Elbow pain can have various causes, often depending on the structures affected, such as muscles, tendons, ligaments, bones, or nerves passing over and around the elbow joint. The most common injuries we see within the elbow joint are:
Lateral Epicondylitis (Tennis Elbow) Caused by overuse or strain of the tendons that attach to the lateral (outer) part of the elbow. This condition is often seen in athletes, particularly tennis players, but can also occur in people who perform repetitive wrist or arm movementssuch as manual workers, painters and decorators and individuals who lift weights. There are various levels of treatment intervention for a tennis elbow, ranging from braces and splints, Strengthening exercises, dry needling, massage, shockwave therapy, fenestration (dry needling under local anaesthetic), Prolotherapy and Platelet Rich Plasma (PRP) injections.
Medial Epicondylitis (Golfer’s Elbow) Similar to tennis elbow but affects the tendons on the inner side of the elbow. It can occur due to repetitive motions like gripping or flexing the wrist. It’s called a golfer’s elbow as when the golf club impacts the golf ball there is considerable load put on the tendons leading to a repetitive strain. In some cases, the tendon can develop small microtears, which can cause the condition to be ongoing for months and sometimes years. It’s very important to get an ultrasound scan to determine the cause leading to a better treatment outcome.
Bursitis
You may have seen a colleague or friend who has a swelling / lump at the tip of their elbow. It’s known as an Olecranon Bursitis, inflammation of the bursa (a fluid-filled sac that helps reduce friction). It can result from trauma, prolonged pressure on the elbow (It use to be known as a student’s elbow), infection, or conditions like gout or arthritis.
Ligament Strain or Sprain
Overstretching or tearing of the ligaments around the elbow joint can lead to pain, often as a result of injury, such as during sports activities. The ulnar collateral ligament (UCL), which stabilizes the elbow, is commonly affected, particularly in throwing athletes (e.g., Javelin and cricketers).
Fractures and Dislocations
Trauma to the elbow, such as a fall or direct impact, can lead to fractures of the bones around the elbow (humerus, radius, or ulna) or dislocation of the joint. These injuries typically cause sharp pain, swelling, locking of the joint leading to limited range of motion. If we diagnose a fracture or dislocation we will happily provide an orthopaedic referral.
Nerve Compression (Entrapment)
There are three main nerves that cross the elbow joint. One of which, known as the ulna that passes along the inside of the elbow through the “Cubital Tunnel” it’s here the ulna nerve can be compressed by a thickened ligament, contracture of the medial head of triceps, arthritis of the joint or the nerve itself can snap back and forth over the bone when the elbow bends and straightens. This leads to the condition known as Cubital Tunnel Syndrome. Symptoms arising from the ulna compression are numbness, tingling, or pain around the inside of the elbow, in the forearm, hand, and fingers (especially the ring and little fingers). This condition is easily diagnosed via an ultrasound scan as the dynamic nature of ultrasound allows the sonographer to see the nerve compression in real time on passive flexion and extension of the elbow. The second nerve to be compressed as it passes the outside of the elbow is a branch of the radial nerve known as the Posterior Interosseous Nerve. This nerve crosses over the outside of the elbow and can be compressed through a fibrous band of tissue known as the “Arcade of Frohse”. If this occurs the individual can get pain in the forearm and potential weakness in the wrist extensor muscles. This condition is often misdiagnosed as tennis elbow. Again, diagnoses are made via a dynamic ultrasound scan.
Arthritis
Osteoarthritis, degeneration of the cartilage in the elbow joint due to wear and tear, leading to pain, stiffness, and reduced range of motion.
Rheumatoid Arthritis, an autoimmune condition where the body’s immune system attacks joint tissues, causing inflammation, pain, and damage to the elbow joint.
Referred Pain
Pain is often felt in the elbow yet symptoms originate from problems in other parts of the body, like the neck or shoulder, due to nerve compression or somatic referral. At the Injury Hub this is a very common finding. Quite often the C6 nerve root in the neck can be compressed and this is felt along the elbow and forearm. Shoulder pathology such as a bursitis can refer to the lateral arm and down to the elbow joint. Quite often a patient will think the elbow is the cause of their pain but on examination it is a clear referral from the neck or shoulder.
Identifying the exact cause of elbow pain is essential for specific and tailored treatment, especially when it’s related to overuse or trauma. The elbow is a great joint to scan via ultrasound, and we can almost certainly give you an instant diagnosis at the Injury Hublocated in Bow, E3.