Who would have thought cleaning brush for a new garden bed could be so much work?  You must have pilled out 30 wild raspberry bushes --- roots and all. It seemed worth it at the time, but since then you’ve had elbow pain wherever you try to lift something, such as a bag of groceries or even your handbag.      

            As with any joint, you generally don’t think about your elbow unless it hurts. Elbow pain may come about for any number of reasons. Sometimes it’s related to a particular condition, such as arthritis. However, elbow pain many times can be tracked back to overuse in such a way that causes inflammation. The good news is that with appropriation treatment and some time, you can usually get back to your regular activities.

Inner Workings

            The elbow functions as a hinge joint. It’s also structured to allow you to rotate your forearm. Three long bones meet to form the elbow --- the humerus in the upper arm and the ulna and radius bones in the forearm.  

            Powering the elbow’s movement are biceps and triceps muscles in the upper arm. The biceps muscle allows for bending your forearm upward (flexion). The triceps on the back of the arm helps straighten the arm by extending your forearm.

            In the midst of all these muscles and bones are key tendons and ligaments that help hold the joint together. Tendons are fibrous cords that connect muscle to bone. Ligaments are fibrous tissue that connect bone to bone. Helping to reduce friction at the tip of the elbow joint is a fluid filled sac called the olecranon (o-LEH-ruh-non) bursa.

Areas of concern

            Elbow pain can vary, depending on which specific area of the joint is involved. These include the:

 
·         Outside elbow area – You don’t have to be on a tennis court to develop the overuse injury called tennis elbow. The medical name is lateral epicondylitis (ep-ih-kon-duh-LI-tis), which means there’s inflammation in the tendons of the forearm muscles where they attach to the bony prominence on the outside of the elbow ( lateral epicondyle).

Tennis elbow comes about due to repeated contraction and overuse of forearm muscles in order to straighten and raise the hand or wrist—such as occurs when playing tennis or a number of other activities, including hammering, painting, raking, operating a chain saw or pulling plants from your garden. Overuse causes inflammation or a series of tiny tears in tendons that attach forearm muscles to bone – specifically, the lateral epicondyle.

            As such, you may experience elbow pain when lifting something, making a fist or gripping something, shaking hands, or turning a door knob. Pain may also occur if you extend your forearm or straighten your wrist, or if you touch or bump the outside of your elbow.

·         Inside elbow area – On the flip side of tennis elbow is another common elbow overuse injury sometimes referred to as golfer’s elbow or baseball elbow. The medical term “medical epicondylitis” describes the pain and inflammation associated with tendons that attach to the inner side of the elbow.

Medial epicondylitis may crop up after any number of activities where there’s repeated forceful use of the whist or clenching of the fingers – such as occurs when playing golf or baseball, or with several other activities, including tennis, gardening and yard work.

    Pain may come on suddenly or gradually and extend along the inner side of the forearm. Your elbow may feel stiff, and you may experience weakness in your hands and wrist. Certain activities or motions may make the pain worse, such as swinging a golf club or a racket, squeezing or pitching a ball, picking something up with your palm down, or bending your wrist toward your forearm. Shaking hands or turning doorknobs also can be troublesome.

·         The elbow tip – The olecranon bursa cushions the elbow’s bony tip. Repetitively bumping the elbow during sports or other activities may aggravate this bursa, causing inflammation (bursitis). Even leaning repeatedly on elbow could result in bursitis at  the tip.

You might experience a dull ache or stiffness in the elbow, pain that worsens with movement or pressure, an area that’s swollen or warm to the touch, and possibly skin redness at the tip of your elbow.

Managing the problem

            Take a clue from your body – if something you’re doing causes pain in the elbow area, stop the activity. In certain instances, immediate medical care is important, specifically if :

·         The elbow is hot, red or inflamed, and a fever is present.

·         You can’t bend the elbow.

·         The joint looks misshapen or you suspect a broken bone.

·         You experience severe pain, especially after injury.

Otherwise, you might find help with simple self-care. Rest your elbow and avoid activities that tend to aggravate the joint. Applying ice periodically can help reduce inflammation, as can taking a nonprescription pain reliever as directed to help ease pain and inflammation. If elbow pain is ongoing (chronic), you may find that applying heat is helpful as well. Our Elbow Brace on page11 of our web site will cut down on the swelling and inflammation and allow your body to heal the elbow. 

            If self-care steps don’t help, see your doctor. Often, a medical history and physical exam are enough to determine what the problem is. In some cases, an X-ray may be used to rule out another possible cause such as a fracture or arthritis.

            Generally, the sooner a helpful treatment plan is in place, the sooner usual activities can be resumed. And even though it may sometimes take several months to see improvement, conservative treatment for elbow pain is often successful.

            In addition to self-care steps, wearing a magnetized forearm strap or a wrist-forearm brace may help elbow pain due to lateral or medial epicondyle. These can reduce the load of everyday movement on the elbow as well as the stress on already-injured tissues in the joint.

             If a favorite sport or regular activity has aggravated your elbow, a therapist can help instruct you on proper form and techniques to stretch and strengthen the muscle areas that support good elbow and wrist motion.  Doing so helps to protect the joint's function.

            In general, keeping your wrist straight during lifting activities allows the bigger muscles of the upper arm to do more of the work than the smaller forearm muscles do. This reduces the force that would otherwise be transmitted to the elbow. It’s also helpful to ice the elbow for 15 to 20 minutes after heavy use. If bursitis is the source of pain, resting and immobilizing the elbow gives the olecranon bursa a break from continued friction. Icing the painful area and taking nonprescription pain relievers as directed can help relieve pain and inflammation. You may find wearing a foam pad on the elbow’s tip offers protection as the swelling goes down. Your doctor may recommend physical therapy or exercises to strength muscles that support the elbw. In some instances, an injection of corticosteroid into the bursa may help and usually brings immediated pain relief.