Elbow

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Christopher S.

Dr. Choi examines the elbow on  Christopher S.

Admit it. When you injure your elbow and someone says, “Oh, you hit your funny bone.” It’s really no joke. Being able to lift your arm to eat, dress, or play sports really becomes painful work.

SportsMed-Wheaton Orthopaedics will properly evaluate your specific medical situation and develop a personalized treatment plan that will alleviate your pain and restore your elbow and arm’s motion.

How the Elbow Works

The elbow is comprised of tendons, bones and three joints: the humerus bone of the upper arm, the ulna and the radius bones of the forearm. The ulna and the humerus meet at the elbow and form a hinge which allows the arms flexibility. The ulna and radius connect to the wrist. The elbow moves mainly with the assistance of the bicep and triceps muscles, and is supported and held in position by cartilage and ligaments.

elbow

Common Causes of Elbow Pain

The elbow is an important joint and is subject to extensive use during daily activities. Because it often has to bear a great deal of overuse, there are many things that can go wrong with the elbow.

Arthritis

The cartilage in the joints gradually breaks down and causes stiffness and increased pain over time.

Dislocation

When the joint surfaces of an elbow are separated, the elbow is dislocated. Elbow dislocations can be complete or partial. In a complete dislocation, the joint surfaces are completely separated. In a partial dislocation, the joint surfaces are only partly separated. A partial dislocation is also called a subluxation.

Nursemaid’s elbow is a common injury of early childhood. It is sometimes referred to as “pulled elbow” because it occurs when a child’s elbow is pulled and partially dislocates. The medical term for the injury is “radial head subluxation.”

Symptoms:

  • A complete elbow dislocation is extremely painful and very obvious. The arm will look deformed and may have an odd twist at the elbow.
  • A partial elbow dislocation or subluxation can be harder to detect. Typically, it happens after an accident. Because the elbow is only partially dislocated, the bones can spontaneously relocate and the joint may appear fairly normal. The elbow will usually move fairly well, but there may be pain. There may be bruising on the inside and outside of the elbow where ligaments may have been stretched or torn. Partial dislocations can continue to recur over time if the ligaments never heal.

Treatments:

Nonsurgical  – reduction maneuver to restore alignment

Surgical – Arthroscopic surgery is often used to to restore bone alignment and repair ligaments.

Biceps Tendon Tear at the Elbow

Your biceps tendons attach the biceps muscle to bones in the shoulder and in the elbow. If you tear the biceps tendon at the elbow, you will lose strength in your arm and be unable to forcefully turn your arm from palm down to palm up.  The tendon should be repaired during the first 2 to 3 weeks after injury. After this time, the tendon and biceps muscle begin to scar and shorten.

Treatments:

After assessing a patient’s risks, surgery is generally the best option to reattach the distal biceps tendon to the forearm bone. Sometimes the tendon is attached with stitches through holes drilled in the bone. Other times, small metal implants are used to reattach the tendon to the bone.

Cubital Tunnel Syndrome (Ulnar Neuropathy)

The ulnar nerve is one of the three main nerves in the arm that sits close to the skin’s surface in the area of the elbow commonly known as the “funny bone.” The nerve travels from the neck down into the hand, and can become constricted in various places. This constriction often causes pressure on the nerve that can cause numbness or pain in the elbow, hand, wrist, or fingers.

You’re more likely to develop cubital tunnel syndrome if you:

  • Repeatedly lean on your elbow, especially on a hard surface
  • Bend your elbow for sustained periods, such as while talking on a cell phone or sleeping with your hand crooked under your pillow

Sometimes, cubital tunnel syndrome results from abnormal bone growth in the elbow or from intense physical activity that increases pressure on the ulnar nerve.

Symptoms:

  • Pain and numbness in the elbow
  • Tingling, especially in the ring and little fingers
  • Weakness affecting the ring and little fingers
  • Decreased ability to pinch the thumb and little finger
  • Decreased overall hand grip
  • Muscle wasting in the hand
  • Claw-like deformity of the hand

Treatments:

  • Physical Therapy with ergonimic modifications to how you live and move your arm
  • Support (i.e. wearing a splint or protective elbow pad to prevent overuse and relieve the undue pressure on the elbow)
  • Non-steroidal anti-inflammatory medication
  • Corticosteroid injections
  • Surgical: Nerve decompression or shifting the nerve to the front of the elbow or under a layer of fat; trimming the bump of the inner portion of the elbow known as the medial epicondyle.

Radial Tunnel Syndrome

Radial Tunnel Syndrome is an increased pressure on the radial nerve that and mostly affects the muscles.

Causes:

  • Injury
  • Noncancerous fatty tumors (lipomas)
  • Bone tumors
  • Inflammation of surrounding tissue

Symptoms:

  • Cutting, piercing, or stabbing pain at the top of the forearm or back of the hand, especially when you try to straighten your wrist and fingers

Treatments: Similar to Cubital Tunnel Syndrome.  See above.

Golfer’s Elbow

This condition occurs when the forearm is over used (i.e. from sports like golf or baseball pitching. Non-athletic people can experience golfers elbow.

Symptoms: Soreness or pain in the inner (medial) part of the elbow.

Treatments: Rest and use ice and/or anti-inflammatory medicines with physical therapy and exercise program.

Tennis Elbow

Tennis elbow, or lateral epicondylitis is an inflammation of the outer part of the elbow where the tendon tissues do not stretch easily and can become prone to injury. The cause is repetitive movement over an increased amount of time.

Symptoms:

  • Pain or burning on the outer part of your elbow
  • Weak grip strength

Treatments:

  • Rest
  • Physical Therapy with ergonimic modifications to how you life and move your arm
  • Support (i.e. a brace to prevent overuse and relieve the undue pressure on the elbow)
  • Non-steroidal anti-inflammatory medication
  • Change of equipment being used

Elbow (Olecranon) Bursitis

Bursae are thin, slippery sacs located throughout the body that act as cushions between bones and soft tissues. They contain a small amount of lubricating fluid that allows the skin to move freely over the underlying bone.

The olecranon bursa lies between the loose skin and the pointy bone at the back of the elbow called the olecranon.

Normally, the olecranon bursa is flat. If it becomes irritated or inflamed, more fluid will accumulate in the bursa and bursitis will develop.

Symptoms: Pain, swelling and limited movement of the elbow joint

Treatments:

  • Standard treatment plans may include applying ice, rest, fluid aspiration or antibiotics.
  • Severe cases or those that do not respond to treatment may require surgery to remove the bursa.

Treatments and Surgical Solutions for the Elbow

Arthroscopy of the Elbow

Arthroscopic debridement of the elbow is medical procedure to treat injured or diseased elbow joints. The procedure is also used to check the  joint for damage to the cartilage, bones, tendons, or ligaments.

Total Elbow Replacement (TER)

Reduction for Dislocated Elbow

Fracture Care

Tendon Reattachment to bone

 

To determine if what treatment is needed for your elbow or arm, please contact us at 630-665-9155 or request an appointment online with one of our board certified orthopaedic surgeons.