Elbow

Conditions We Treat:

Arthritis
Fractures
Tennis Elbow/ Lateral Epicondylitis
Medial Epicondylitis/ Golfer’s Elbow
Nerve entrapments
Osteochondritis
Stiffness
Tendonitis

Arthritis

Arthritis is inflammation or degeneration of one or more joints, which is where 2 bones meet..

Causes:

Arthritis involves the breakdown of structures of the joint, particularly cartilage. Normal cartilage protects a joint and allows it to move smoothly. Cartilage also absorbs shock when pressure is placed on the joint, such as when you walk. Without the normal amount of cartilage, the bones under the cartilage become damaged and rub together. This causes swelling (inflammation), and stiffness.

Management

Low-impact aerobic activity (also called endurance exercise) such as walking
Range of motion exercises for flexibility
Strength training for muscle tone
Avoid staying in one position for too long.
Eat foods rich in omega-3 fatty acids, such as cold-water fish (salmon, mackerel, and herring), flaxseed, rapeseed (canola) oil, soybeans, soybean oil, pumpkin seeds, and walnuts.
Avoid smoking and excessive alcohol consumption.
Lose weight, if you are overweight. Weight loss can greatly improve joint pain in the legs and feet.

Fractures

A fracture is a break in a bone. There are different types of fractures based on whether the bone is partially or completely broken, whether the bone breaks through the skin, the direction or shape of the break, the cause of the break, and the location of the break.

Causes:

Fractures commonly happen because of car accidents, falls, or sports injuries. Overuse and repetitive motions can also cause fractures. Low bone density and osteoporosis are conditions which cause weakening of your bones. Having one of these conditions makes you much more likely to break a bone.

Management:

Cast or splint: Wearing a cast or a splint will keep your bone from moving while it heals. How long you need to wear it will depend on the type of fracture and which bone is affected.
Recovering from fractures (Bone Health and Osteoporosis Foundation)

Ulnar Nerve Entrapments

The ulnar nerve is one of the three main nerves in your arm. It travels from your neck down into your hand and can be constricted in several places along the way, such as beneath the collarbone or at the wrist. The most common place for compression of the nerve is behind the inside part of the elbow.

Causes:

The ulnar nerve is especially vulnerable to compression at the elbow because it must travel through a narrow space with very little soft tissue to protect it. Also, when you bend your elbow, you slightly compress and stretch the nerve and decrease its blood supply. This is often why the symptoms get worse when the elbow is bent.

Other common causes of compression:

In some people, the nerve slides out from behind the medial epicondyle when the elbow is bent. Over time, this sliding back and forth may irritate the nerve.
Leaning on your elbow for long periods of time can put pressure on the nerve.
Fluid buildup in the elbow can cause swelling that may compress the nerve.
A direct blow to the inside of the elbow can cause pain, electric shock sensation, and numbness in the little and ring fingers. This is commonly called "hitting your funny bone."
Throwing a baseball puts a large amount of stress on the inside of the elbow and can sometimes lead to ulnar nerve irritation.

Management:

Avoid activities that require you to keep your arm bent for long periods of time.
If you use a computer frequently, make sure that your chair is not too low. Do not rest your elbow on the armrest.
Avoid leaning on your elbow or putting pressure on the inside of your arm. For example, do not drive with your arm resting on the open window.
Keep your elbow straight at night when you are sleeping. This can be done by wrapping a towel around your straight elbow or wearing an elbow pad backwards.

Tennis Elbow/ Lateral Epicondylitis

Tennis elbow is soreness or pain on the outside (lateral) side of the upper arm near the elbow.

Causes:

When the muscle attached to the bone on the outside of the elbow is used repetitively, small tears may develop in the tendon. Over time, the tendon cannot heal, and this leads to irritation and pain where the tendon is attached to the bone.

This injury is common in people who play a lot of tennis or other racket sports, hence the name "tennis elbow." Backhand is the most common stroke to cause symptoms.

But any activity that involves repetitive twisting of the wrist (like using a screwdriver) can lead to this condition. Painters, plumbers, construction workers, cooks, and butchers are all more likely to develop tennis elbow. This condition may also be due to repetitive typing on the computer keyboard and mouse use. However, sometimes there is no known cause of tennis elbow.

Management:

Rest your arm for 2 or 3 weeks and avoid or modify the activity that causes your symptoms.
Put ice on the outside of your elbow 2 or 3 times a day.
If your tennis elbow is caused by sports activities, ask your provider about changes you can make to your techniques
If your symptoms are related to working on a computer, you may try changing your chair, desk, and computer setup. For example, a wrist support or a roller mouse may help.
A physical therapist can show you exercises to stretch and strengthen the muscles of your forearm.

Medial Epicondylitis/ Golfer’s Elbow

Medial epicondylitis is soreness or pain on the inside of the lower arm near the elbow. It is commonly called golfer's elbow.

Causes:

When the muscle attached to the bone on the inside of the elbow is used repetitively, small tears may develop in the tendon. Over time, the tendon cannot heal, and this leads to irritation and pain where the tendon is attached to the bone.

This injury can occur from using poor form or overdoing certain sports, such as golf, baseball and other throwing sports, racquet sports, and weight training. Repeated twisting of the wrist (such as when using a screwdriver) can lead to golfer's elbow. People in certain jobs may be more likely to develop it, such as painters, plumbers, construction workers, cooks, assembly-line workers, computer users, and butchers.

Management:

Avoid the activity that causes your symptoms for at least 2 to 3 weeks or longer until the pain goes away.
Gradually return to activity.
Put ice on the inside of your elbow 3 to 4 times a day for 15 to 20 minutes. Wrap the ice in a cloth. Do not put ice directly on the skin.
Do stretching and strengthening exercises.
If you play golf, have an instructor check your form, or ask about changes you can make to your techniques.
Check any sports equipment you are using to see if any changes may help. For example, using lighter golf clubs may help. Also check if the grip of your equipment is causing the elbow pain.

Osteochondritis

Osteochondritis disease (OCD) is a condition that develops in joints, most often in children and adolescents. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen.

Causes:

It is not known exactly what causes the disruption to the blood supply and the resulting OCD. Doctors think it probably involves repetitive trauma or stresses to the bone over time.

Management:

In most cases, OCD lesions in children and young teens will heal on their own, especially when the body still has a great deal of growing to do. Resting and avoiding vigorous sports until symptoms resolve will often relieve pain and swelling.

If symptoms do not subside after a reasonable amount of time, your doctor may recommend the use of crutches, or splinting or casting the affected arm, leg or other joint for a short period of time.

In general, most children start to feel better over a 2- to 4-month course of rest and nonsurgical treatment. They usually return to all activities as symptoms improve.

Stiffness

Elbow stiffness, or elbow contracture, is diagnosed when there is a limited range of motion of an individual’s elbow joint. It limits an individual’s ability to turn their palm up and down, bend and straighten the elbow, and pick up objects. Such limitations can create difficulties in one’s ability to perform basic activities of daily living.

Causes:

Elbow stiffness is usually the result of an injury. Sometimes after injury, the muscles don’t contract well. Arthritis can also cause stiffness in some people. After injury or surgery, a biologic reaction can occur. It is called heterotopic ossification. Pain and swelling can also cause stiffness in the elbow.

Management:

Treatment for elbow stiffness often starts with exercises, stretching, and splinting. Exercises are usually guided by a physical or occupational therapist. Many patients find low-impact exercises such as swimming to be beneficial because the underwater movement can help elbow motion.

If the stiffness is caused by swelling and pain, ice can reduce swelling and pain, and compression sleeves or dressings can be critical to minimize swelling. In addition, a range of motion of the fingers and wrist can increase the venous and lymphatic return to the area to decrease swelling.

Tendonitis

Causes:

Tendinitis usually happens after repeated injury to the affected area. It causes pain and soreness around a joint. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.

Management:

Most cases of tendonitis can be successfully treated with rest, ice, compression (a sleeve or wrap), elevation, stretching, and modification of activities. The quicker your tendonitis is treated, the quicker you will recover to full strength and flexibility.