Pain in the elbow region can arise from elbow joint or adjoining structures or radiate from the neck or shoulder.
Common soft tissue conditions around the elbow are as follows:
- Tennis Elbow (Lateral Epicondylitis): Lateral epicondyle is the outer part of the arm bone (humerus) to which extensor muscles of the forearm are attached. Swelling of these attachments (usually due to overuse) causes localized pain and tenderness. Pain is aggravated by lifting or bending the arm or grasping even light objects such as a cup of tea. The grip can be impaired (e.g., shaking hands) due to this pain. Pain is generally more after exerting the hand. Movements such as gripping, lifting, and carrying heavy objects tend to be troublesome. Tennis elbow is usually self-limiting as the pain settles down over a year in about 80% of patients. Avoidance of overwork and ensuring adequate rest are essential. The use of an elbow strap or brace during work can serve this purpose. Painkillers, local icepacks, and ointments can give some relief. Local injection of corticosteroids, though initially painful, can provide extended pain relief. Early pain relief is desirable as this allows commencement of stretching and other exercises followed by a strength and endurance program. Treatment failure is usually due to failure to remove the cause of the tennis elbow. Nonresponsive disabling symptoms can be treated with surgical measures.
- Golfer's Elbow: Golfer's elbow is a similar condition on the inner (medial) side of the elbow. Flexor muscles of the forearm are attached to the medial epicondyle of the humerus. Pain, therefore, is on the inner side of the elbow and may radiate downwards along the forearm and may be associated with some numbness and tingling in this area. Making a fist (e.g., squeezing a ball) or resisted flexion (e.g., pressing fingers against tabletop) is painful. Treatment is similar to that of the tennis elbow.
- Olecranon Bursitis: Swelling of bursa overlying tip behind elbow ('student's elbow') may cause pain aggravated by pressure. There may be a history of injury to the elbow from behind or repetitive occupational use. However, tender swelling is usually clearly demarcated, and the range of elbow movements is not affected. Needle aspiration of bursa fluid followed by local glucocorticoid injection usually resolves the problem within a week.