The elbow is a complex structure. It consists of three bones, the joints between them, the ligaments that keep it stable and the muscles that generate strength and motion. Your elbows take a lot of stress from regular movements like lifting or carrying a bag to more complex motions like throwing a baseball. The muscles that surround the elbow are also used for motion in the wrist. Elbow problems can be caused by overuse, traumatic injury, and/or changes that occur naturally in your body.
Suffering from elbow pain? Contact us to learn about treatment options.
How Your Elbow Works
The elbow consists of three bones: the upper arm bone (humerus) and two bones in the forearm the ulna and the radius. The ulna bone runs on the bottom side of your forearm, from the wrist to the elbow and is the bone used to rest your arms. It has a U-shape to it that holds the bottom of the upper arm bone (humerus). The radius is the other bone in the forearm and it rotates around the ulna. These bones, the radius and ulna, are responsible for turning the palm of your hand up and down.
There are two main ligaments in the elbow that help provide stability. These ligaments are commonly injured in sports or during traumatic injuries. The radial collateral ligament provides stability to the outside of the elbow while the ulnar collateral ligament (UCL) provides stability to the inside of the elbow. The UCL is more commonly injured as this ligament can be stretched with throwing or racket-type sports.
Surrounding the elbow joint, there are four main groups of muscles that help power the elbow and wrist. The biceps muscles are located on the front of the upper arm bone, which bend the elbow. On the backside of the upper arm bone are the triceps muscles, which straighten the elbow. Some wrist flexor tendons attach on the outside of the elbow while the wrist extensors attach to inside of the elbow. These muscles all work together to allow the hand to turn palm up and palm down as well as bend and straighten the elbow.
There are two main nerves that can cause pain in the elbow and numbness/weakness in the hand, the ulnar nerve and radial nerve. The ulnar nerve travels behind the inside of your elbow and is the nerve responsible for the zinging pain down into your hand when you hit your “funny bone”. This nerve provides feeling for your little finger and half of your ring finger on the palmar side of the hand. The radial nerve travels through the muscle of your forearm and provides some sensation to the back of your hand but primarily is responsible for powering the muscles in the forearm and hand.
Evaluating Elbow Pain
Evaluation for elbow pain starts with you giving us a history of your problem: when and how it started, how it currently feels, and which treatments you have tried so far. We also ask you about other medical conditions that may contribute to your elbow pain. We do a physical exam to test the structures of your elbow. We check your elbow’s range of motion, strength and do special tests that can uncover specific problems.
Based on the findings of your physical exam, we may recommend a cortisone injection as both a clinical test and treatment for your pain. The numbing medicine mixed in the injection helps us determine the source of your pain, whereas the cortisone medication of the injection can provide pain relief. Sometimes we order tests such as x-rays or MRIs to visualize your bones and soft tissues. X-rays can show us things like fractures, spurs, and changes from arthritis. MRIs can show us more detail of the bones, as well as soft tissue damage like tears of the ligaments or the tendons.
Whatever the cause of your elbow pain, we are dedicated to helping you find the best treatment. Request an appointment today.
Causes of Elbow Pain
- Less common causes– infection, tumors, or nerve problems
Treating Elbow Pain
Treatment of elbow pain is very specific to the diagnosis and severity of your symptoms.
Medications can help with some elbow conditions. Non-steroidal medications (NSAIDs) such as ibuprofen or naproxen can relieve inflammation. If the inflammation is severe, then a short burst of a steroid medication may be an option. Medications like acetaminophen (Tylenol) can help to control your pain.
Cortisone injections are used to target a specific location in your elbow using a powerful anti-inflammatory medication. Numbing medications mixed in the injection help us know if the injected spot is the source of your pain.
Physical therapy is a form of treatment that focuses on getting your muscles and joints to work properly together to move your arm. Even if you are very strong and active, you may have muscle imbalances which are causing you elbow pain. Physical Therapists can identify and address these muscle imbalances through corrective exercises. They may give you a series of take-home exercises to help return you to regular activities pain-free.
Braces are available to help with a variety of conditions including ones to help increase the stability of the elbow (hinged braces), ones that help relieve pain with lifting (tennis elbow strap) and ones that keep the elbow compressed (elbow sleeve).
Surgery may be the next option for certain elbow conditions if all other treatment options have been exhausted. Although many surgeries can be done through small incisions using a special camera to see inside the body (arthroscopy), some may still require a traditional open surgery.