The musculoskeletal system is a complex and important system in the body. It gives form to the body and helps with movement. The musculoskeletal system consists of various parts such as bones, muscles, ligaments, and tendons.
A tendon is a highly organized connective tissue fusing the muscle to the bone. As a result, it provides resistance to high tensile forces while transmitting the forces from the muscle to the bone. Tendons are made up of cells of various shapes, fibers, and ground substance.
The elbow contains a tendon that provides strength and power to the arms.
However, in some cases, this tendon becomes inflamed and painful, causing a condition called elbow tendonitis.
Elbow tendonitis like tennis elbow or golfer’s elbow happens when a tendon inflames and becomes painful after an injury. This is self-limiting, and you can treat it yourself for about 2 to 3 weeks, but the pain can be managed by the doctor if it’s too painful already.
Elbow tendonitis is the inflammation or irritation of a tendon in the elbow. This tendon is thick fibrous cords that attach the muscle to the bone. Commonly, rest, physical therapy, and medications for pain may help manage the condition. However, for severe cases of elbow tendonitis that involve the rupture of the tendon, surgery may be needed.
2Signs and symptoms
The common signs and symptoms of tendonitis occur in the area where the tendon attaches to the bone. These include:
- Pain (dull, particularly when moving the affected joint or arm)
- Inflammation or mild swelling
Some types of pain can occur suddenly and may last for days or more. The pain usually gets better with treatment and rest. The pain is described as a dull ache that’s concentrated around the affected joint or arm. The pain increases with movement and when touched.
When to see a doctor
It is important to make sure the area will not be infected. For regular cases, the pain and swelling may go away with rest and home remedies. In some cases, however, the condition may lead to more serious complications. If the affected tendon has been ruptured or torn, seek medical attention right away. On the other hand, if there is an obvious sign of infection, go to the doctor immediately for early treatment.
Though elbow tendonitis can be caused by a sudden blow to the elbow or injury, the condition is more likely to root from repetitive movements for a prolonged period. Most individuals develop the condition due to their occupations or hobbies that put stress on the tendons of the arms.
Furthermore, improper body mechanics when moving may also lead to the development of elbow tendonitis. The inappropriate technique can overload the tendon, which can occur in conditions like tennis elbow or golfer’s elbow.
There are many activities that can result in elbow tendinitis, including:
- Cleaning the house
- Other racket sports
- Throwing and pitching sports like baseball, football, javelin, and others
Also, the incorrect posture at work or home may lead to elbow tendonitis. Poor stretching or condition before working out or playing any sport also heightens the risk.
There are certain factors that may increase one’s risk of developing elbow tendonitis, which includes:
Age – As people get older, the tendons become less flexible, leading to the development of various injuries.
Sports – Certain sports may increase the risk of having elbow tendonitis. These sports usually involve repetitive motions, particularly if the athlete’s movement and technique are improper or aren’t optimal. The sports activities include baseball, bowling, basketball, swimming, golf, tennis, running and badminton.
Work – Some occupations are at a higher risk of developing elbow tendonitis. These jobs involve awkward positions, repetitive movements, overhead reaching, vibration and forceful exertion.
Incorrect posture at work or home – Incorrect posture at work or at home may also lead to elbow tendonitis, particularly if you do not practice proper body mechanics.
Poor stretching or conditioning before working out – Before working out, exercise or a sports activity, you will get elbow tendonitis if you do not properly stretch or condition the muscles and tendons.
Arthritis and other conditions – People with these conditions may have a higher risk of having elbow tendonitis and tendonitis of the other parts of the body. The conditions include rheumatoid arthritis, psoriatic arthritis, gout, medical reactions and thyroid problems.
Tendon rupture – If the condition is left untreated, it can increase the risk of having tendon rupture, a serious condition that may need surgery.
Tendinosis – Also, if elbow tendonitis is not treated immediately, it might lead to tendinosis may develop, a condition where degenerative changes in the tendon happen, with abnormal new blood Bessel growth.
A primary care doctor can diagnose elbow tendonitis with a medical history and physical examination. If there is chronic and persistent swelling or redness around the joints, fever, and chills, seek medical attention to make sure there isn’t an infection.
First, the doctor will need to take a medical history of the patient, asking questions about the severity of the symptoms, when the symptoms first appeared and the activities the patient is regularly performing. The physical examination will involve the doctor checking for tenderness, redness, inflammation, limited movement of the area affected and muscle weakness.
Some doctors may require blood tests to look for the causes of the inflammation around the joint, such as gout or rheumatoid arthritis.
In some cases, the doctor may also require X-rays to confirm that there is no fracture or dislocations. Moreover, ultrasound or magnetic resonance imaging (MRI) scan may be needed to detect tendon damage and the extent of the damage.
Since the condition causes inflammation, pain, and tenderness, it may get better with rest. However, in some cases, treatment may be needed.
The common treatment options include:
Rest and splints – Many soft tissue problems are caused by the overuse of the muscle. The initial treatment is to rest the affected area and avoiding doing some activities for the meantime. The use of splints, slings, and braces are effective in helping the area rest as the pain eases.
Warm and cold compress – The cold compress can help reduce the swelling and pain when the injury happened. It is effective in the first 48 hours after overuse, swelling or injury. After which, a warm compress is ideal for long-term or chronic pain.
Medicines – Over-the-counter medicines may be recommended for pain and inflammation. Usually, non-steroidal anti-inflammatory (NSAID) medicines are recommended because they target both pain and swelling.
Corticosteroids – The doctor may also resort to corticosteroid injections around a tendon to relieve elbow tendonitis. The injections reduce inflammation and can help ease the pain.
Platelet-rich plasma – Platelet-rich plasma (PRP) involves taking a sample of the blood of the patient to separate the platelets and other healing factors. The plasma is then injected into the affected area.
Physical therapy – The doctor may recommend that you enroll in a physical therapy program of specific exercise. This exercise is designed to strengthen and stretch the affected muscle-tendon unit.
Surgery – When all else fails, the doctor may recommend surgery depending on the severity of the condition.
Dry needling – Dry needling is a procedure wherein small holes are made in the tendon with the use of a needle to stimulate the healing factors to act on the injured or damaged tendon.
Ultrasonic treatment – Ultrasonic treatment is minimally-invasive wherein a small incision is made to insert a device that can remove the scar tissue in the tendon through the use of ultrasonic sound waves.
Lifestyle changes and home remedies
For home remedies, you should remember the acronym RICE, which means rest, ice, compression and elevation to reduce pain and inflammation.
Rest – As soon as you felt pain during activity, you should rest. Also, avoid activities that can increase pain and swelling. It is the key to tissue healing and a faster recovery.
Ice – As soon as injury or pain happens, you can reduce pain by applying ice to the affected area for up to 20 minutes many times a day. Do not apply the ice pack directly to the skin. Use a thin washcloth or towel before applying it.
Compression – Since swelling may lead to reduced motion, compress the area until the swelling has ceased. Elastic bandages can be used.
Elevation – Elevate the affected area, if it’s located in the lower part of the body.
To prevent and reduce the risk of developing elbow tendonitis, here are the preventive measures:
- Avoid activities that put extra stress and pressure on the tendons, particularly the elbow area.
- Improve your technique in sports activities to make sure there will be no tendon problems.
- Observe proper body mechanics when lifting, throwing, or working.
- Stretch before working out or any sports activities
- Use proper workplace ergonomics
- Warm up before starting strenuous exercise
- Perform the intensity of the workout gradually
- Avoid activities that require prolonged periods of reaching over the head
- For people performing racket sports, change the racket with a larger head to prevent re-injury.