What to Do About Chronic Elbow Pain
For all its complexity, your elbow is a fairly rugged joint that can withstand high force loads. Nevertheless, overuse from sports like tennis or golf, repetitive occupational use, and carrying heavy loads with extended elbows can all lead to debilitating chronic pain. The first step to treatment is pinpointing the exact location and cause of your elbow pain.
Your elbow is a hinge joint where three bones converge, the humerus, ulna, and radius. The joint is supported by multiple structures that enable it to bend and flex, and to withstand rotational forces generated from the wrist and shoulder.
- Ligaments: Two important elbow ligaments are the medial collateral ligament on the inside of the elbow, and the lateral collateral ligament on the outside. These ligaments provide stability by holding the humerus and the ulna tightly together. Another ligament, the annular ligament, holds the radius tightly in place.
- Tendons: Tendons are made up of strong fibrous tissue that is continuous with muscle. The biceps tendon attaches your biceps muscle to bone at the front of your arm, and the triceps tendon attaches your triceps muscle to bone at the back of your arm.
- Muscles: Your forearm muscles cross the elbow joint and attach to the humerus. The bump on the outside of your elbow, called the lateral epicondyle, is where your wrist extensor muscles attach. The muscles that straighten your fingers and wrist attach to the medial epicondyle, or the bump on the inside of your elbow. The tendons of these attachments are common locations of tendonitis.
- Nerves: Three main nerves, the radial nerve, the ulnar nerve and the medial nerve, all begin together at your shoulder and pass through your elbow. These nerves signal your muscles to work, and relay sensations of touch, pain and temperature back to your brain.
Lateral Elbow Pain
Pain experienced on the outside of your elbow is called lateral elbow pain. This type of chronic pain is often referred to as tennis elbow, or lateral epicondylitis, but tennis is only one cause of lateral elbow pain.
Sources of lateral elbow pain include:
- Tennis elbow: The most common cause of tennis elbow is inflammation or degeneration of the wrist extensor tendon where it inserts into the elbow. Tennis elbow is also called lateral epicondylitis or extensor tendinopathy.
- Radial Tunnel Syndrome: When the radial nerve gets compressed or restricted where it passes through the tunnel at the elbow, it causes pain and discomfort. Also known as radial nerve entrapment.
- Osteochondritis Dissecans: This condition is a fragmentation of the cartilage and underlying bone within a joint. The condition most commonly occurs in adolescents in whom the ends of bones have not fully hardened.
- Synovitis: Synovitis of the elbow is inflammation of the synovial membrane that surrounds the elbow joint.
- Radiohumeral Bursitis: This condition is inflammation of a bursa, a small sac of fluid that sits between the tendon and bone to help cushion and lubricate it.
Posterior Elbow Pain:
Pain on the back of your elbow is called posterior elbow pain, which can have an acute sudden onset or can develop gradually over time. Chronic elbow injuries may occur subsequent to an acute injury that was not properly treated.
Causes of posterior elbow pain include:
- Elbow Bursitis: Elbow bursitis, sometimes called student’s elbow or olecranon bursitis, is inflammation of the bursa sac which protects the end of the ulna bone at the back of the elbow.
- Olecranon Fracture: The large bony prominence at the back of the elbow on the ulna forearm bone, called the olecranon process, is often fractured from direct impact or a fall on a bent elbow.
- Triceps Tendinitis: The triceps tendon at the back of the elbow can become inflamed and painful from sudden impact or repetitive overuse.
Treatment for Chronic Elbow Pain
Despite its debilitating pain, there are a number of treatment strategies to which elbow pain is highly responsive, including:
- Therapeutic exercise
- Dynamic Neuromuscular Stabilization (DNS)
- Extracorporeal Shock Wave Therapy (ESWT)
- Myofascial manipulation
Treatment is often multimodal in nature, and is geared to optimal pain-free function of the elbow joint.
Elbow Pain Treatment in NYC
If you are suffering from ongoing elbow pain, the orthopedic specialists at NYDNRehab can help. We use cutting edge technologies combined with years of expertise to diagnose and treat patients suffering from musculoskeletal pain. Do not let your elbow pain go untreated. Call NYDNRehab today, and let our dedicated team of Sports Medicine professionals put you back in the game!