Elbow Problems | Orthopaedic Surgeon Queensland

Elbow Problems

What is the Elbow?

The elbow is a complex joint that connects the upper arm bone (the humerus) with the two bones of the forearm (the radius and the ulna). It's one of the major joints in the human body and plays a crucial role in arm movement.

What are Elbow Problems?

Elbow problems encompass a variety of conditions that can cause pain, discomfort, and limited movement in the elbow joint. These can range from temporary conditions like a simple sprain to chronic issues like osteoarthritis.

How Do Elbow Problems Impact Your Anatomy and Health?

Elbow problems can significantly impact the functionality of your arm, limiting your ability to carry out daily activities, work tasks, or enjoy your favourite sports. Depending on the condition, it can also lead to muscle weakness, joint instability, nerve damage, and chronic pain.

Who is Most at Risk for Elbow Problems?

While elbow problems can affect anyone, certain groups are more at risk. Athletes, manual labourers, and office workers often encounter these issues due to repetitive motion or strain on the elbow joint. Age is also a factor, with conditions like osteoarthritis more common in older adults.

Causes of Elbow Problems

Elbow problems can arise from a variety of causes, which include:

Overuse or Repetitive Strain: Activities that involve constant twisting of the wrist or forearm, such as tennis, golf, or certain work tasks, can strain the muscles and tendons in the elbow, leading to conditions like tennis elbow or golfer's elbow.
Trauma: Elbow injuries like fractures or dislocations can occur due to trauma, such as a fall, a direct blow to the elbow, or an accident.
Wear and Tear: Over time, the cartilage that cushions the elbow joint can wear away, causing conditions like osteoarthritis.
Inflammatory Conditions: Some elbow problems are related to inflammation, such as rheumatoid arthritis, an autoimmune disease, or bursitis, which involves inflammation of the bursa, a small fluid-filled sac at the point of the elbow joint.
Nerve Entrapment: Conditions like cubital tunnel syndrome or radial tunnel syndrome occur when pressure increases on the nerves that pass through the elbow region, often due to repetitive bending and straightening.
Infections: In rare cases, bacteria can invade the elbow joint and cause a painful infection known as septic arthritis, a serious condition that needs immediate medical attention.

Symptoms of Elbow Problems

The symptoms of elbow problems can vary depending on the specific condition and its severity, but they often include the following:

Pain: The most common symptom and can be experienced in different ways. It might be a sharp, shooting pain, a dull ache, or a throbbing sensation. The pain could be constant or only occur when you use your arm a certain way.
Swelling or inflammation: Some conditions, like bursitis or arthritis, can cause the elbow joint to become swollen and warm to the touch.
Stiffness: You might find your elbow joint stiff, especially after inactivity or waking up.
Reduced range of motion: In some cases, you might not be able to fully extend or flex your arm due to pain or stiffness in the elbow joint.
Weakness: Some elbow conditions can cause weakness in the arm or hand, making it difficult to grip objects or perform certain tasks.
Numbness or tingling: If a nerve in the elbow is affected, you might experience numbness, tingling, or a "pins and needles" sensation in your forearm, hand, or fingers.
Redness and heat: In cases of infection or significant inflammation, the skin over the elbow may become red and warm to the touch.

Types of Elbow Problems

Several types of elbow problems can result in pain, discomfort, and limited movement. Here are some of the most common:

Tennis Elbow (Lateral Epicondylitis): Caused by overuse of the forearm muscles and tendons, leading to pain on the outer part of the elbow.
Golfer's Elbow (Medial Epicondylitis): Similar to tennis elbow, this condition affects the inner part of the elbow and is caused by overuse of the forearm muscles and tendons.
Bursitis: Occurs when the bursa, a small sac of fluid that cushions the elbow joint, becomes inflamed, often due to repetitive motion or trauma.
Fractures: These can occur from a fall, a direct impact on the elbow, or a twisting injury. Fractures can involve different elbow parts, such as the distal humerus, radius, or ulna.
Cubital Tunnel Syndrome: Caused by increased pressure on the ulnar nerve, which passes in a groove on the inner side of the elbow. Symptoms can include numbness and tingling in the hand and fingers.
Osteoarthritis of the Elbow: A type of arthritis that occurs when the cartilage that cushions the elbow joint wears down over time.
Rheumatoid Arthritis: This autoimmune condition can cause inflammation in any joint, including the elbow.
Dislocation: Occurs when the bones of the elbow are forced out of alignment, typically due to trauma such as a fall or accident.

Stages of Elbow Problems

The progression or stages of elbow problems can vary greatly depending on the specific condition. However, for some common conditions like arthritis or tendonitis, they can be typically classified into the following general stages:

Early Stage: Symptoms may be mild and intermittent. There may be occasional discomfort or stiffness in the elbow, especially after periods of inactivity or excessive use. Swelling may not be noticeable, and the range of motion is usually unaffected.
Intermediate Stage: As the condition progresses, symptoms may become more frequent and severe. You might experience more pain, even during rest. Swelling might be more apparent, and you might notice a decreased range of motion.
Advanced Stage: The joint might be noticeably swollen or deformed. The pain could be constant and severe, and you might have difficulty moving your elbow.

Elbow Problems Diagnosis

Patient History: The diagnosis begins with reviewing your symptoms, medical history, and any specific incidents or activities that might have led to the onset of your elbow pain. Your doctor will ask you questions about the nature of the pain when it started, and whether anything makes it better or worse.
Physical Examination: This may include checking your elbow for swelling, tenderness, or deformity; assessing the range of motion in your elbow; applying pressure or asking you to move your arm in certain ways to see if it causes pain.
Diagnostic Tests: Your doctor may order one or more diagnostic tests depending on the physical exam results. These can include:
X-rays: These images can reveal fractures, bone spurs, or other abnormalities in the elbow joint.
MRI (Magnetic Resonance Imaging): Provides a detailed view of the soft tissues in your elbow, such as muscles, tendons, ligaments, and cartilage.
CT (Computed Tomography) Scan: Provides a more detailed image of the bones and can help diagnose complex fractures.
Ultrasound: Used to visualise soft tissues like tendons and ligaments and can also guide injections for treatment.
Nerve Conduction Studies: Help diagnose nerve entrapment syndromes like cubital tunnel syndrome.

Elbow Problems Treatment

Elbow problems range from minor injuries to chronic conditions affecting the joint and surrounding structures. The treatment for elbow problems depends on the specific condition and severity.

Here are some common treatment approaches for various elbow problems:

Rest and Activity Modification: For mild elbow problems, rest and avoiding activities that exacerbate the symptoms can allow the affected area to heal.
Pain Management: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help alleviate pain and reduce inflammation in the elbow.
Physical Therapy: A physical therapist will design a customised exercise program to improve the elbow joint's range of motion and the strength of surrounding muscles. They may also use manual therapy, ultrasound, or electrical stimulation to alleviate pain and promote healing.
Immobilisation: In some cases, immobilising the elbow joint with a splint, brace, or cast may be necessary. Immobilisation helps protect the injured or inflamed area, allowing it to heal properly. It also reduces stress and strain on the elbow joint during recovery.
RICE Therapy: RICE stands for Rest, Ice, Compression, and Elevation. This therapy is commonly used for acute injuries like strains, sprains, or tendonitis. Resting the elbow, applying ice packs to reduce swelling, using compression bandages to provide support, and elevating the elbow can help alleviate pain, reduce inflammation, and promote healing.
Medications: Besides over-the-counter NSAIDs, your doctor may prescribe stronger pain medications or corticosteroid injections to manage severe pain and inflammation. These medications can provide temporary relief but are typically part of a comprehensive treatment plan.
Occupational or Sports-Specific Therapy: This may be recommended if the elbow problem is related to specific occupational or sports activities. These specialised programs focus on improving techniques, modifying movements, and using ergonomic tools or equipment to prevent further strain or injury to the elbow.
Platelet-Rich Plasma (PRP) Therapy: This involves injecting a concentrated solution of platelets derived from the patient's blood into the affected area. Platelets contain growth factors that can promote healing and tissue regeneration. PRP therapy is sometimes used for conditions such as tennis elbow (lateral epicondylitis) or golfer's elbow (medial epicondylitis).
Surgical Intervention: In cases where conservative treatments fail to provide relief or when there is significant damage to the elbow joint or surrounding structures, surgical intervention may be necessary. The surgical procedure will depend on the underlying condition and can range from minimally invasive arthroscopic surgery to open surgery for more complex cases.

Surgical options may include removing loose bodies, repairing or reconstructing tendons, or joint replacement in severe cases.