Elbow pain and problems are not restricted to one medical condition. There are different conditions that manifest through elbow pain and other related symptoms. Let’s take a look at some of the most common conditions that are associated with pain in the elbow.
Golfer Elbow
What is Golfer’s Elbow?
Golfer’s elbow, or medial epicondylitis in medical terminology, affects the area between the elbow and the wrist. The inner elbow pain here occurs due to damage to the tendons, which are tissues connecting muscles to bones, that are responsible for bending the wrist and fingers towards the palm. The medical condition is also referred to various other names like baseball elbow, forehand tennis elbow, and suitcase elbow.
Elbow pain causes
Golfer’s elbow is caused due to excessive exertion of pressure on the wrist while bending it towards the palm. It is common among players of golf, baseball and other sports, although it is not restricted to sportsmen only. It can also affect individuals involved with the following activities:
- Using an axe to chop wood
- Throwing a javelin
- Using a spin serve during tennis
- Using a tennis racket that is too short or tightly strung
- Carrying a heavy suitcase
- Weak muscles of the wrist and shoulders
- Excessive and repetitive use of hand tools as common among carpenters, plumbers and construction workers
Risk factors
The following types of individuals are more susceptible to developing the elbow conditions:
- 40 years of age and above
- Obese
- Smokers
- Performs repetitive activities that exert excessive pressure on the wrist muscles and tendons for more than 2 hours
Symptoms
The possible symptoms of the condition are:
- Inside elbow pain, wherein the pain may extend to the inner side of the forearm
- The affected elbow and fist may hurt
- Weakness of hand and wrist
- The pain may spread to more or more fingers, especially the little and ring fingers
Diagnosis
The physician is likely to conduct a physical examination of the patient’s arm, wrist and fingers to check for inflammation, stiffness and rigidity. He/she may rest the arm on a table or bend it to evaluate whether it is flexible. Patients are expected to feel an inner elbow pain if he/she has a golfer’s elbow.
Elbow pain treatment
- Ice pack on inflammations to reduce the pain, tenderness and stiffness
- Physical therapy to control pain and strengthen the affected muscles
- OTC (over-the-counter) anti-inflammatory medications and corticosteroid injections like ibuprofen, acetaminophen and naproxen sodium
- Bracing
- Surgery, in rare cases
Tennis Elbow
What is it?
Tennis elbow, or lateral epicondylitis in medical parlance, refers to the inflammation of tendons, called the exterior carpi radialis brevis, which bends the wrist backwards in the opposite direction. It occurs due to microtearing these tendons that connect the muscles of the forearm to the outer side of the elbow. As indicated by the name, the medical condition is not restricted to tennis players, although it is more prevalent among players of games that involve repetitive hand movements.
Elbow pain causes
- Overuse of the tendons that join the forearm muscles to the outer elbow leads to micro-tearing of the tendons. This pulls the wrist backwards and away from the palm, causing the muscle to rub against the bony bumps of the elbow. This, in turn, causes inflammation and outer elbow pain.
- Receptive movements and excessive exertion of the forearm muscles as in the case of carpenters, butchers, cooks, etc.
- Unattended weightlifting at the gym can also lead to an injury of the forearm muscles.
- Athletes are not the only people who get tennis elbow. Many people with tennis
Risk factors
The following individuals are more prone to developing the medical condition:
- Between the ages of 30 and 50 years
- Both men and women can get affected by it
Symptoms
- Outer elbow pain and/or burning sensation
- Lack of grip strength
- Pain at night
Diagnosis
The doctor is likely to check the area and extent of the inflammation and other associated symptoms. He/she is likely to recommend the below medical tests to accurately diagnose the cause behind the symptoms.
- X-ray: This imaging test can evaluate the presence of abnormalities of the elbow, along with its exact location and extent of the condition.
- MRI: This test is also effective in diagnosing the extent of damage in the forearm tendons if any. It can also detect whether arthritis of the arms or slip disk of the spine are the factors behind the piter elbow pain.
- Electromyography (EMG) of the affected elbow will help in detecting the presence of nerve problems, if any, which may have caused the pain.
Elbow pain treatment
- Medications: Corticosteroid injections like acetaminophen or anti-inflammatory medications like ibuprofen may assist in controlling the swelling and pain.
- Physical therapy: This helps in strengthening the forearm muscles. Ice massage and ultrasound may also be recommended as a part of physical therapy.
- Platelet-rich plasma: This treatment aids in enhancing the biological treatment of the affected tendons and tissues.
- Brace: A brace that supports the back of the affected elbow and forearm may offer these areas the much-needed rest required for it to heal.
- Extracorporeal shock wave therapy: This therapy administers sound waves on the elbow to accelerate the body’s natural healing process.
- Surgery: Arthroscopic Surgery is usually recommended only in chronic & resistant cases.
Cubital Tunnel Syndrome
What is it?
Cubital tunnel syndrome occurs when the ulnar nerve suffers from damage. The ulnar nerve refers to the one that passes through the cubital tunnel – a tunnel of muscle, bones, and ligament – located on the inner side of the elbow.
Elbow pain causes
The medical condition may develop as a result of frequent bending of the elbow while reaching out, pulling and lifting, or exerting pressure on the elbow. Other incidences and medical conditions like injuries, arthritis, dislocations and fractures of the elbow may also lead to this medical condition, in certain cases, the root cause behind cubital tunnel syndrome remains inconclusive.
Symptoms
- Tingling sensation numbness of the fingers, especially the little and ring fingers, specifically when the elbow is bent
- Pain of the hand
- Clumsiness in the affected hand
- Weak grip due to muscle weakness
- Inside elbow pain
Diagnosis
Accurate diagnosis of this medical condition is essential because its symptoms are similar to that of a golfer’s elbow.
- X-ray and Electromyogram
- Nerve conduction test: This test analyses the speed at which a signal travels through a nerve. This helps in evaluating the presence of compression or constriction of the nerve.
Elbow pain treatment
- Tasking rest is essential to free the affected area of stress
- Elbow pad may be recommended to offer the elbow the necessary support and protect it from irritation on coming in contact with hard surfaces
- Foam elbow brace or splint to reduce movement and control irritation
- Nerve gliding physical therapy
- Anti-inflammatory medications like ibuprofen and naproxen
- Steroid injections to control inflammation and pain
- Surgery may be considered as the last resort
Dr. Arun G S, Consultant – Orthopaedics, Sahyadri Narayana Multispecialty Hospital, Shimoga