Elbow pain can be due to a variety of causes and can vary in severity. Elbow pain should be evaluated by a doctor if it persists for more than three days.
What is elbow pain?
Pain in the elbow often occurs with severe or incorrect stress from both everyday movements and sports. Pain in the elbow often occurs with heavy or incorrect stress from both everyday movements and sports. However, elbow pain can also occur after a prolonged period of immobilization (for example, due to a cast). Depending on the cause, pain can be felt as stabbing, pulling or pressing. The elbow is a joint composed of three partial joints, which have a joint capsule. The bone of the upper arm (humerus) and the bones of the lower arm, ulna and radius, are each connected by a partial joint. The elbow joint allows the forearm to be bent, extended and rotated. In addition to the bones, the joint area also includes cartilage, synovial fluid, ligaments and tendons. In the case of joint inflammation, a warming of the elbow can be felt. In addition, the mobility of the joint is often limited when there is pain in the elbow.
Causes
A wide variety of strains can trigger pain in the elbow. Incorrect or excessive stress can be causative, as can previous immobilization or injury. Inflammatory causes of elbow pain include arthritis, rheumatoid arthritis based on immune system dysfunction, inflammation of joint bursae, and tenosynovitis. So-called tennis elbow and golfer’s elbow can be due to inflammatory or wear-related (degenerative) changes in the elbow, but despite their names are mostly based on stresses during work. Joint wear and tear, which can also lead to joint pain, is called osteoarthritis. Irritation of the ulnar nerve (for example, due to an impact of the so-called musician’s bone against an edge), dislocation (joint dislocation), injuries to tendons, ligaments or the joint itself, bone fractures and muscle injuries or muscle strains can equally cause pain in the elbow.
Diseases with this symptom
- Joint inflammation (arthritis)
- Tendonitis
- Osteoarthritis
- Rheumatism
- Tennis elbow
- Bone inflammation
- Bursitis (inflammation of the bursa)
- Bone fracture
- Torn muscle fiber
Diagnosis and course
Since pain in the elbow can be due to a wide variety of causes, a careful diagnosis is important in order to take the appropriate measures to relieve the pain. In many cases, pain resolves on its own without the need for further intervention. These include the discomfort that occurs after a bump on the funny bone or after a temporary heavy load on the elbow. However, if the pain in the elbow lasts longer, if there is swelling (indicating inflammation), or if there is heating of the joint, a doctor should be consulted. In order to narrow down the cause of the disease, the medical history, including any previous illnesses, is first clarified. In addition to an exact localization of the pain, the previous period of pain and any overloading of the joint that may have occurred are important. If osteoarthritis has already been diagnosed or if the pain was preceded by an accident, the elbow must first be thoroughly examined for any swelling and for mobility. If bone damage is suspected, an X-ray examination is performed. Sonography (ultrasound examination), magnetic resonance imaging (MRI) or arthroscopy are also possible. A blood test provides information about any focus of inflammation. In the case of joint effusions, a joint puncture may be appropriate if there is pain in the elbow.
Complications
Elbow pain, no matter the genesis, can lead to more or less severe complications. Early treatment (after three days at the latest) is therefore advisable.Swelling, which can also indicate inflammation in the joint, is just as much a complication as (severe) heating of the elbow joint and must be treated immediately. Signs of wear and tear do not always correlate with the symptoms and are therefore often detected very late, which can lead to an increase in pain. Elbow stiffness is one of the serious complications of a failed or too late therapy. If epicondylitis humeri radialis (tennis elbow) has been diagnosed, surgery is necessary after unsuccessful conservative therapy. This can result in an injury to the annular ligament around the head of the radius with painful movement restrictions. Pain and discomfort as well as excessive scarring cannot be ruled out postoperatively. Thanks to modern surgical methods such as minimally invasive techniques, infections, post-operative bleeding and injury to nerves and blood vessels have become very rare. However, they cannot be ruled out. There is also a risk of seroma (“encapsulation of wound secretion as a local prallelastic swelling in the surgical area”). Untreated osteoarthritis or rheumatoid arthritis may result in the need for an elbow prosthesis later in life. This also applies to fracture and osteomyelitis if there is damage to the cartilage layer.
When should you go to the doctor?
Elbow pain is not necessarily a reason to see a doctor immediately. Often there is a trivial reason for them and they pass quickly. A typical trigger for elbow pain is bumping the so-called funny bone. Another trigger of pain is overloading of the elbow. However, if the elbow joint swells and is overheated, a visit to the doctor is recommended. Likewise, it is advisable to see a doctor if elbow pain persists for more than three days. As the junction of the upper arm and forearm, the elbow joint is basically exposed to a special load. Elbow pain manifests itself primarily as pulling, stabbing or pressure. In addition to overuse of the joint, elbow pain can be caused by other factors, including tendonitis, tennis elbow, inflamed bursa and joint wear and tear. Tense or injured muscles also trigger elbow pain. It is also worth mentioning the possibility of arthritis or rheumatism as a cause of elbow pain. At the beginning of the treatment for elbow pain, the doctor asks his patient specific questions about the complaints, habits and previous diseases. This is followed by movement checks and further examinations, which are based on the findings from these. Sonography, magnetic resonance imaging and X-rays may be involved, as well as blood tests, arthroscopy or a joint puncture in case of fluid accumulation. If elbow pain is pronounced, a visit to the doctor can prevent permanent late damage to the elbow.
Treatment and therapy
The therapeutic measures result from the identified causes of the pain in the elbow. Pain due to temporary overloading or incorrect loading usually resolves without special therapy. If, on the other hand, immobilization of the elbow joint is indicated, a plaster splint or an ointment bandage may be necessary. Pain can be treated with anti-inflammatory painkillers (usually in ointment or tablet form). Joint lavage or joint injections with administration of cortisone-containing medications, as well as local anesthesia, can also help relieve joint pain. If chronic elbow pain is present or if the patient is an inpatient in a hospital anyway, anesthetic and pain medication can be delivered directly to the arm nerves via a catheter placed near the armpit (“brachial plexus blockade”). If milder (conservative) means are not sufficient to eliminate pain, surgery may be considered. Many causes of pain can be eliminated by means of arthroscopy (joint endoscopy) of the elbow joint. In the case of pain triggered by osteoarthritis, a so-called osteotomy, in which bones are cut or parts of bones are removed, may help under certain circumstances. Accompanying physiotherapeutic treatment can also be considered.Cold or heat treatment, exercise that strengthens and stretches the muscles, and participation in sports that place little stress on the joints complete the therapeutic options for elbow pain.
Outlook and prognosis
The elbow joint is subjected to a lot of stress in everyday life, so overuse pain is common. The first treatment for overuse pain is immobilization. Patients should rest the arm as much as possible, neither lifting heavily nor performing one-sided activities. A typical condition is “tennis elbow“. It develops during excessive tennis and table tennis play, but also during manual activities such as the forceful insertion of screws. All of this must now be avoided. Similarly often, tension in the neck muscles or problems with the cervical spine cause elbow pain. Both lead to poor posture with radiating pain into the arm, sometimes extending to the fingertips. Here, the underlying disease must be treated. Tense muscles must be loosened. Infrared radiation, warm compresses and massages, for example, can help. If the pain occurred after a fall, an X-ray should ensure that there is no injury to the bone. A bruise can also cause severe discomfort and takes a long time to heal. Painful wear and tear of tendons often develops in advanced age and presents with similar symptoms. Wear and tear cannot be stopped, but it can be positively influenced by gentle gymnastics and a healthy diet. Cool compresses and anti-inflammatory ointments can relieve inflammatory symptoms. Immobilization is also important in this case. If necessary, the arm must be worn in a sling.
Prevention
Prophylaxis is not possible against all causes of pain in the elbow. However, sports can be selected, for example, that involve as little stress as possible on the elbow joint. One-sided stresses on the elbow joint, for example, should be avoided. Elbow pads can reduce the risk of joint injury in hazardous occupations or sports. The earliest possible treatment of noticeable symptoms such as swelling or warming can counteract the expansion of any inflammation in the joint and the development of possible complications of pain in the elbow.
What you can do yourself
With the help of various measures, elbow pain can be relieved. The pain can be cooled and thus relieved with an ice pack. A piece of cloth should be placed between the skin and the ice pack. The cooling time should be about 20 to 30 minutes. At least one hour should elapse between applications. Pain relieving can also be compresses with curd or white cabbage. The bandages can be left on the arm overnight; during the day they should be changed as soon as they have warmed up. Homeopathic remedies such as Arnica or Bryonia D4 or D6 can also relieve elbow pain. People with elbow pain should avoid movements that trigger or increase pain. Stretching exercises can be useful. The elbow should be stretched and the forearm gently turned inward. Then the painful hand is slowly pressed to the side so that the fingers point outward. This position should be held for about 15 seconds. It makes sense to perform the exercise several times a day. An elastic bandage around the wrist and forearm – a so-called epicondylitis brace – relieves the muscles and tendons. It is available in pharmacies, medical supply stores and sports stores. Ergonomically correct posture at the workplace is also recommended. This includes, among other things, a comfortable and upright sitting posture and adjusting the monitor to eye level.
