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Pandora's Box  |  Health & Wellness

Treating and Preventing
Common Elbow Problems


(Part 1)

Common Elbow Problems

Your elbow is a joint you probably don't think about much.
That is, until it starts to hurt.  When it does, the pain can really get in your way.
This article will help you understand the most common elbow problems and what to do about them.

 


Epicondylitis

Using an elbow or hand the same way over and over
or with poor technique can cause epicondylitis.
This is inflammation or a tiny tear in a muscle or tendon on either side of the elbow.  It can cause pain, making it hard to grip things, to turn your hand or
to swing your arm.  Many athletes get the problem,
so it is often called tennis elbow or golfer's elbow.
But most cases are not due to sports.



Fractures

Falling on your elbow or whacking it on something hard may crack or break a bone.  Your elbow can then swell and hurt, making it hard to move your arm.






Bursitis

A fluid-filled sac called the bursa cushions the tip of your elbow.  Banging the tip hard or using the elbow too much can make the bursa swell and hurt.
This is called bursitis, which means inflammation
of the bursa.


Cubital Tunnel Syndrome

Your "funny bone" is actually a nerve that runs through your elbow.  If this nerve gets irritated, your elbow may ache or your little finger and ring finger may feel tingly or numb.  Irritation can be caused by overuse
of the elbow, leaning too hard on it or banging it on something.  Swelling caused by some other problem can also irritate the nerve.


 

Diagnosing and Treating Elbow Problems

Some elbow problems go away on their own.  But many get worse if you put off taking care of them.
Your healthcare provider can diagnose your elbow problem and suggest the best treatment.

Treatment Can Help

Once the problem is diagnosed, your healthcare provider may recommend one or more of the
following treatments:


   RICE.  If the problem came on suddenly, you may
     find relief with RICE: Rest it, out Ice on it,
     Compress it with an elastic wrap, and Elevate it
     above your heart when lying down.

   Medications and therapy.  These can reduce pain
     and inflammation.  A splint, brace or other aid
     may help support the elbow as it heals.  Your
     healthcare provider may assign you exercises to
     speed recovery.

   Surgery.  Some elbow problems require surgical
     treatment.  Arthroscopic surgery uses only a few
     small incisions.  Open surgery involves a larger
     incision.
 




Pinpointing the Problem

Your healthcare provider will ask questions about your injury.  He or she will then look at and feel your elbow and have you move it in all directions.  Tests can help identify your problem.  You may have one or more of the following:

   An x-ray shows damage to the bones.

   A CT (or CAT) scan shows damage to the bones
     and soft tissues.

   An MRI (magnetic resonance imaging) shows
     damage to the soft tissues.

   A nerve conduction study (NCS) and
    
electromyography (EMG) measure how well your
     elbow's nerves and muscles work.

   Aspiration is the process of taking fluid out of your
     elbow.  This may be done to check the fluid or as
     a treatment.

   Arthroscopy is a king of surgery that lets a doctor
     see inside your elbow with a small TV camera.
     It may be used to diagnose the problem, to treat
     it, or both.


 

 

 

A Healthy Elbow

Bones, muscles, tendons and nerves work together to move your arm and hand.
The elbow is where they all meet.  When these parts of your arm are healthy,
you can bend and straighten your arm and move your hand without pain.

Parts of the Elbow

                            The arm has three bones.  The humerus is the bone in the upper arm.
                              The radius is the forearm bone closest to your thumb.  The ulna is the
                              forearm bone closest to your little finger.

                            The arm muscles cross the elbow joint and help move the arm.

                            Tendons are the tough tissues that attach muscles to bones.

                            The nerves that control the hand and wrist also pass through the elbow.

 


 

Referred Pain

Pain felt in one area of the body can actually be due to a problem elsewhere in the body.  This is called
referred pain.  Your neck or other areas may be checked for problems that could be causing elbow pain.


The Elbow in Motion

The elbow joint is involved as your arm turns, bends and straightens during your daily tasks.
Here are some of the ways the elbow moves to allow your hand and arm to work:



 


 

Straightening

Straightening the elbow to move the hand away from the body is called extension.

 

Bending

Bending the elbow to move the hand toward the body is called flexion.

 

 


 


 

Turning Palm Up

Rotating the forearm to turn
the palm up is called
supination.
 

 

Turning Palm Down

Rotating the forearm to turn
the palm down is called
pronation.
 

 

 


 

Neutral

Holding the palm sideways, as if to shake hands, is called
the
neutral position.  This position puts the least stress on the elbow.

 

What Is Epicondylitis?

Epicondylitis is the most common type of elbow problem.  It is named for the epicondyles,
the bony knobs on the inside and outside of the elbow.  A muscle or tendon there may get
inflamed or may develop tiny tears.  If the problem is in a tendon, it is called tendinitis.
The main cause of the problem is using the elbow or hand the same way over and over.
Treatment can help relieve pain and restore use of your elbow.
 

Lateral Epicondylitis

This occurs on the lateral side of the elbow, the side farthest from your ribs. The muscles and tendons that extend your wrist, open your hand and turn the palm up are most at risk of this problem.  It is often called "tennis elbow", even though most people who get it do not play tennis. Lateral epicondylitis is the most common type.

Medial Epicondylitis

This occurs on the medial side of the elbow, the side closest to your ribs.
It can be caused by a movement like
a golf swing.  So the problem is often called "golfer's elbow", even though most people who have it don't play golf.
One or more muscles and tendons
along the inner elbow may be injured.


Inflammation or even tiny tears
in a muscle or tendon can make it
hurt to move your elbow or hand.

 

Treating Epicondylitis

The goals of treatment are to relieve the pain and to get your elbow back to work quickly and safely.
Your healthcare provider will probably have you start by caring for yourself at home.
If the problem persists, you might need further treatment.

 









 

First Steps

When your elbow starts hurting, the first steps are usually to:

   Rest your elbow.  Stop doing whatever you think
     may have caused the problem.  This gives your
     elbow a chance to heal.

   Put ice on the hurt area for 15 to 20 minutes at a
     time, 2 or 3 times a day for the first day or two.
     This helps
prevent swelling and reduce pain.

   Switch back and forth between hands at work.
     This may be enough to take the stress off an
     overused elbow.

Further Treatment

Your healthcare provider may also suggest that you do one or more of the following:

   Receive an injection of cortisone or take
     anti-inflammatory medication to reduce swelling
     and pain.

   Do motion exercises to increase your flexibility,
     strength, or both.  You may be referred for
    
rehabilitation (physical therapy or occupational
     therapy).  Your therapist may use techniques such
     as ultrasound, which sends painless sound waves
     into your elbow to promote healing.

   Wear a splint or forearm band to reduce stress on
     the injured tissue.


   Have surgery to treat damaged tissue.


Exercises for Epicondylitis

You may be asked to do exercises such as the ones below.
They will help you improve and then maintain muscle flexibility.
Your healthcare provider will fill in the blanks.  If an exercise makes
your elbow pain worse, stop and consult your healthcare provider right away.
 



Wrist Flexor Stretch

Flexors are muscles that help you bend your arm.

   Hold your right arm out at shoulder height.
     Hold your palm out, fingers up.  Don't raise your
     shoulder.

   Put your left hand across the palm of your right
     hand.

   With your left hand doing the work, gently pull
     your right hand toward you.  Don't bend your
     fingertips back.

   Hold for ........ seconds.

   Now switch hands and repeat.

   Do this with each hand ........ times a day.
 



Wrist Extensor Stretch

Extensors are muscles that help you straighten your arm.

  Hold your right arm out at shoulder height.  Hold
     your palm in, fingers down.  Don't raise your
     shoulder.

   Put your left hand across the back of your right
     hand.

   With your left hand doing the work, gently pull
     your right hand toward you.  Don't bend your
     fingertips back.


   Hold for ........ seconds.

   Now switch hands and repeat.

   Do this with each hand ........ times a day.
 

 



Wrist Curls

   Hold a ........−pound weight or ........−ounce
     soup can in your hand.


   Sit with your wrist, palm down, supported over
     the end of your knee or edge of a table.

   Keeping your forearm on its support, curl your
     wrist up to lift the weight as high as you can.

   Lower your wrist back to the starting position.

   Repeat this ........ times (one set).  Now do the
     same thing palm up.  Do ........ sets a day palm
     up and the same number palm down.

        

Keeping Epicondylitis from Coming Back

The three basic causes of epicondylitis are repetitive motions, poor technique and poor positioning.
Keep the tips below in mind as you work and as you play.


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