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Elbow

Elbow pain is a common complaint that can affect your ability to use your hands, as well as your entire arm. The elbow is a hinged joint that connects the bones of the upper arm (humerus) to the two smaller bones of the forearm (radius and ulna). Muscles and ligaments attached to these bones help the arm flex, extend and turn. Because we use our arms for so many things, elbow pain – like shoulder pain – can slow us down and make simple activities such as brushing our hair or closing the car door agonizing to accomplish.

Common causes of elbow pain include lateral epicondylitis ("tennis elbow"), bursitis, arthritis and tendinitis.

Texas Health Resources has experts including physicians on the medical staff who can effectively diagnose the source of elbow pain and provide you with a range of treatment options. Texas Health has elbow specialists on the medical staff who can perform advanced surgeries, as well as make recommendations about other treatments. Many Texas Health hospitals offer rehabilitation services with advanced equipment and experienced therapists. Plus, you can try these tips for keeping your elbows healthy and pain free.

    Try the following tips for keeping elbow pain and injuries at bay:
  • Reduce how much time you spend doing the activity that causes elbow pain.
  • Warm up slowly. Stretch the forearm before, during and after exercise.
  • Use an "elbow sleeve" to help keep your elbow warm while playing.
  • Use ice or ibuprofen after the activity to prevent swelling and pain, if you have had an elbow injury in the past.
  • Prevent tennis elbow by using the correct grip size, a two-handed backhand and racquet strings that are not too tight.
  • Wear an "elbow band" over an injured or rehabilitated area to prevent further injury and reduce pain.
  • Perform regular stretching and strengthening exercises (given to you by your physical therapist or doctor).
  • To prevent nursemaid's elbow in children, do not pull on a straightened arm. Avoid lifting or holding the child up by the hands or forearm. Children who get nursemaid's elbow once can easily get it again. Usually this is outgrown by age four.

Diagnosing the source of elbow pain

Elbow pain has many causes; therefore, it is important to get an accurate diagnosis of the cause of the pain in order to receive the proper treatment. Your physician will diagnose your elbow pain based on the findings of a medical history, physical exam and diagnostic tests.

    For your medical history, the physician may ask questions such as:
  • Are both elbows affected?
  • Does the pain shift from the elbow to other joints?
  • Is the pain over the outside bony prominence of the elbow?
  • Did the pain begin suddenly and severely?
  • Did the pain begin slowly and mildly and then get worse?
  • Is the pain resolving spontaneously?
  • Did the pain begin following an injury?

During the physical exam the physician will manipulate your elbow to determine how well it moves and where the pain is located.

Depending on the findings of the medical history and physical exam, your physician may also refer you for X-rays to determine the source of your elbow pain.

    Common diagnoses for elbow pain include:
  • Lateral epicondylitis ("tennis elbow")
  • Bursitis
  • Arthritis
  • Tendinitis
  • Cubital tunnel syndrome
  • Fracture
  • Dislocation
  • "Nursemaid's elbow" in children

Treatment options

Depending on the cause of the elbow pain, treatment can range from rest and anti-inflammatories to surgery. You may be told to modify your exercise routine or be prescribed nonsteroidal anti-inflammatory drugs (NSAIDS). If these treatment options are ineffective, your physician may inject a steroid to reduce pain and inflammation or refer you to a physical therapist.

    One of the following surgeries might be recommended:
  • Elbow joint replacement: Surgery that replaces the entire joint with either a linked or unlinked type of prosthetic device. The unlinked implant allows more natural movement but requires greater stability in the surrounding structures; the linked implant constrains movement somewhat but is preferred when other structures are weak.
  • Surgery for "tennis elbow": Treatment of lateral epicondylitis ("tennis elbow") usually includes rest, medication, rehabilitative exercise, massage and/or various braces. For severe cases, arthroscopic surgery can also provide relief by removing diseased tissue and reattaching healthy tendon to the bone.

After your treatment

Surgical treatment of elbow pain usually requires extensive rehabilitation to restore the function of the elbow. A dedication to working at recovery is essential for the best results from elbow surgery. Patients will receive written instructions concerning rehabilitation when they leave the hospital, and their physician may prescribe specific rehabilitation services.

Many Texas Health hospitals offer rehabilitation services with advanced equipment and experienced therapists.

Patients may want to participate in an aquatic program offered at some of our Texas Health hospitals. In this program, participants are led by certified aquatic fitness professionals through a series of specially designed exercises that, with the aid of the water's buoyancy and resistance, can help improve joint flexibility and muscular strength. The warm water and gentle movements can also help relieve pain and stiffness. A physician's permission is required to participate in the class. For more information on quatic programs, call 1-888-THR-WELL.

Frequently asked questions

Q: If I am experiencing elbow pain, what are some signs that would indicate that I should see a physician?

    A: Some signs that you should see a physician include:
  • You have a prolonged case of tendinitis that doesn't improve with home care.
  • The pain is due to a direct elbow injury.
  • There is obvious deformity.
  • You are unable to use the elbow.
  • You have fever or swelling and redness of your elbow.
  • A child has elbow pain.

Q: How likely is it that I will need surgery to relieve my elbow pain?

A: Not very likely. Most patients can relieve their elbow pain through simple treatments such as altering activities, rest and medication.

Q: What is bursitis?

A: Bursitis is inflammation of the fluid-filled sac (bursa) that lies between a tendon and skin, or between a tendon and bone. Bursae are fluid-filled cavities near joints where tendons or muscles pass over bony projections. They assist movement and reduce friction between moving parts. Bursitis can be caused by chronic overuse, trauma, rheumatoid arthritis, gout or infection. Sometimes the cause cannot be determined. Chronic inflammation can occur with repeated injuries or attacks of bursitis.

Q: What is tendinitis?

A: Tendinitis in the elbow is an inflammation (irritation and swelling) of the tendons of the elbow. Inflammation of the tendons of the elbow muscles can occur in sports such as golfing and tennis, as well as from activities such as gardening and using a screwdriver.

Q: What is tennis elbow?

A: The most common cause of elbow pain, tennis elbow is an inflammation or injury of tendons on the outside of the elbow which causes pain and difficulty in grabbing objects.

Q: What is nursemaid's elbow?

A: Young children commonly develop "nursemaid's elbow," usually when someone is pulling on their straightened arm. The bones are stretched apart momentarily and a ligament slips in between, where it becomes trapped when the bones try to snap back into place. Children will usually quietly refuse to use the arm, but often cry out with any attempt to bend or straighten the elbow. This condition is also called an elbow subluxation (a partial dislocation ).