Inner elbow pain
Pain is a very subjective sensation that is described differently by each person. The symptoms of "elbow pain" can range from an uncomfortable feeling of pressure in the area of the joint to the strongest stinging with every movement.
The pain can occur suddenly, as a result of a certain movement, or chronically. Often this characteristic gives an initial indication of the cause of the pain.
The causes of pain in the elbow are very diverse. In most cases, the symptoms are due to incorrect or overuse of the affected arm. As a result, this leads to damage to the structures involved in the joint.
In addition to injuries to the ligaments, muscle tendons, bones and cartilage, these can also be inflammatory processes and the narrowing of various nerves. This damage ultimately causes the pain.
Read more information about inflammation in the joint here.
With the so-called golfer's elbow, Epicondylitis humeri ulnaris, the pain comes from the common tendon of origin of the hand and finger flexors on the inner elbow.
As the name suggests, the pain is usually the result of excessive strain, which is often associated with racket sports such as e.g. the golf.
However, everyday stress, especially with one-sided and repetitive stress, can also trigger the pain. As a result of the overstrain, the tendon is repeatedly torn and injured. The body tries to repair this by means of an inflammatory reaction.
As part of such an inflammation, the body releases a large number of messenger substances in the tissue, which among other things also cause pain.
The cause of the pain is therefore not the actual injury, but the repair of this and a protective mechanism of the body to avoid further damage. The flexion of the hand, especially against resistance, and direct pressure on the inner elbow are particularly painful.
The pain can occur locally and radiate along the muscles to the entire forearm.
Read more about the golfer's elbow here.
Ulnar sulcus syndrome
The Ulnar sulcus syndrome belongs to the nerve congestion syndromes. These arise when a nerve is constricted in its course by surrounding structures and thereby irritated.
On the inner elbow, the ulnar nerve runs along the back in a bone groove. There, the generally relatively narrow conditions can very quickly lead to a narrowing of the nerve, particularly as a result of fractures or other inadequately healed injuries. As a result, this leads to pain along the entire nerve and to sensory disturbances in the target area on the back of the hand and in the area of the ring finger and the little finger.
Furthermore, there may be a reduction in strength and a restriction in the ability of these fingers to bend. This is particularly noticeable when closing the fist, which can then only be carried out incompletely.
With a longer course and inadequate treatment, the disturbed supply of the muscles by the nerve can lead to a significant decrease in these. This muscle wasting becomes visible through the formation of clear grooves on the ball of the little finger.
As in all joints in the body, osteoarthritis can occur in the elbow. This can be caused by any damage to the articular cartilage.
Common causes are incorrect loading, injuries, inflammation or misalignment of the joint. However, a defined cause of osteoarthritis cannot be determined in all cases.
In the course of the disease, there is an increasing number of active and passive movement restrictions and sometimes noticeable rubbing in the joint, so-called Crepitation. In the case of acute activation of osteoarthritis, swelling and effusion can also be observed on the elbow.
Please also read our article on elbow arthrosis.
The biceps brachii muscle attaches to the spoke of the forearm via its tendon directly below the elbow joint. Inflammation of this tendon can therefore also lead to pain in the elbow area.
As with all tendinitis, the cause is usually an overload of the muscle and the associated tears in the tendon.
The inflammatory response is the body's attempt to repair these tears. However, since tendons have a complex connective tissue structure, this is usually not possible completely. As a result, scarring occurs within the tendons. These scars in the tendon structure lead to a significant loss of elasticity and can thus lead to a limitation of muscle function.
Read our article Inflammation of the biceps tendon.
Since pain is the result of complex processes within the affected structure, it is usually associated with a number of other symptoms.
If the symptoms are based on inflammation, there is usually also significant swelling, reddening, overheating and functional impairment in the affected areas. In the area of the elbow, these are mainly the outer soft tissues and the bursa, which are used to move between the skin and the bony structures of the joint.
If the inflammatory reaction takes place within the joint space, it is called osteoarthritis. In addition to swelling, this is often associated with effusion and possibly noticeable rubbing within the joint, known as crepitations.
Other possible symptoms are a reduction in strength, sensory disturbances, restricted mobility and muscle wasting, which indicate a nerve congestion syndrome. In most cases, this affects the ulnar nerve of the elbow.
Symptoms that occur while stretching
Pain that occurs when stretching the elbow joint often results from inflammatory processes in the area of the joint, which have led to an effusion.
This effusion is not in itself painful. However, it puts pressure on the surrounding structures because it takes up too much space within the joint. If the arm is then stretched, the space is narrowed even further, the pressure within the joint increases and the surrounding structures are even more displaced and irritated. This eventually leads to the pain.
Other causes of pain during elbow extension can be injuries to the cartilage and bones that cause pain when rubbing during movement.
The causes of tenderness felt in the elbow are diverse. Depending on the exact localization, the pain can be triggered by injuries to the muscle tendons, nerve congestion syndromes, inflammation of the bursa and injuries to the cartilage or bones.
In addition to the localization, accompanying symptoms such as movement or sensitivity restrictions as well as the precise history of the disease provide a clear indication of the cause.
At the beginning of every diagnosis, there is first and foremost a precise anamnesis. In this regard, inquiries about possible previous injuries and illnesses in the area of the elbow, existing underlying illnesses and exact inquiries about existing complaints are of particular importance.
This is followed by the clinical examination of the joint. The doctor first pays attention to all externally recognizable signs of an injury or illness, such as swelling, misalignments in the joint axis or hematomas. Then the main structures of the joint are palpated and checked for pain under pressure and the mobility of the joint is tested.
The combination of anamnesis and examination usually gives a reasonable suspicion of the cause of the pain. Imaging (x-ray, ultrasound, CT, MRT) is usually carried out to further confirm the suspicion: Other helpful measures can also include a puncture of the synovial fluid or blood analyzes.
Treatment options for elbow pain include a range of conservative measures as well as surgery. In most cases, the former is sought first and surgery is only considered if there is no improvement or the symptoms increase.
The first measure is to relieve the affected structure. This can be done by simply protecting the arm or by immobilizing it in a splint. In addition, a so-called epicondylitis brace can be used for the golfer's elbow, which reduces the tensile stress at the tendon attachment.
Anti-inflammatory drugs and ointment dressings can be used as support. After the symptoms have improved, guided movement and strength exercises often prove to be useful. Since elbow problems usually result from improper or overloading of the arm, such exercises can help to recognize them and to avoid them in the future. Further possible measures from the field of physical therapy are electrotherapy and heat or cold applications.
In the area of surgical therapy, the relief of the affected structure is also in the foreground.
Depending on the variety of causes and the different treatment options, the time it takes for the patient to heal completely can vary greatly.
In general, joint problems usually take a considerably longer time than other injuries to completely resolve. In most cases, however, a combination of the different types of therapy can very quickly result in a significant improvement in the symptoms.