Elbow Injuries and Disorders

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1 Elbow Injuries and Disorders Introduction Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. There are many injuries and disorders that can affect the elbow. Treatment for elbow injuries and disorders depends on the cause. Treatment may include medicine, physical therapy, surgery or other treatments. This reference summary will help you understand injuries and disorders that affect the elbow. It covers common injuries and disorders of the elbow, as well as treatment options. The Elbow Bones connect at the joints. The most obvious joints are the shoulders, elbows, wrists, hips, knees and ankles. The elbow is a joint that helps flex the arm and rotate the palm of the hand up and down. Three bones form the elbow: The upper arm bone, or humerus. Two forearm bones: the radius and the ulna. Muscles make the bones move at the joints. Muscles are attached to bones by tissue called tendons. A material called cartilage covers the ends of the bones of a joint. It allows the bones to move smoothly and without pain. There is a little bag containing a small amount of fluid between the two pieces of cartilage in a joint. The fluid is called synovium. The combination of cartilage and synovium allows for smooth, painless motion in any given joint. 1

2 Symptoms Many elbow injuries and disorders have similar symptoms. The main symptoms are pain and swelling in or around the elbow joint. The pain may be dull or more severe. It can get worse when doing certain activities. In some cases, the pain may be relieved by rest. Other common symptoms of elbow injuries and disorders are: Bruising. Difficulty moving the affected elbow. Pain in the arm, hand or shoulder. Swelling or weakness in the wrist or elbow. Some elbow injuries and disorders may also cause: A popping or tearing feeling. Numbness in the arm, hand or fingers. Redness or tenderness at the joint. Stiff, achy joints. Visible deformity of the elbow. Talk to your health care provider if you notice any of these symptoms or other changes. Finding a problem early makes treatment easier in most cases. Tendinitis Tendinitis is a common condition. It causes swelling around muscles and bones. It happens most often in the: Shoulders. Elbows. Knees. Hips. Heels. Wrists. 2

3 Tendinitis is usually caused by overuse or by repeated injury to a certain area. People who do activities that require repetitive motions or that place stress on joints are at higher risk for tendinitis. Inflammation of a tendon may also be caused by: Arthritis. Diabetes. Infection. Old age. Thyroid disease. Treatment focuses on healing the injured tendon. The first step in treating tendinitis is to reduce pain and inflammation with: Rest. Putting pressure on the affected area. Elevating the injury. Physical therapy Over-the-counter anti-inflammatory medicines, such as aspirin or ibuprofen, can also help. Your health care provider may advise you to limit the amount of activity involving the affected joint. In some cases, protective devices may temporarily reduce stress on an inflamed tendon. For severe cases of tendinitis, you may receive an injection in the area around the swollen tendon. Other treatments may include: Iontophoresis. Therapeutic ultrasound. Iontophoresis may also be used to deliver medication to the affected area. Iontophoresis uses an electrical current to push the medicine through the skin directly over the inflamed tendon. Therapeutic ultrasound is a type of physical therapy in which sound waves are used to massage certain tissues. It warms deep tissues and can improve blood flow. Surgery may be needed to repair the damage if there is still no improvement or if a tendon is completely torn. After surgery, an exercise program is needed to strengthen surrounding muscles to prevent repeated injury. 3

4 Sprains and Strains A sprain is a stretched or torn ligament. Ligaments are tissues that connect bones at a joint. There are many ligaments in the elbow that may be sprained. Many things can cause a sprain. Falling, twisting or getting hit can force a joint out of its normal position. This can cause ligaments around the joint to stretch or tear. Sprains can happen if people: Experience a sudden blow to a joint. Fall on an outstretched arm. A strain is a stretched or torn muscle or tendon. A tendon is a tissue that connects muscle to bone. A strain is caused by twisting or pulling a muscle or tendon. In some cases, strains can happen suddenly. In other cases, they can develop over days or weeks. Some people are at greater risk of getting a sprain or strain. These people: Are overweight. Are in poor physical condition. Do not properly warm-up before being physically active. Have a history of sprains or strains. Treatment of sprains and strains depends on the severity of the injury. It usually involves: Resting and icing the injured area. Wearing a bandage or device to compress the area. Using medicines to reduce pain and swelling. Treatment for sprains may later include exercise and physical therapy. Exercise helps to prevent stiffness and to increase strength. Physical therapy helps make the injured area stronger and more stable. Surgery may be needed if you have a torn ligament or ruptured muscle. Your health care provider will tell you when you can start to do normal activities, including sports. If you start too soon, you can injure the area again. 4

5 Fractures and Dislocations A fracture happens when any one of the bones in the body breaks. Fractures may affect the bones that form the elbow joint, including the humerus, radius or ulna. Fractures can happen at the same time as sprains in the elbow. You can fracture the elbow by: Falling onto an outstretched arm. Direct impact to the elbow. Twisting the elbow. Treatment depends on the severity of the injury. If the bones are still in place and are likely to stay that way, the elbow and arm may be placed in a cast or splint. Surgery may be needed to treat more severe fractures. This may be when the joint is not stable or if a bone has broken through the skin. You will likely need physical therapy for a few weeks or longer to help regain strength and motion in the injured elbow. Dislocations are joint injuries that force the ends of your bones out of position. An elbow dislocation happens when any of the bones slip out of their proper placement. Elbow dislocations are not common. They often happen if a person falls onto an outstretched hand. They can also happen in car accidents when the passengers reach forward to cushion the impact. One of the most common elbow injuries in children under age 5 is called nursemaid s elbow. This happens when the radius is dislocated from the elbow joint. It is often caused by a child being pulled up by one arm. A dislocated joint often is swollen, painful and visibly out of place. You may not be able to move it. A dislocated joint is an emergency. If you think you may have one, seek medical care right away. Treatment for an elbow dislocation might include: A splint. Bone repositioning. Medicine. Rehabilitation. 5

6 When properly repositioned, the elbow joint may not be able to function and move normally again. Bursitis and Arthritis Bursitis and arthritis are common conditions that cause swelling in joints and around muscles and bones. They commonly affect the shoulders, elbows and wrists. Bursae are found throughout your body, including in the elbow. Bursitis happens when one of your bursae becomes inflamed. Bursitis is usually caused by overuse, repeated injury to a certain area or direct injury to a joint. People who do activities that require repetitive motions or that place stress on joints are at higher risk for bursitis. Inflammation of a bursa may also be caused by: Arthritis. Diabetes. Infection. Thyroid disease. Treatment focuses on healing the injured bursa. The first step is to reduce pain and inflammation. This is done with rest, compression and elevation. Anti-inflammatory medicines can also help. Your health care provider may tell you to limit the amount of activity involving the affected joint. This can encourage healing and prevent further injury. Severe cases of bursitis may be treated with other therapies, such as steroid injections, physical therapy or surgery. Arthritis happens when the cartilage and the synovium in joints is inflamed or destroyed. There are many types of arthritis that can affect the elbow. Osteoarthritis is due to chronic wear and tear. It is more common in older people. Osteoarthritis happens due to repetitive use of the joints. Repetitive use of the joints leads to wear and tear on the cartilage in the joint. Grinding and crackling sounds come from affected joints when they move. Post-traumatic arthritis is due to trauma to a joint. Trauma may happen during a car accident, sports injury or other types of trauma. 6

7 If the synovium in a joint becomes inflamed, it could end up being destroyed. It could also destroy the underlying joint. This destruction is called rheumatoid arthritis. The cause of rheumatoid arthritis is unknown. In rheumatoid arthritis, the immune system of the body attacks the synovium of the joint, destroying the joint. Rheumatoid arthritis appears to run in some families. There is no cure for most types of arthritis. Antiinflammatory medicines, physical therapy and splints may help. If other treatments are unsuccessful, surgery to fuse or replace joints may stop deformation and increase use of the joint. Summary Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. There are many injuries and disorders that can affect the elbow, including: Tendinitis. Sprains and strains. Fractures and dislocations. Bursitis and arthritis. Many elbow injuries and disorders have similar symptoms. The main symptoms are pain and swelling in or around the elbow joint. The pain may be dull or more severe. It can get worse when doing certain activities. In some cases, the pain may be relieved by rest. Treatment for elbow injuries and disorders depends on the cause. Treatment may include medicine, surgery or other treatments. Talk to your health care provider if you notice any symptoms. Finding a problem early makes treatment easier in most cases. 7