Brief overview
- Causes of elbow pain: e.g. overloading, fractures, joint inflammation or dislocations
- What helps against elbow pain? Depending on the cause, for example, immobilization and cooling of the elbow joint, medication, surgery
- When to see a doctor? If the pain is severe and/or persistent and/or if there are accompanying symptoms such as overheating or swelling.
Pain in the elbow: Causes and possible diseases
Pain in the elbow can be caused by an injury or overloading or be a sign of an acute or chronic illness. Common causes of elbow pain are
Tennis elbow
The affected hand is also no longer quite as strong: patients are unable to close their hand forcefully into a fist, hold a cup or grip firmly when shaking hands. It is also quite painful to stretch the fingers against resistance.
Golfer’s elbow
If the elbow pain occurs on the inside, i.e. in the area of the lower bony prominence on the elbow, this is called medial epicondylitis (“golfer’s elbow”). This is a painful irritation of the tendon insertion of the hand and finger flexor muscles on a bony prominence on the inside of the elbow.
Golfer’s elbow” is much rarer than tennis elbow and is often seen in throwing athletes. However, it also occurs in gymnasts, for example, and in people who train a lot with free weights.
Irritation of the ulnar nerve
The ulnar nerve can also be chronically irritated at this sensitive point on the elbow, causing the radiating elbow pain and discomfort described above. Doctors refer to this as sulcus ulnaris syndrome (cubital tunnel syndrome).
Chassaignac’s palsy
Elbow dislocation
Sometimes elbow pain is caused by a dislocation of the joint. In this case, the bone suddenly jumps out of the joint, the elbow can no longer be moved and is misaligned. People often dislocate their elbow when they try to catch themselves with their hand in a fall with a bent or hyperextended elbow.
Broken bones (fractures)
A bone fracture in the area of the joint can also be the cause of pain in the elbow.
Distal biceps tendon rupture
Bursitis
Sometimes the elbow pain becomes noticeable when leaning on something. The elbow area can also become swollen, reddened and overheated. In such cases, acute bursitis is usually behind the symptoms.
Because students in particular often lean on their elbow during lectures or when studying, this condition is known colloquially as “student’s elbow”.
If the bursa on the elbow is not acutely inflamed but chronically inflamed, there are hardly any symptoms.
Joint inflammation
In diseases such as rheumatism (rheumatoid arthritis) and gout, inflammation occurs in many joints and is associated with joint pain. Elbow joints can also be affected.
Joint wear and tear can affect various joints – including the elbow joint. Those affected initially feel pain in the elbow when weight is placed on it. Later, the pain occurs with every movement in the elbow joint and eventually also at rest.
If the joint wear is accompanied by inflammatory processes (activated osteoarthritis), this can also cause pain in the elbow.
Osteochondrosis dissecans
This may be due to repeated tiny injuries or stresses (such as repeated throwing movements). This can cause small fragments of cartilage and/or bone to break off and become trapped in the joint space as free joint bodies.
Panner’s disease (juvenile osteochondrosis)
Elbow pain: what helps?
It is possible to do something about elbow pain yourself, depending on the cause. If you can still move your elbow and it is neither overheated nor swollen, you can try to relieve the pain with a painkiller (e.g. ibuprofen). Immobilizing the elbow with a bandage can also help.
How the doctor treats elbow pain
Depending on the cause of the elbow pain, the doctor will suggest a suitable treatment. Here are a few examples:
A tennis or golfer’s elbow will usually be treated conservatively: The joint is immobilized and must be spared for a while. Cold (in the acute stage) or heat (in the chronic stage) and pain-relieving medication can help to relieve the pain in the elbow.
Sharp pain in the elbow caused by bursitis is also usually treated conservatively: The joint is immobilized and the patient is given anti-inflammatory and pain-relieving medication. If the swelling is severe, the doctor may puncture the joint: He uses a hollow needle to puncture the accumulation of fluid in the joint in order to drain it. Surgery is only the last treatment option for bursitis.
Elbow pain due to Panner’s disease often heals spontaneously. Symptomatic measures such as ointment dressings and avoiding sports that strain the joint (such as tennis) support the healing process. The doctor will only operate if free joint bodies occur or the joint is blocked.
Treatment for pain in the elbow due to osteochondrosis dissecans is similar: Conservative treatment is preferred. Surgery is only considered in advanced stages.
Elbow pain: examinations
To get to the bottom of elbow pain, the doctor will first ask you about your medical history (anamnesis). He or she will ask you to describe the nature of the pain in your elbow in detail. For example, it may feel stabbing, pulling or dull. Possible questions during the medical history interview are
- Where exactly do you have pain? Is it acute or chronic?
- How long have you been experiencing pain in your elbow joint?
- What is your profession? Do you do sport?
- When exactly do you feel the pain in your elbow – for example when gripping and lifting an object or when stretching your forearm, etc.? Is there also pain at rest?
- Do you have any other complaints such as limited mobility of the elbow?
- Do you have any systemic diseases such as arthritis (“rheumatism”) or gout?
The physical examination, the movement and function tests and the information from the medical history interview are often sufficient for the doctor to determine the cause of the pain in the elbow. If not, or if there are doubts about the diagnosis, further clinical or instrumental examinations are used as required.
Further examinations
Nerve damage in sulcus ulnaris syndrome can be determined by measuring the nerve conduction velocity (electroneurography = ENG).
If there is a suspicion that inflammation is generally causing the pain in the elbow, measuring the inflammation parameters in the blood (such as blood sedimentation, CRP, leukocytes) can help.
Pain in the elbow: When do you need to see a doctor?
You should see a doctor if you experience severe and/or persistent pain in your elbow. This is especially true if additional symptoms occur, such as swelling and overheating of the joint, a misalignment of the elbow or significantly restricted mobility of the forearm.
In such cases, you can seek advice from your family doctor, an orthopaedist or a sports physician.
