Common Symptoms of Elbow Pain
Tendon pain around the elbow
The elbow joint is surrounded by muscles that facilitate movement in the elbow, wrist and fingers. The muscles are attached to bone through tendons and these can become painful when placed under high repetitive loads, for example a weekend of painting with a roller. Common tendon pain conditions at the elbow include tennis elbow, golfers’ elbow and biceps tendinopathy.
‘Tennis elbow’ – lateral epicondylitis
Tennis elbow is a condition that causes pain on the outside of the elbow when gripping, for example, opening a door or jar, lifting the kettle and lifting bags. The condition is common and can affect anyone; however, you are most likely to suffer with symptoms around the ages of 40-50 years.
Tennis elbow often occurs after placing the wrist extensor tendons under repetitive strenuous activity. This repetition causes micro tears in the tendon that initiates inflammation, degeneration, and reduced grip strength. The good news is that tennis elbow is a self-limiting condition and can spontaneously improve however, recovery timescales can be improved significantly with self-management and physiotherapy. Physiotherapy treatment can often involve activity modification, relative rest, strengthening, self-help, shockwave therapy and acupuncture. Your physiotherapist will take you through your best treatment options to suit your needs.
Read our blog: ‘Anyone for Tennis’
‘Golfers elbow’ – medial epicondylitis
Golfers elbow is a condition that causes pain on the inside of the elbow that may extend into the forearm. The condition occurs after placing the wrist flexor tendons under repetitive strenuous activity. This repetition causes micro tears in the tendon that initiates inflammation, degeneration, and reduced grip strength. Like tennis elbow, golfers elbow can spontaneously improve however physiotherapy is highly effective at managing the condition and preventing it from returning. Physiotherapy treatment can often involve activity modification, relative rest, strengthening, self-help, shockwave therapy and acupuncture. Your expert FP physiotherapist will guide you through your best treatment options to suit your needs.
Bicep pain – tendinopathy
Bicep tendon pain or bicep tendinopathy is pain that is localised centrally and just below the elbow joint. It is caused by the same process as tennis and golfers elbow as they are all tendon pains. Bicep pain is characterised by a stiffness and ache when the elbow is straightened particularly after rest. You may also experience sharper discomfort when lifting heavier loads for example undertaking a bicep curl.
Radial head fractures
Radial head fractures are common injuries that can occur as a result of a fall on the outstretched slightly bent arm. Anyone is at risk of a radial head fracture however they are more common in women aged between 30-40 years. Signs and symptoms of a radial head fracture includes pain on the outside of the elbow, swelling around the elbow joint, difficulty and pain in turning or rotating the forearm such as accepting change and difficulty bending and straightening the elbow (disabling if its your drinking arm!). Treatment depends on the type of fracture and how far out of line the bones are from their normal position. The good news is that in the majority of cases this type of fracture is managed well with relative rest and early movement.
The olecranon is the bony prominence at the back of the elbow joint which you would lean on or during Covid19, offer up as a modern hand shake. The triceps muscle attaches to the olecranon and works to straighten the elbow from a bent position. The olecranon bursa is a fluid filled sac which lies beneath the tendon preventing friction on movement facilitating smooth muscle tendon glide. Olecranon Bursitis occurs when the bursa becomes irritated and inflamed which may occur through trauma, repetitive leaning on the elbows or infection.
The olecranon bursa is commonly infected due to its locality and is more prone to minor injuries. Symptoms of olecranon bursitis include swelling; it may be tender and warm to the touch and movement of the elbow is predominantly pain free except at full bend when the bursa is compressed. It is difficult to distinguish from an infective bursa however, some features might include pain, redness, heat that is progressive and worsening, fever, local abrasions, a high heart rate and low blood pressure. If you have any concerns, contact your GP. In the majority of cases olecranon bursitis responds very well to conservative treatments.
Osteoarthritis of the elbow
The elbow joint is lined with cartilage that allows smooth gliding movement. Osteoarthritis occurs when the body attempts to repair this cartilage. The body, however, cannot replace like for like so the cartilage is replaced with small bits of bone. In time this build-up of bone may cause reduced movement for example difficulty straightening the elbow, swelling and sometimes pain. Treatment may vary depending on age, job, impact on lifestyle, previous history such as trauma and pain. Physiotherapy is directed to pain reduction, restoring joint movement and strengthening the muscle around the elbow to reduce joint loading. If you require further management we will discuss the treatment options available and liaise with your GP as required.
The median, radial, and ulnar nerves run through or around the elbow to supply the forearm and hand with power and sensation. All three nerves have points in the elbow where they can be compressed or irritated the most common of these is cubital tunnel.
Cubital tunnel syndrome
Cubital tunnel syndrome is the compression of the ulnar nerve located on the inside of the elbow in an area commonly referred to as the ‘funny bone’. The cubital tunnel runs close to the skin surface and is bordered by bones of the elbow and forearm muscle tendons. The ulnar nerve passes through the tunnel and supplies sensation to the little finger, half the ring finger and inside palm of the hand. It also controls some of the small hand muscles used for fine dexterous movements.
The exact cause of compression is unknown, however, can be attributed to direct impact, fracture, dislocation, repetitive elbow movements and more commonly sustained positions of the elbow being bent. Symptoms include pain on the inside of the elbow, numbness and tingling of the little and ring fingers.
It is common for symptoms to come and go depending on the position of the elbow and is more common at night when the elbow is bent. Should symptoms become more consistent then you may experience muscle wasting and a weakened grip. The good news is that in most cases symptoms can be managed with activity modification, education, reducing direct pressure and repetitive movements.