Elbow pain

introduction

The treatment of the complaints depends on the cause and varies greatly.

The term elbow pain describes a common ailment of many people. The individual causes and nature of the discomfort vary, with some common causes of elbow pain being described below. The term elbow is colloquially referred to as the elbow joint, which consists of the connection of three bones. The elbow joint connects the humerus with the bones of the forearm, the ulna and the radius. To ensure smooth movement, the joint is encased in a joint capsule filled with synovial fluid and certain structures are protected with so-called bursa.

In addition to the bones, which are covered with cartilage at the connection points, other structures such as nerves and vessels run along the elbow joint. A number of different structures can be damaged and cause pain. In addition to acute pain, which can be traced back to an injury such as that caused by an accident, there is also pain in the elbow which is due to wear and tear and overuse of the structures.

The individual therapy basically depends on the diagnosed disease. In many cases, the treatment can be treated conservatively, i.e. solely through the use of medication and immobilization of the joint. Other diseases and injuries to the structures of the elbow require surgical intervention. If the pain in the elbow persists for a long time, a doctor should be consulted in any case, who can make the individual diagnosis and also make an adapted therapy recommendation. Specialists in the field of diseases that typically cause elbow pain are specialists in orthopedics.

Symptoms

Depending on the underlying disease pattern, the pain in the elbow can vary. The description of the pain as well as the movements during which the pain occurs can thus help the attending physician to gain an impression of which disease is possibly the cause of the complaints.

So pain, which is mainly caused by Pressure on the elbow, such as occurs when propping up, for example a reference to a Inflammation of the bursa be. A pain that occurs when moving the joint can be a pathological nerve course or one Wear and tear of the cartilage mean as reason. Also the appearance of other symptoms such as one swelling, Redness or one overheated skin can help the doctor to further limit the form of the disease. Often there are elbow pains that occur when the joint is twisted and bent, as well as when pressure is applied to the joint. In addition to the intensity and the triggering movement, the time at which the pain often occurs can also be important. Elbow pain, which mainly occur in the morning can thus be a reference to an existing one Rheumatoid arthritis represent as cause against what night elbow pain rather on one degenerative osteoarthritis of the elbow joint indicate.

diagnosis

If you experience elbow pain, it is advisable to visit your general practitioner or an orthopedic specialist. In acute cases, such as suspected fracture following an injury, a hospital emergency room can also be visited. The diagnosis usually begins with a conversation, during which the attending physician, if necessary, explains how the accident happened, the type and duration of the elbow pain and the individual history he asks. With this so-called anamnesis alone, the doctor can often make a guess about the cause of the symptoms and adjust the further diagnosis.

If the anamnesis is complete, usually one follows physical examination of the patient. In addition to the external assessment of the affected elbow, a Movement test carried out to determine the movement during which a possible pain stimulus can be perceived. It is also checked whether the affected elbow shows tenderness.

The further diagnosis depends on the individual symptoms which can be seen in the anamnesis and the physical examination. If a bone fracture is suspected or if there is a degenerative change due to wear and tear of the joint, usually X-rays made which give an impression of the injuries and joint changes. For questions that affect soft structures such as nerves, muscles or tendons, a Magnetic resonance imaging (MRI) be performed. In rare cases it may be necessary puncture the capsule of the elbow joint and look for the cause of the symptoms in the synovial fluid. The attending physician will discuss every diagnostic examination to be carried out with the affected patient and is the right contact for any unanswered questions.

causes

In general, different categories of causes that can lead to elbow pain must be distinguished. On the one hand, this can lead to injuries to the structures at the elbow joint, which cause acute pain. The most common injuries of this type are cuts, abrasions and broken bones.
Torn ligaments on the elbow can also occur.

On the other hand, so-called degenerative causes can be held responsible for the development of the pain. This group of diseases of the elbow joint is summarized under chronic diseases of the elbow.

  • Acute occurring pain

Acute, severe pain can usually be traced back to a specific event that triggered the complaint. For example, bruises in the elbow or a broken bone in the upper or lower arm can cause severe pain in the elbow. The reason for this is damage to the tissue. If tissue that is surrounded by nerves is damaged and destroyed, as is the case with a break or a severe bruise, nerves are stimulated which transport the information of the pain to the brain. With such acute pain, the pain usually lasts until the damaged structures have healed. This can take a different amount of time, depending on the damaged tissue.
A capsule tear on the elbow, primarily caused by external violence, also leads to severe pain.
Damaged tissue can affect bones, cartilage, tendons and ligaments, or muscles. Sociable sports are predestined for causing injuries to the elbow. The elbow joint can often not be properly protected and is exposed to extreme loads.

  • Chronic diseases of the elbow

Chronic diseases that can lead to elbow pain are mostly based on overloading the joint structures and the associated inflammation of the elbow. The type of pain and its therapy mainly depend on the affected structure and the severity of the disease. Common chronic diseases of the elbow can be traced back to years of overloading the joint. One reaction of the joint to such overload is inflammation of the bursa, which can cause severe pain. In addition, excessive or improper strain can lead to tendinitis of the elbow. In addition, degenerative diseases such as osteoarthritis of the joint and pain that can be traced back to gout in the joint occur.
Even if nerves are pinched, severe pain can occur. On the one hand, this can occur directly on the elbow, whereby the so-called ulnar nerve is usually affected, but on the other hand it can also be a problem with the nerve course on the shoulder. Ultimately, autoimmune diseases such as rheumatoid arthritis can also be the cause of the symptoms.

The so-called tennis elbow is another chronic disease of the elbow joint which can lead to severe pain in this region. The cause of the disease, which by far not only occurs in tennis players, is irritation of the tendon attachments on the outside of the elbow joint. Irritation of the tendons on the inside of the elbow can also lead to elbow pain and is also known as golfer's elbow. However, this is much rarer than the tennis elbow.

therapy

Depending on the underlying cause of the elbow pain, different therapy options can be considered. A number of causes that lead to elbow pain can be treated conservatively with medication and immobilization of the joint, while other diseases require more or less expensive operations. Symptoms that arise from osteoarthritis in the elbow joint are usually treated conservatively.

  • Conservative treatment

Conservative treatment is with Pain medication, the so-called NSAIDs carried out and includes consistent protection of the joint. If the elbow is overloaded, the therapy should also focus on protection. For example, the so-called tennis elbow is initially spared so that the irritated structures can calm down. At the same time, new therapy methods such as the so-called Cold therapy with these forms of elbow pain help relieve the symptoms.

Pain medication even helps twice with inflammation. They help to reduce pain and at the same time have anti-inflammatory properties. For this reason, for example aspirin, Ibuprofen or Diclofenac good for treating inflammatory elbow pain.Most elbow diseases that cause elbow pain can be treated conservatively.

In case of serious injuries as well as problems that arise due to a pathological nerve course, it can still be that a surgery is necessary. A bone fracture usually has to be treated with plates and screws so that the two pieces of bone grow together cleanly and there is no restriction of movement or permanent pain. Pain that arises due to a pathological nerve course must also be eliminated with the help of an operation. Mostly the so-called ulnar nerve is affected, which can be relieved by an operation.

If conservative therapy is unsuccessful and an operation is not indicated or promising, there are other methods of relieving elbow pain. A so-called Brachial plexus anesthesia numbs the nerves running in the arm that carry pain information to the brain. In this way, pain medication can be administered through a permanently running catheter and freedom from pain can be established.

Depending on the clinical picture, a minimal invasive jointoscopy can be carried out with which the causes of the elbow pain can be eliminated if necessary.

The therapy of elbow pain that is based on a systemic disease, such as rheumatic disease, should include systemic treatment of the underlying disease. Individual advice from a specialist is advisable in these cases.

forecast

The prognosis for elbow pain depends in principle on the underlying disease causing the symptoms. In most cases, however, it is an overstressing of the joint and the adjacent structures which, if treated correctly, usually only causes symptoms for a short time. Nevertheless, it is important to consult a doctor in the event of elbow pain in order to be able to rule out serious illnesses and to discuss an individual therapy. The sooner a suitable therapy is started, the faster the damaged structures of the elbow can heal. In the case of harmless overload syndromes, freedom from pain can be achieved after a few days and without therapy, whereby the duration of therapy for fractures of the elbow can be significantly longer.

prophylaxis

Elbow pain occurs for a variety of reasons. Some of these triggering factors can be prevented while others do not have prophylaxis. In particular, it helps with complaints that arise due to overloading the elbow and the adjacent structures not to carry out the triggering movement at first. In particular, sports and physical activities that put a lot of strain on the elbow should initially be avoided. If it is known in the individual that there is a tendency to develop such an overload syndrome, rest should be taken even more seriously.

Other illnesses and of course injuries cannot be prevented.

Summary

Elbow pain is a common symptom that does not always have the same causes. So can the pain for one acute or chronic arise and be of inflammatory or degenerative cause. Mainly is one Overloading the tendon attachments at the elbow to blame for the elbow pain. This is also known colloquially as tennis or golfer's elbow. But also a pathological nerve course can cause severe elbow pain.

The treatment of the complaints depends on the cause and varies greatly. Mostly conservative therapy is done alone Pain medication and a Protection of the elbow successfully. In other cases a Operation of the elbow cannot be bypassed for therapeutic success. In general, the prognosis for elbow pain is very good through consistent treatment of the disease. For this reason, if symptoms arise, a doctor should be consulted who can find the individual cause and initiate suitable therapy. In addition to medication and surgery, a physical therapy can be prescribed which can also prevent movement restrictions in the joint.