Overview:
Orthopedic Hand, Wrist, and Elbow Treatment
Elbow pain is a common occurrence for many people at some point in their lives.
Pain in (or around) the elbow region is normally triggered from overuse or repetitive actions/activities. The most common causes of elbow injuries (and elbow pain) occur from routine activities that cause inflammation, repetitive movements during certain sports (such as “golfer’s elbow” or “tennis elbow”), and arthritis.
What are the causes of elbow pain?
The elbow is a joint that connects the upper arm with the lower arm through a network of tendons, muscles, and ligaments. As a complex hinge joint, the elbow enables the flexing, rotating, and extending of the forearm and wrist. Joined by three critical bones (humerus, ulna, and radius), the elbow also assists in the lifting and movement of objects.
Pain in the elbow joint can occur for a variety of reasons, such as:
- Use of incorrect equipment for performing activities that are repetitive in nature
- Lack of flexibility and strength in the structures of the elbow
- Lack of proper technique while playing sports
- Lack of proper technique while lifting and shifting objects
- Instability of the elbow joint
- Overuse
Pain in the elbow joint can also be caused by certain medical conditions that often require specific treatment to resolve the pain and inflammation they produce in a patient. These conditions include:
- Tendonitis — Condition that causes inflammation and pain of the tendons of the elbow area due to overuse, repetitive actions, and (in rare cases) infection.
- Osteoarthritis — Causes the cartilage in the elbow joint to become brittle, leading to pain and inflammation.
- Radio humeral bursitis — Caused by pressure and inflammation because of overuse
- Nerve entrapment — Occurs when the radial nerve is pinched by the elbow joint.
- Osteochondritis Dissecans — Occurs when a bone and cartilage comes loose off a joint.
- Carpal tunnel syndrome — Condition that affects the ulnar nerve
- Lyme’s disease — A bacterial infection that causes inflammation in the elbow joint.
- Radial collateral ligament sprain and radial tunnel syndrome
- Autoimmune diseases (such as rheumatoid arthritis)
- Throwing injuries (such as “thrower’s” elbow in baseball)
- Ulnar neuropathy and collateral ligament injuries
- Infections (such as cellulitis and septic arthritis)
- Erb’s palsy (or brachial plexus injury)
- Osteochondral defect of capitellum
- Hyperextension of the elbow
- Bicep tendon rupture
- Distal radius fracture
- Olecranon bursitis
- Elbow contracture
- Osteomyelitis
- Tumors
Acute injuries also affect the elbow joints and cause significant pain and discomfort, which include:
- Joint and ligament sprains and strains
- Bone fractures
- Bone dislocations
- Avulsion fractures
What are the symptoms of elbow pain?
The most common symptoms of elbow pain are:
- Inability to stretch, bend, or flex the arm and wrist
- Redness and warmth in the affected area
- Pain when opening the fingers
- Tenderness in the region
- Constant, dull ache
- Soreness and pain in the joint
- Inability to grasp objects
- Pain when making a fist
- Weak grip
What are the risk factors associated with elbow pain?
Risk factors associated with elbow pain include:
- Auto-immune diseases (such as rheumatoid arthritis)
- Infections (such as septic arthritis and cellulitis)
- Repetitive, strenuous movements
- Infections to the elbow structures
- Trauma to the elbow joints
- Repetitive stress
What are the complications associated with elbow pain?
Elbow pain can become aggravated if left untreated, often causing pain and other symptoms to become chronic.
These complications include:
- Loss of flexibility in the elbow, forearm, and/or wrist
- Degenerative changes in the structures of the elbow
- Loss of function in the elbow, forearm, and/or wrist
- Loss of mobility in the elbow, forearm, and/or wrist
- Chronic inflammation
- Chronic pain
When should I see a doctor for my elbow pain?
Elbow pain is often resolved with at-home care, rest and over-the-counter (OTC) medications to manage inflammation and pain. If, however, the injury does not respond to treatment or if you are experiencing any of the symptoms listed below, it is recommended to seek immediate professional medical treatment:
- Swelling, redness, tingling, and warmth in the region
- Constant or gradually increasing pain in the region
- Loss of movement in the affected area (including the inability to bend or move the arm)
- Stiffness and loss of flexibility
- Fever over 100 degrees F
Advanced Orthopedics offers same and next day appointment with their team of Orthopedic Doctors and Pain Management Physicians, so if you are in pain there is no need to wait. Call 512.244-4272 or visit www.austinpaindoctor.com.
How is elbow pain diagnosed?
Elbow injuries and conditions are diagnosed by the physicians at Advanced Orthopedics in a comprehensive manner that involves:
- A complete evaluation of a patient’s past medical history
- A physical examination to evaluate the current condition
- Tests and procedures to support a diagnosis and treatment plan (if applicable)
To determine an accurate diagnosis, the specialists at Advanced Orthopedics will ask the following questions to assist in the diagnostic process:
- Did the pain increase rapidly (indicative of an acute injury such as a sprain, strain, or fracture) or steadily (indicative of an overuse issue)?
- What are the other symptoms that you are experiencing?
- What kind of sports do you play?
- When did the pain begin?
- What is your occupation?
As a part of the physical examination, the specialist will evaluate the following:
- Any visible inflammation, deformities, redness
- Any tenderness and weakness in the joints
- Range of motion in the elbow joints
Along with a complete physical examination, your orthopedic specialist might also recommend the following tests and procedures to support a diagnosis:
- X-rays to diagnose bone and/or tendon problems including fractures and calcification
- MRIs to diagnose soft tissue injuries and/or nerve compression
- Aspiration to remove joint fluid in case of suspected infections
- Diagnostic elbow arthroscopy to evaluate existing damage
- Biopsy of the bursa fluid to rule out tumors
- Positron emission tomography or PET Scan
- Angiograms to rule out vascular disorders
- CT scans for a detailed view of the bones
- Bone scans to detect stress fractures
- Electromyography
How is elbow pain treated?
Elbow pain treatment is usually simple and straightforward using non-invasive treatments and therapies, such as:
- Prescribed exercises to strengthen the elbow joints, muscles, tendons, and ligaments (such as eccentric, isometric, and static stretching)
- Over-the-counter anti-inflammatory and/or pain medication
- Medications (such as antibiotics and antirheumatic drugs)
- Friction/myofascial release massage
- Rest and the application of ice
- Braces and supportive devices
- Taping the elbow and forearm
- Massage of the soft tissues
- Electrical stimulation
- Ultrasound
In more severe cases of elbow pain and inflammation, orthopedic specialists may recommend corticosteroid injections, and, if necessary, surgery.
Before surgery, consult with Advanced Orthopedics to understand the wide range of proven and leading edge non-surgical treatment options offered:
- Absorbable antibiotic bead treatment
- Olecranon bursa aspiration
- Nerve conduction study
- Closed reduction
- Fiberglass casting
- Joint injections
- Physical therapy
- Cold laser therapy
If non-surgical treatments for elbow pain are not working for a patient, surgery might be recommended to restore mobility and function of the elbow joint and/or supporting structures. Some common surgery options to address elbow pain are:
- Medial ulnar collateral ligament reconstruction (or the Tommy John surgery)
- Cubital tunnel release at the elbow
- Radial tunnel release at the elbow
- Distal biceps tendon surgery
- Arthroscopic debridement
- Elbow arthritis surgery
- Elbow fracture surgery
- Elbow replacement
- Elbow arthroscopy
- Synovectomy
- Ulnar nerve transposition at the elbow
- Elbow tendonitis treatment surgery
- Ulnar collateral ligament repair
- Elbow reconstruction surgery
- Nerve decompression surgery
- Ulnar decompression surgery
- Tendon repair surgery
- Tennis elbow surgery
- Elbow fusion surgery
Considerations of elbow surgery (pre-surgery / post-surgery)
If necessary, Advanced Orthopedics offers both minimally invasive and traditional surgical procedures at their surgical centers.
Prior to surgery, an orthopedic surgeon and supporting team of nurses will walk through specific “do’s” and “don’ts” to eliminate any problems during surgery and explain possible complications that may arise once the surgery has been completed.
After surgery, soreness and pain are expected for a few weeks. In most cases, at-home treatments that include applying ice, rest and over-the-counter (OTC) medications will help control the pain and discomfort. It may also be advised to wear an assistive/supportive device (such as a splint, sling or brace) during this recovery period.
After a few weeks, the physical therapist team at Advanced Orthopedics will recommend an initial regiment of mild stretching and strengthening exercises to improve elbow strength. If the elbow heals correctly after surgery with no complications, patients can expect to gain regular use of their elbow joint anywhere between 6 weeks and 6 months. Recovery times depend on the amount of physical therapy the patient receives along with additional levels of healing and strengthening that take place post-surgery.
If, however, any of the following symptoms are experienced after surgery, speak to your specialist immediately as they may be signs of potential complications:
- Reduced strength and/or flexibility
- Numbness and/or tingling
- Drainage from the wound
- Changes in skin color at the elbow
- Continuous inflammation
- Severe pain
- Fever
How can you prevent elbow pain?
There are ways to reduce the risk of elbow injury. Here are some simple tips to reduce the possibility of experiencing elbow pain:
The team of specialists at Advanced Orthopedics are committed to effectively diagnosing your condition and developing a multi-specialty treatment plan to provide you relief from your pain and get you back to feeling your best. Our team of doctors and nurses specialize in non-invasive and surgical treatments using the latest techniques and technology in our state-of-the-art surgery centers. For same or next day appointments, call 512-244-4272 or visit www.austinpaindoctor.com.
FAQs
Q: How do you treat elbow pain?
A: Elbow pain will often resolve itself naturally with at-home treatments and rest. Therapy options to treat elbow pain include:
- Rest and application of ice
- Specific exercises to strengthen the elbow joints and the surrounding muscles, tendons, and ligaments.
- Massage of the soft tissues
- Taping the elbow and forearm
- Braces and supportive devices for the elbow
- Ultrasound
- Electrical stimulation
- Friction/myofascial release massage
- Over-the-counter anti-inflammatory and/or pain medication
- Medications (such as antibiotics and antirheumatic drugs)
In more severe cases, orthopedist physicians may recommend corticosteroid injections, (or even surgery) if elbow pain does not subside after previous treatment protocols.
At Advanced Orthopedics, doctors will often recommend non-surgical treatment options first to try and resolve elbow pain before recommending surgery. These treatment options for elbow pain include:
- Closed reduction
- Fiberglass casting
- Joint injections
- Olecranon bursa aspiration
- Nerve conduction study
- Physical therapy
- Absorbable antibiotic bead treatment
- Cold laser therapy
If these treatments do not provide relief from elbow pain and discomfort, surgery may be recommended to restore mobility, function, and strength. Common surgery options to address elbow pain include:
- elbow arthroscopy
- synovectomy
- arthroscopic debridement
- elbow replacement
Q: How long does tendonitis in the elbow take to heal?
A: If you have been diagnosed with elbow tendonitis, the healing process and duration depend on several factors which include:
- How quickly did you seek treatment?
- What was the treatment given (at-home care and medication, non-surgical procedures, or surgery)?
- Did you follow the precautions and instructions after treatment?
- Did you follow the exercises advised by the physical therapist?
In most cases, acute elbow tendonitis heals in several weeks. If the pain condition becomes chronic and surgical intervention is needed, the healing process may take anywhere from 6 and 12 months.
Consult with a physician at Advanced Orthopedics for a comprehensive evaluation and personalized treatment plan based on your diagnosis. We also offer Pain Management, Rheumatology and Neurosurgery specialties, so each patient’s case is treated uniquely among a team of pain care specialists. If you are in pain, there is no need to wait.
