Elbow Pain: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment and Prevention

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A man who holding his elbow because of elbow pain

1Overview

Can you imagine not being able to flex your arms? The elbow provides the ability of the arm to fold and extend. This way, you can perform all the activities of daily living without any problem.

The elbow is a joint where the three long bones meet – the humerus or upper arm,
the ulna or the inner bone of the forearm and the radius, which is the outer bone of the forearm.  It’s in the middle part of the arm.

The elbow is present to make it possible to move the arm like a hinge, which entails moving the arms forward and backward and in the rotation, which involves twisting inward and outward.

The elbow can be affected by many things, which may lead to elbow pain. It can be affected by the inflammation of certain tendons, bursae or conditions that can affect the bones and joints such as nerve irritation, fractures, and arthritis.

Elbow pain is not usually serious, but it can affect many activities since the elbow is used in many ways. Thus, elbow pain can be annoying and frustrating.

2Symptoms

Numerous disorders cause elbow pain and these can affect either the inner or outer elbow. The most common signs and symptoms include:

  • Funny sensation bone sensation  as a result of nerve irritation
  • Numbness
  • Tingling sensation
  • Pain
  • Inability to move freely
  • Pins and needles sensation in the arms
  • Joint instability
  • Swelling
  • Popping sound when folding arm

3Causes

Elbow pain can be caused by various factors, such as:

Simple sprain – When you’re doing many activities than you used to, you can injure the ligaments in your elbow. Ligament problems happen in any ligament found in the joint of the elbow. Sprains may be the result of repeated stress or trauma. In some cases, the ligament becomes stretched, completely torn or partially torn.

Medial epicondylitis – This condition affects the inner tendons of the elbow. This is also dubbed as “golfer’s elbow” and “little leaguer’s elbow”. This results from the repeated throwing motion in baseball and golf, the downward swing of the golf club. Aside from this, it can result from repetitive hand motion like working as a carpenter who swings the hammer every day.

Lateral epicondylitis – Also called tennis elbow, this condition affects the outside tendons in the elbow. This is commonly seen in tennis players, cooks, carpenters, painters, plumbers, and autoworkers. The condition results from the strenuous overuse of the tendons and muscles near the elbow joint.

Bursitis – The repetitive motion of the arm can lead to the build-up of fluid over the elbow joint. Also called olecranon bursitis, this leads to pain and inflammation.

Osteoarthritis (OA) – Osteoarthritis is a condition that affects the cartilage found in joints. The everyday use of the joint may lead to cartilage wear down and damage.

Dislocation or fracture of the elbow – Dislocation or fracture of the elbow may result from trauma, overstretched arm or elbow or fall. A dislocation happens when the bone moves out of the joint. On the other hand, a fracture occurs when the bone breaks or cracks.

Squashed or trapped nerve – The “wear and tear” may occur on the joints and spinal column as a result of progressing age. When the spine is squashed and the nerve is trapped, this may lead to numbness and pins and needle sensation in the arms.

Osteochondritis dissecans – Also known as Panner’s disease, the condition happens when small pieces of cartilage and bone become trapped in the elbow joint. This happens as a result of injury or trauma to the elbow.

4Risk Factors

There are two main risk factors for elbow pain – overuse of the joint and excessive stress on the elbow joint. Another risk factor has autoimmune and inflammatory diseases.

Overuse of the elbow joint – The overuse of the elbow joint may take a toll on the bone, joint, ligaments, and cartilage in the elbow. Overuse is usually seen in people who produce many elbow movements during work, activities, and sports, including lifting, swinging and gripping. Some sports activities may require repetitive motions and as a result, may lead to elbow pain.

Other risk factors include too much weightlifting for bodybuilders and engaging in other gym exercises such as push-ups.

Excessive stress on the elbow joint – When there is too much stress on the elbow joint, it could lead to damage to the ligament or tendon. In some cases, dislocation and fracture may happen, too.

This usually happens during work accidents, vehicular accidents and sports accidents like in football and wrestling. Trauma or repetitive stress may also lead to pain, inflammation, and nerve compression.

Autoimmune diseasesSome diseases, which may lead to autoimmunity and inflammation can cause joint pain and joint damage. For instance, people with rheumatoid arthritis are at a higher risk of having elbow pain, compared to others.

5Complications

To restore and maintain the elbow joint’s flexibility and health, early treatment is important. If the condition is left untreated, it may lead to many  complications, including:

  • Chronic elbow pain
  • A lasting fixed bend in the elbow also called contracture
  • Limited range of motion
  • Numbness in the hand and fingers
  • Elbow instability
  • Progressive arthritis in the elbows
  • Debilitating pain
  • Problems with the ability to function at home and work.

6Diagnosis

Diagnosing elbow pain will always begin with a physical assessment and an interview of the medical history.

Medical history – Usually, a medical history interview will involve several questions including the symptoms experienced, the timing of the pain or the history of falls, accidents or trauma to the area. Also, the doctor will ask about the activities the patient engage in, such as contact sports, gym exercises, and weightlifting.

Physical assessment – During the physical assessment, the doctor will examine the elbows and the other joints. He may look for areas where there are a pain, tenderness, and swelling.

Imaging tests – Imaging tests can confirm the results of the physical examination. These will allow the doctor to examine the inside of the elbows. The common imaging tests used are:

X-ray – X-ray or radiography is a test to create a 2D image of the bones. This machine can show images of bone spurs, fractures, and joint space. The joint space shows that there is a sign of arthritis. Bone spurs, which are bony overgrowths, are also signs of osteoarthritis. Lastly, fractures will also show with its severity and location.

Computerized axial tomography (CAT) scan – This is also dubbed as CT scan (computed tomography). This procedure shows cross-sectional slices of the internal structures of the body. The images can show elbow fractures, problems with soft tissues such as ligaments, muscles, and cartilage.

Bone scan ­– The bone scan is used to view the stress fractures caused by excessive and repetitive trauma to the elbow. The procedure is done by injecting a small amount of radioactive material, and this material will collect in the bone, where bone growth and fractures are healing. Then the doctor will view these areas through a scanner.

Magnetic Resonance Imaging (MRI) – This procedure uses a strong magnet attached to a computer. Just like CT scan, it will show the internal structures of the elbow. Aside from the bones, it can show the soft tissues as well.

Laboratory tests – In some cases, samples of blood and joint fluid are taken to help the doctor confirm a diagnosis. For instance, the blood test may show increased levels of the rheumatoid factor. This is an antibody that damages the blood component gamma globulin. This will suggest that the patient has rheumatoid arthritis.

To confirm a dermatomyositis, the doctor may request a laboratory test called erythrocyte sedimentation rate (ESR). Moreover, joint fluid tests that show high levels of uric acid may suggest gout or it may show signs of calcium pyrophosphate dehydrate, which will confirm the diagnosis of pseudogout.

7Treatment

The treatment of elbow pain entails addressing the underlying cause. Here are the common treatments used for elbow pain.

Medications

The doctor may prescribe medicines to relieve pain, reduce inflammation, slow the progression of bone loss and prevent further joint damage. The most common drugs used are:

Nonsteroidal anti-inflammatory drugs (NSAIDs) – These drugs are used to relieve pain. Though they are available over-the-counter, it is still best to ask the doctor for a prescription to prevent adverse effects.

Analgesics – Aside from NSAIDs, analgesics are used to treat many forms of elbow pain, especially those caused by arthritis. Unlike NSAIDs that target both pain and swelling, analgesics are just for pain relief.

Corticosteroids – Corticosteroids are potent anti-inflammatory drugs. These relieve inflammation. This is usually prescribed for people with severe pain. These are effective with a few side-effects. These should be done and injected by doctors.

Drugs for the underlying diseases – If the elbow pain is caused by underlying medical conditions such as rheumatoid or gouty arthritis, there are drugs used to treat these conditions.

For instance, disease-modifying anti-rheumatic drugs are used to treat rheumatoid arthritis and modify the course of the inflammatory disease.

Also, for people with gout, some medications may reduce the uric acid levels in the body. Also, some drugs can relieve the pain during an acute attack. There are also drugs used to treat osteoporosis, which is a disease that may lead to bone loss.

8Prevention

Elbow pain can be prevented through measures used at work, school or during sports activities. To prevent elbow pain, strengthen your arm, wrist, back and shoulder muscles. This will prevent injury to the elbow and will protect the area from trauma and stress.

Also, do not overuse your elbow. Provide rest periods in between activities and you can purchase an elbow support to prevent injuries.