months. You will also be required to provide information on any previous medical conditions or trauma that could have resulted in your pain.
- – Physical Examination and Assessment
Your doctor or physical therapist will examine the joint for signs of inflammation. You might also be asked to perform some movements that could elicit pain in the joint and help the examiner pinpoint the cause of your pain.
- – Radiographic Investigation
Your doctor or physical therapist can request radiographs such as MRI, CT Scan, and X-rays to take a look at the bones that make up the elbow joint and the joint itself.
- – Laboratory Test
In a case where conditions such as rheumatoid arthritis are suspected, you might be required to take a laboratory test to enable the medical personnel to make an accurate diagnosis. A biopsy of the bursa fluid can also be requested.
Treatment of Elbow Pain
Elbow pain can be managed in the following ways:
- – Rest
Since most causes of elbow pain revolve around overuse and repetitive movement of the elbow joint, the foremost line of managing elbow pain is rest.
- – Medications
Yes, you guessed right! Painkillers are one of the most common medications for elbow pain. Some painkillers can be gotten over the counter while you might need your doctor’s prescription for some other types. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also common drugs used to manage elbow pain. They help reduce inflammation and associated pain. Your doctor must be aware of any drug hypersensitivity or allergy before the prescription. Your doctor might also prescribe drugs that help to reduce the effects of rheumatoid arthritis (Disease-modifying antirheumatic drugs (DMARDs)). Your doctor will prescribe some antibiotics in the case of infections at the elbow joint. Ensure that you use your medications as directed by your doctor, even after you feel better. Steroid injections are also sometimes prescribed to reduce elbow pain.
- – Surgery
You may require surgery to repair the elbow joint depending on the cause of your elbow pain. Severe damage to ligaments and tendons usually requires surgical repair for better prognosis and faster healing. Some fractures are also hard to manage using conservative methods such as arm slings, Plaster of Paris, etc. These types of fractures usually require a surgical reduction.
- – Physical Therapy
Physical therapy is a great conservative management option for various types of elbow pain. A physical therapist is a trained medical professional that can expertly assess your elbow pain and prescribe and apply various evidence-based treatment modalities such as ice therapy, massage, progressive exercises, elbow pain stretches, etc which will help in reducing your pain and improving elbow function and movement over time.
Home Management of Elbow Pain
Depending on the cause of your elbow pain, the following might be useful in reducing your elbow pain (2):
- – Ice Pack, Heat Pack, Hot Water Bottle: Placing these over the painful area for an extended period can provide a level of relief for your pain.
- – Braces or Immobilizers: Elbow braces can be very helpful in reducing elbow pain, especially at very early stages of injury. They also help to protect the joint, allowing better healing by disallowing further injury to the bones, muscles, ligaments, and tendons of the joint.
- – Stopping and reducing overuse of the elbow joint: If there is a particular activity that you are aware might be the cause of your elbow pain, you would have to stop or greatly reduce such activity to allow the joint to heal. However, gentle elbow pain stretches help in pain reduction.
- – Taping: Elbow pain kt tape (kinesiotape) provides some placebo pain relief (12). In addition to this effect, when done properly, elbow pain kt tape could act as a brace and protect the ligaments and tendons of the elbow joints from further injury.
- – Elbow Padding
Ensure that you discuss all modalities with your doctor or physical therapist before trying them out at home.
Prevention of Elbow Pain
Usually, elbow pain is caused by overuse of the elbow joint for jobs, sports, and hobbies. Elbow pain can be prevented by (14):
- – Using the proper sporting techniques.
- – Using elbow padding.
- – Warming up and stretching the muscles around the elbow before sporting activities.
- – Using a properly-sized grip on sports equipment and applying the right tension when handling racquets.