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Elbow pain - what's behind it?

definition

Elbow pain can come in many different forms. Depending on its causes, the pain can range from acute stabbing and shooting through to chronic and dull. The elbow joint is made up of three individual joints that move bones, some muscles, tendons, and bursa. These structures are susceptible to damage and injuries in the event of abrupt injuries but also after years of incorrect loading.

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One speaks of acute pain if the pain occurs immediately and suddenly and is due to a specific event. Such acute pain subsides within a few days to hours with the treatment of the cause. However, chronic pain can also develop in the elbow, which is permanently dull or can be triggered by movements in the joint. Chronic pain is usually when the pain persists for more than 6 months.

Causes of Elbow Pain

The pain occurs when there is irritation or damage to the painful structures. In rarer cases, the cause of the pain may be elsewhere. For example, if the pain is transmitted from the spine to the elbow, it is called radicular pain, which is caused by irritation of the nerve root.

In most cases, new pain on the outside of the elbow is irritating the tendons and ligament structures. Tendons are the tight ends of a muscle that are anchored to a bone and that transmit the force of the muscle to the bones and joints. When the associated muscle is overused, these tendons can become irritated or inflamed. A common disease that causes pain in the outer elbow is tennis elbow. Such tendinitis is present here, caused by monotonous movements that are carried out in tennis in particular.

Direct violence and accidents can also lead to damage and pain in the elbow. The upper ambone, the radius or the ulna can break close to the joint or assume misalignments.
A capsule rupture in the elbow joint can also occur. This is also associated with severe pain.
A very common injury in children is the dislocation of the spoke in the area of the elbow. This can often be caused by a slight pull on the child's hand. As a result, the child holds the arm in an angled relieving position due to pain.

Inflammation of the joint can occur less frequently. The inflammation can be caused by pathogens or occur without an apparent cause, for example in the context of a rheumatic disease. If left untreated, inflammation in the elbow joint can damage the joint structures and cartilage. The bursa in the joint can also become infected. This often has to be surgically removed for treatment.

The cartilage can also be damaged as part of joint arthrosis. This is a disease that occurs mainly in the elderly and can be traced back to years of wear and tear. Here, the pain is increased, especially with strain and movement.

Inflammation in the elbow

If the pain can be provoked by targeted pressure from the outside on the elbow, this indicates an existing inflammatory process. Inflammation often leads to swelling, reddening, overheating and restricted mobility. Tennis elbow in particular is a common cause of inflammation of the elbow joint. Even with acute injuries to the bones, muscles and ligaments, local inflammations can occur, which are painfully felt through pressure.

Capsule tear on the elbow

A capsule tear in the elbow joint is primarily caused by force acting on the joint.
Capsules surround all joints in the body and serve on the one hand as protection against tensile and pressure loads and also to nourish the articular cartilage with the so-called "synovial fluid". The synovia lubricates the joint surfaces and makes the movements smoother and smoother.
A capsule tear can be associated with numerous accompanying injuries and symptoms and cause severe pain.
Injury to the joint capsule in the elbow severely restricts the function of the joint.
Secondary illnesses can also result from the injury.

If you suffer from a capsular tear in the elbow joint, read up on the treatment options in the following article:
Torn capsule on the elbow - this is how it is treated

Bursitis

Bursae have the function of cushioning movements in healthy joints and protecting bones, cartilage and tendons. These are small bags that are filled with what is known as "synovial fluid". The synovia is the joint fluid that enables low-friction, sliding movement in the joint. Bursae are located in the knee joint as well as in the elbow. Inflammation of the bursa can have many causes. Often this is caused by overstressing the joint, prolonged pressure or acute injuries such as broken bones. Then there is redness and swelling, which makes movements in the elbow painful. In many cases, the bursitis can go away on its own with cooling and gentle treatment.Quite often, however, the effusion in the joint has to be punctured or even operated on.

Blockage on the radial head

The radius head describes the uppermost part of the spoke, one of the two forearm bones. The radial head is partly involved in the elbow joint. It primarily interacts with the upper part of the ulna, around which it rotates when the forearm rotates. The spoke can slip out of the anchorage with the ulna if the hand is pulled jerkily. This blockage of the radial head is also known as "Chassaignac's palsy" or "nannies' elbow". It is the most common dislocation of a joint in childhood. If the child's hand or forearm is pulled abruptly, the spoke can easily dislocate. The arm becomes immobile in the elbow and assumes a hanging, slightly internally rotated protective posture. The reduction is usually carried out very easily by a doctor.

You might also be interested in: Childish fracture

Elbow osteoarthritis

In contrast to osteoarthritis of the knee or hip joint, elbow arthrosis is a rather rare disease. In the case of osteoarthritis, one speaks of joint wear, which is caused by a reduction in and wear and tear of the cartilage on the joint surface. As the disease progresses, any movement in the joint becomes painful and the bony joint surfaces rub against each other and can also be damaged. Since the elbows have to bear little weight, they are less affected by natural wear and tear. Premature wear of the cartilage can only occur after injuries, by construction workers or in the event of severe improper stress. Therapy only consists of stopping the osteoarthritis from progressing and, in the event of severe damage and severe pain, having a joint prosthesis inserted.

What is a tennis elbow?

Tennis elbow, also known as epicondylitis humeri lateralis, is a disease of the tendons on the elbow. Translated, the technical term means "inflammation of the outer upper arm". The disease has its German name because it occurs more frequently among tennis players. However, it can also occur for no apparent cause or as part of other movements and sports. Various muscles are attached to the outer protrusion of the humerus, which radiate into the forearm bones or the hand and cause these joints to stretch. The so-called "supination", the turning of the palm forwards, is also carried out by these muscles. In the event of overuse, the tendons slide along the elbow and can become painfully inflamed, painfully restricting these movements.

The treatment consists of an interruption of sport and rest. The inflammation must be given sufficient time and rest so that it heals completely and does not become chronic.

Read more on this topic at: Tennis elbow

Pain when straightening the elbow

In most cases, pain in the outer elbow particularly affects the stretching process in the joint. The muscles that run along the spoke to the outside protruding elbow are responsible for the extension. The tennis elbow is caused directly by the inflammation of these muscles, which also restricts the extension and the so-called "supination", the turning of the palms forward. Even if the radial head is blocked, extension is painful and restricted. In the case of advanced osteoarthritis, all movements are restricted by the rubbing of the worn joint surfaces against each other.

Concomitant symptoms

Pain in the outer elbow joint is often aggravated by movement. The pain limits movement in the joint in the long term. Depending on the cause of the pain, muscle paralysis and incorrect or relieving postures can also occur. If nerves are involved in the development of the pain, the pain can also radiate into the forearm and hand. If the joint is inflamed, externally visible redness, swelling and overheating can occur.

Diagnosis of pain in the elbow

The diagnosis is largely made on the basis of a detailed questioning and external examination of the elbow. The causes of the pain can be determined quickly, especially after acute injuries or sporting activities. Some diseases require imaging tests to be used to make a diagnosis. Arthroscopy, known as arthroscopy, is an invasive way of looking directly into the joint using a camera. In the case of arthritic changes, the conventional X-ray image can also provide information about the condition of the joint. Inflammatory diseases can be diagnosed well in the MRI, since the soft tissue can be better recognized there.

treatment

Most elbow complaints must first be treated with rest. In particular, inflammation and bruises of the joint should be immobilized until the pain is tolerable. Physiotherapy can then be performed to maintain or restore mobility in the joint. In some cases, with some bursitis, surgical removal and clearing of the inflammation must be carried out. Osteoarthritis can also be treated surgically in advanced stages. For this purpose, complete prostheses for the joint are possible with heavily worn cartilage.

Some local complaints, such as foreign bodies in the joint, can also be treated with a jointoscopy. Arthroscopy is a diagnostic and therapeutic tool at the same time.

How long does elbow pain last?

The duration depends heavily on the cause of the pain in the outer elbow. The tennis elbow, for example, can take a long time. The tennis elbow can only be healed in the long term through consistent protection. Very often, after renewed, earlier, sporting activity, the pain comes back and can even become chronic, i.e. persist for more than half a year.

Osteoarthritis of the elbow joint cannot be cured. It develops over years, but the pain can come on suddenly. Your treatment will last for the rest of your life. However, osteoarthritis does not always have to be painful.