Elbow problems may include multiple issues which can be dangerous if not treated on time. Below mentioned are the types of elbow problems that may arise due to specific reasons.
Degeneration of cartilage covering the ends of the elbow bones is the cause of arthritis. This may happen in response to an injury, fracture, dislocation, aging, and repetitive or overuse of the elbow joint. It persuades pain which gradually reaches its extremity if ignored. Elbow arthritis obstructs activities comprising lifting and holding weight and makes it tough to play sports that involve the use of elbow joints like tennis, badminton, or volleyball. Noticeable symptoms are:
- Pain increases gradually.
- Swelling and stiffness around the affected joint.
- A sensation of clicking, tingling, and locking.
- Joint instability
- Rotating and stretching the arm becomes painful.
- Restricted range of motion.
- Ring and the small finger becomes numb.
Rheumatoid arthritis, osteoarthritis, gout, psoriatic arthritis, juvenile arthritis, and lupus-related arthritis are common forms encountered in most patients with elbow concerns. On-time diagnosis and treatment will keep intact elbow motion and relieve abrasive signs.
The patient is examined physically to look for visible signs. Your doctor may judge the motion of the elbow joint through assisted and non-assisted movement. He may also press the elbow area to search for a tender part. The extent of internal damage is gauged through imaging tests like X-rays or MRIs. A treatment plan is stretched over the cause and seriousness of the issue. Therapies including RICE therapy and physical therapy are suggested along with certain medicines for pain management. Chronic conditions are dealt with an arthroscopic surgery by which loose bodies i.e. fragments of bone, cartilage, or damaged tissues are removed through a small incision and a rough surface is smoothed out. This procedure is effective as small cuts heal quickly and the patient recovers faster. Synovectomy is another surgical method to remove bone spurs through larger cuts. Eventually, elbow replacement surgery is conceived when arthritis reaches the worst level and damages are hard to retrieve.
Irritation or inflammation of the bursa located right below the bony and pointy part of the elbow is termed elbow or olecranon bursitis. Here, the bursa is a cushion between the elbow joint and the skin inhibiting friction due to motion. It is a thin sac containing nominal fluid. A major cause of elbow bursitis is trauma because of a sudden fall or a hit to a hard surface which may usually happen during sports like hockey, football, basketball, or volleyball thus sportsmen are more vulnerable to elbow bursitis. Moreover, people involved in occupations with repetitive use of elbows such as plumbers, mechanics, gardeners, miners, etc. are much more likely to develop this. Prolonged resting of the arm over a hard surface like while typing and disease such as elbow arthritis is also a reason.
Major signs include swelling at the back of the elbow, and pain when the elbow is pressed or moved. If the olecranon bursa is infected, the skin over the elbow joint becomes red, feels warm, and a patient might develop a fever. A physical examination and discussion with the patient reveal the reason for the issue. An orthopedist will assess a range of joint motion and recommend certain laboratory and imaging tests to uncover its exact reason. A sample of fluid is taken from the olecranon bursa to check for infection.
The treatment plan relies on the severity of an issue where a minor issue is mendable through:
- Taking rest from activities that put pressure on the elbow.
- Using a compression bandage to wrap around the elbow for swelling reduction.
- Icing the affected area for 15 to 20 minutes to lessen swelling and inflammation.
- Wear an elbow pad to protect the elbow from direct external pressure.
Painkillers and anti-inflammatory medicines are prescribed for quick relief. If symptoms persist excessive fluid from the olecranon bursa is removed using a needle and a corticosteroid is inoculated to manage inflammation. Surgical segregation is very uncommon but can be employed to handle critical conditions however bursa regrows after several months. For infected bursitis, a fluid sample extracted from the elbow bursa is tested in the laboratory so the doctor can start the antibiotic course accordingly.
Dislocation or separation
When any three of the bones making up the elbow joint slip out of their anchored position dislocation occurs which is a painful event that needs immediate medical handling. The cause behind dislocation might be the contact of an outstretched hand with a hard surface during a fall, a vehicle accident, sports injuries, excessive use of elbow joints, or a syndrome like Ehlers-Danlos that is abnormal flexibility and loosening of joints.
Elbow dislocation could be either partial (subluxation) or complete separation (luxation) of bone. Symptoms depend on the severity of the injury and the bone involved but in both cases, pain is a common mark. Other signs include bruising, visible deformity of the elbow, weakness in the arm, joint instability, loss of movement, and swelling.
As deformity is visible, an orthopedist could diagnose the ailment by looking at the elbow, but he does give a physical inspection to check joint mobility. Severe dislocations could be damaging to the bone, soft tissues, blood vessels, and nearby nerves so it is indispensable to have a look at these internal damages through imaging tests. Thus an orthopedist orders X-rays, MRI, or CT scans to get an in-depth view of the internal matter.
Slight dislocations are relocated on their own but for severe ones, medical help is needed so the doctor can press it back in place manually. Once the bone is relocated medication is provided to relieve pain and the arm is put at rest using a sling to avoid misalignment while healing. Surgery is conceived under chronic conditions when a doctor cannot relocate bone and repairing associated soft tissues, nerves, or blood vessels is required.
Ligament sprains or tears
Elbow ligaments connect the upper arm bone (humerus) to the lower arm bones (radius and ulna) thus a joint is made. Damage to these ligaments can happen with sudden forceful twisting or bending of the arm. This painful incident can deprive of joint motion like straightening or bending of the elbow joint. Other ascending symptoms include inflammation, bruising, or redness. A pop sound is heard or felt when sprained elbow is moved. Immediate diagnosis and treatment are mandatory for speedy recovery otherwise deterioration could get things out of hand.
An orthopedist evaluates the condition through physical examination looking for visible signs and moving the arm to judge a range of joint motion. He may ask various questions inquiring about the reason for injury. The core matter is examined through imaging tests such as X-ray, MRI, CT scan, and ultrasound which generate visuals to determine the severity of the damage. The treatment plan comprises surgical and non-surgical approaches depending on the sternness of the case under discussion. Non-surgical procedures include:
- RICE therapy i.e. rests, ice, compression, and elevation.
- Physical therapy to strengthen muscles and improve joint motion.
- Medication to reduce pain and inflammation is prescribed which may include oral drugs or topical ointments.
Surgery is conceived under the crucial condition when ligaments couldn’t heal on their own and need repair. A minimally invasive technique i.e. arthroscopic procedure is incited to reconstruct torn ligaments through small incisions. Either the torn ligament is sewn back or a graft tendon is extracted and fixed in the affected place to provide a platform for ligament reconstruction.
Loose or foreign bodies
Loose bodies are the bone or cartilage fragments that move about freely within a joint and may cause hindrance to joint motion. In the elbow, loose bodies are formed due to a fracture, impingement lesions or wear and tear of cartilage due to osteoarthritis. Activities that put unbearable stress on the elbow like while sports or weight lifting. A patient can feel the movement of loose bodies within an elbow. It instigates pain, makes a joint stiff, and a catching or locking sensation is discerned.
An orthopedist gives a physical examination, inquires about the reason for the injury, and then checks the range of joint motion through assisted and non-assisted movement. He orders imaging tests like an x-ray or MRI to detect loose bodies around the joint and rule out other reasons with similar symptoms. Diverse treatment methods are adopted depending on the condition and reason for the issue. RICE therapy (rest, ice, compression, and elevation) lets the patient give self-care at home and it helps to reduce troubling symptoms. Your doctor may ask to limit the motion of the elbow joint through a brace until the issue is sorted. Oral medicines to kill the pain are prescribed along with anti-inflammatory drugs to soothe inflammation. Sometimes steroids to soothe synovium inflammation are inoculated into an elbow to lessen impingement.
Failure of non-surgical methods drives toward surgical repairs through arthroscopy. It let removes debris, loose bodies, and bone spurs if present. Moreover, damaged ligaments are reconstructed or sewn back. Physical therapy is recommended to strengthen muscles around to confiscate joint freeze and improve motion.
Many reasons lead to elbow pain which could be due to overuse of joints, a disease or an injury. Concerns may involve your elbow ligaments, arm muscles, tendons, bones, or bursae (especially olecranon bursae). Common reasons include:
Also known as golfer’s elbow it occurs due to repetitive use of the hand or wrist for throwing like in baseball and to workers who use hammers on daily basis. It affects the inner elbow tendons.
It’s a joint disease that causes wear and tear of the cartilage covering the bone ends of the elbow joints.
Dislocation and fractures
A sudden fall or hard hit to the elbow can dislocate or fracture the bones.
Also known as tennis elbow, it affects the outer tendons of an elbow. People who indulge in sports like tennis or squash and occupations like cooking, carpentry, plumbing, or painting are more liable to this disorder. Patients may experience an issue in gripping things.
It is the inflammation of the bursae that lies right under the pointed bone of the elbow. The condition is also known by the name student’s, miner’s, or draftsman’s elbow. An infection, disease, hard hit to the elbow, or putting stress over the elbow through prolonged leaning are the reasons for olecranon bursitis.
Commonly known as panner’s disease it befalls when an injury causes the dislodging of tiny cartilage or bone pieces. Sportsmen are more under threat of getting this ailment.
Strain and sprains
Sprains are damage to elbow ligaments whereas tear to tendons is termed strains. Over-stretching, repeated stress, or an injury are major reasons for sprains and strains.
Major symptoms are pain, swelling, tenderness, redness, warmth, visible deformity in case of dislocation, locking, grating, and popping sensation while joint motion, and limited range of motion.
The orthopedist explores the medical history of a patient and carries out certain physical, imaging, and laboratory tests to evaluate the reason. Imaging tests include X-rays, CT scans, MRIs, and electromyography. Laboratory tests may include biopsy in case of bursitis, blood tests, etc.
A treatment plan is laid down over the severity and nature of the issue. It comprises RICE therapy, physical therapy, steroid injections, oral medications, elbow joint immobilization through a brace, elbow padding, or a surgical repair if the condition doesn’t get better through non-surgical ways. Surgical methods may include tendon grafting, bone repair, and relocation, arthroscopy, or elbow replacement surgery as a last resort.
Tennis or golfers elbow (epicondylitis or tendinitis)
Tennis or golfer’s elbow is an elbow pain that happens due to damage to the tendons connecting forearm muscles to the inner part of the elbow. It controls the motion of your fingers and wrist. Pain begins at the elbow, spread to the forearm, and ultimately affects the wrist. Forceful finger and wrist movement, repetitive stress over forearm muscles, and lifting or throwing weight improperly are major causes of the golfer’s elbow complaint. Sports such as those using rackets, throwing a ball, and lifting weights put you at the stake of getting this disorder.
Pain develops gradually and exacerbates with certain joint movements. The inner side of the elbow becomes tender to touch, the joint feels stiff and weak, and sensations such as tingling or numbness arise in the fingers. The patient’s medical history and physical examination explain the reason. For further confirmation, an orthopedist may apply little pressure on the affected part or may ask to move the elbow, fingers, and wrist in different directions to judge joint motion. Internal examination is made through imaging tests like X-rays and in rare cases, for more detailed insight MRI can also be ordered.
In minor cases, doctors recommend RICE therapy along with medications to manage symptoms and strengthening exercises which gradually help to recover. However, under severe conditions, surgery is considered the best solution. The minimally invasive technique TENEX procedure is conceived by which damaged tissues are removed surgically.
Elbow stiffness or contractures
Elbow contracture or stiffness restricts the extending ability of the elbow joint. A normal elbow can flex from 30 to 145 degrees whereas with stiffness or elbow contracture this degree may drop more than 30 degrees. It affects daily activities making tasks like eating and bathing difficult to perform. Elbow injury, surgery, a disease like arthritis, loose bodies, joint infection, burns, bone spurs, dislocation, and fractures can stiffen the elbow limiting its range of motion.
The pain usually doesn’t feel if you have a stiff elbow but the ability to fully extend the arm is lost. The patient is examined physically and questioned about their health history on his first visit. Imaging tests such as x-rays, MRI, CT scan, and nerve conduction tests may be ordered to get an internal view for an accurate evaluation of the main cause. Non-surgical methods such as physical therapy, massage, splinting, or casting can cure the issue effectively. However, the surgical approach is made when other treatment procedures miscarry to cure. Arthroscopically, the elbow capsular release process is performed through a small incision to relieve stiffness.
In an attempt to prevent a fall with an extended arm, the elbow may get fractured. Moreover, a sports injury, a hard hit or blow to the elbow can also crack the bones. Damage usually occurs to the olecranon (pointy elbow tip) as it is not shielded by muscles. However, fractures to the radial head and distal humerus fractures are also probable. Generally encountered indications are intense pain, visible deformity, bruising, stiffness, swelling, numbness, weakness, and tenderness.
Visible signs are enough to diagnose the elbow fractures as deformity and swelling are evident with the naked eye. Still, an orthopedist carries out a physical examination and checks the range of joint motion to evaluate the extent of the damage. Imaging tests are prescribed for internal examination to see the damage that occurs to soft tissues and blood vessels. Treatment procedures stick to the magnitude of damage. Non-displaced fractures can be cured by immobilizing the elbow joint through a cast or splint. Medicines to relieve pain and inflammation are prescribed. On the other hand, displaced fractures are fixed through surgery whereby displaced bone is relocated, debris is removed, and soft tissues are reconstructed. Surgical hardware like pins, screws, and plates are used for securing bone in place until it heals.