CAUSES OF ELBOW PAIN
The elbow joint is a hinge-joint that connects the humerus in the upper-arm (with two forearm bones, radius and ulna) at its distal end. Articular cartilage lines the ends of the bones, and ligaments support both sides of the elbow joint. This is because the elbow rests near nerves and vessels serving both the upper arm, problems with those that can mimic an “elbow issue” mentioned earlier.
TRAUMATIC
Fracture: Any fall, motor vehicle accident, or direct blow Whether dog bite or Human biting injury can be some of the mechanisms for sustaining fracture at the elbow. Commonly seen fractures include the Supra condylar fracture (common in the pediatric age group), Distal Humerus, Intercondylar, and Fracture Dislocations.
Dislocations: Dislocations commonly occur with a fall or the patient tries to avoid falling by using his hand for support. One of the most common is what happens in children called infantile subluxation or pulled elbow. This can occur when a child is swung by their arms or suddenly picked up jerkily catching the arm.
DEGENERATIVE
Tendonitis/ Tendinopathy: Lateral Epicondylitis or tennis elbow will have a pain on the lateral aspect of the elbow. The common extensor tendon is the one involved in this condition. Medial Epicondylitis/ Golfer’s elbow– Pain at the inner side of the elbow joint because here common flexor tendons are attached which leads to medial epicondylitis.
Elbow arthritis can occur as a result of mechanical wear and tear to the joint articulating surfaces or secondary to trauma. Auto immune conditions e.g. Rheumatoid arthritis Gout-which can lead to the Degeneration of the joint
Bursitis: Bursae are sac-like structures and may get packed with fluid leading to inflammation and pain. The most commonly-seen around the elbow was olecranon bursitis
INTRAARTICULAR
- The wrong massage and improper manipulation of supracondylar fractures humerus cases is one more incidence of Myositis Ossificans/Heterotropic Ossification (this deformity mostly seen in Indian Sub-continent).
- Intraarticular extension of loose bodies and osteophytes
- Adhesive capsulitis
NERVE ENTRAPMENTS
- C6 or C7 radiculopathy
- Ulnar tunnel syndrome (ulnar nerve at the wrist) Cubital tunnel syndrome (entrapment of ulnar nerve at the elbow)
- Ulnar or median neuropathy. Ulnar neuritis, anterior interosseous nerve entrapment there is tard Palsy of ulnar nerves
DEVELOPMENTAL
Osteochondritis dissecans: Often seen in adolescents, this condition results when a small piece of bone becomes avascular (as the cartilage and the underlying bone fragments). This causes pain on physical exertion. Most of these cases are treated conservatively.
UNCOMMON CAUSES
- Lyme’s disease
- Lupus
- Herpes Zoster
- Several pathologies may mimic medial epicondylitis, including neuropathy (eg C6 or C7 radiculopathy, cubital tunnel syndrome, ulnar/median nerve entrapment, and neuritis among others) as well ligamentous injury to the elbow joint (eg. Ulnar/Medial collateral elongation or sprain);. This also encompasses intra-articular issues (adhesive capsulitis, arthrofibrosis, loose bodies); osseous concerns (medial epicondyle avulsion fracture; osteophytes), myofascial problems like flexor or pronator strain; tendinopathy ([including lateral] epicondylitis, triceps tendonitis) synovitis valgus extension overload dermatologic considerations (eg shingles) ways things can go wrong.
- Note: Your elbow is a joint where three bones meet — the upper arm bone (humerus), and the ulna and radius, two bones of your forearm.
- The cartilage on the end of each bone allows bones to slide against one another without damage and also absorbs shocks. They are held in place by strong tissues known as ligaments. From there, your bones are held together by ligaments (what holds your femur up to the rest of you) and then connective tissue like fascia helps compartmentalize muscles into groups for specific functions — say palming a basketball.
- If anything goes wrong with any of those bits, let alone all the nerves and blood vessels around that can make you hurt.
Here are some of the different ways your elbow can hurt:
One-time Injuries
- Many injuries— and let’s hope all of them are one-off events, as in the case when you fall hard or get hit playing hockey.
- Dislocated elbow (the bones that make up the elbow are forced out of alignment)—Caused by a sharp blow to the joint an all-too-common reason is sticking your hand out when you fall. Toddlers can also do it when you swing them by their forearms — that’s nursemaid’s elbow. Call your doctor if you think that either you or someone else, such as a child in your family, has dislocated an elbow.
- If you break (fracture) one of the bones in your forearm just above the elbow, it is called broken bone-fractured elbow. Typically, this occurs with a sudden impact such as you would receive while playing contact sports or during an auto collision. Then again, you could move your elbow, but do not be deceived. If you are hurting, and it’s not proper it may be broken. You will require healthcare
- Strains and sprains: These fall into the category, “Oof, I might have overdone it a bit.” Strain: when muscles are stretched or torn. A sprain refers to ligaments.
- If you put a lot of stress on your elbow muscles, such as lifting heavy items or oversporting yourself, the result can be activated by getting a strain.
- Injuries that cause elbow sprains are often experienced by athletes who throw, use racquets, or play contact sports.
- In general, both are managed with RICE (Rest-Ice-Compression-Elevation) initially followed by gentle range of motion exercises and strengthening around the hip after symptoms have settled.
Wear-and-Tear Injuries
Some injuries take time to develop as you repeat certain motions causing your elbow wear and tear. This could be playing a sport or on workplace accidents in any number of situations, from factories to officers.
- Bursitis – Often the result of repeating the same motion, you may gain bursitis from trauma or infection as well. Bursa Bursae are small sacs filled with fluid. You have them inside of your joints to provide padding for your bones, tendons, and muscles. They also permit skin to slide over bone. But they can become inflamed and hurt. Most of the time, bursitis is treated with pain medicine and improves over a period of weeks.
- Tennis elbow and golfer’s elbow: Both are forms of tendinopathy or tendinosis, in which the person has damage in his or her extensor/receiver tendon (what attaches that muscle to your bone) due to overuse. Although the name does imply a golfer or tennis player injury. You simply might as well be more likely to come down with them based on the armed actions necessary in those sports. The difference is that tennis elbow happens on the outside of your elbow, and golfers occur in view of within.
- The most common is carpal tunnel syndrome, and that involves a nerve in your wrist being squeezed so it can cause some difficulty with your wrists and arm. Your elbow can have the same issues.
- Cubital tunnel syndrome is when one of the major nerves in your arm (the ulnar nerve) becomes trapped as it passes through a tissue called the cubital tunnel, which runs along the inside part of your elbow. You might feel a burning sensation on your hand, arm, and fingers.
- Radial Tunnel Syndrome: If you have radial tunnel syndrome, this means that the nerves associated with your arm are pinched as they cross through a small opening near the lateral part of your elbow called The Radial Tunnel. A sensation of your outside forearm and elbow burning or going numb.
- Stress fractures: A small crack in one of your arm bones due to overuse is known as a stress fracture. So, thing occur many more frequently than in the elbow, often seen as “shinsplints” into lower extensions but a thrower (like a baseball pitcher) may have had one around an elbow. Pain is common, especially in throwing.
Diseases
- Arthritis: Two main forms can affect your elbow, Rheumatoid arthritis and Osteoarthritis.
- The most common type of arthritis in the elbow is rheumatoid. A condition in which your immune system attacks the body, which leads to swelling of joints is called Arthritis. Your elbow cartilage breaks down over the years and that’s how you end up with osteoarthritis- where your bones rub together, making it painful to move.
- Osteochondritis dissecans: Occurs most often in children and adolescents, when a piece of bone along with its overlying cartilage gradually separates away from the end of the distal humerus within the elbow. A bone fragment and a bit of cartilage come off, triggering pain with exercise. The knee is most often affected, but the elbow may be involved as well.
- Gout: Gout is a form of arthritis. What happens is that uric acid, which under normal circumstances should be excreted out of your body as a waste product, accumulates in the form of crystals inside tissues. If the buildup occurs in your elbow, it can be extremely painful.
- Lupus: Another disease in which your immune system targets healthy parts of the body — especially your joints and organs. It most frequently involves the hands and feet, but it may affect your elbow.
- Lyme disease: Transmitted by ticks, Lyme disease can have significant issues if left untreated. You may be diagnosed with a neurological problem such as pain in your joints or lower extremity (knee).
