Elbow problems


 

The elbow is made up of 3 bones, the Humerus (upper arm) and the Radius and Ulna (the two forearm bones).

As a result there are 3 joints as both forearm bones move on the upper arm and move on each other.

The main movements at the elbow are therefore flexion and extension (bending and straightening) and pronation and supination (turning the palm to face up and down).

There are numerous ligaments that surround the elbow which give stability to the joint, in particular the collateral ligaments which support the elbow from either side. Muscles also cross the elbow and are involved in movements of the elbow as well as the hand and wrist.


 

Why do I have elbow pain?

Elbow pain can be caused by a number of structures around the elbow. An understanding of the location of pain, the aggravating movements and the time of onset of the symptoms can help make a diagnosis. Pain can be present as the result of trauma leading to damage to one of the numerous structures around the elbow however this is not always the case. Pain can be present in the absence of structural damage and can be termed persistent pain.

As there are a number of possible causes of elbow pain, a thorough examination by a healthcare professional may be required to make an accurate diagnosis.

 

How can I help myself?

There are a number of things that you can do to help manage your pain before seeking help from a medical professional. Below are some ways that you may wish to try to help manage your elbow pain.

 

I have just injured myself …

If you have suffered an acute elbow injury you may be suffering with pain, swelling and bruising. In this instance the best treatment is;

  • Rest – Whilst it is important to keep the elbow and arm moving it is also important to have a period of relative rest from strenuous activity. This may mean avoiding lifting, weight-bearing through the arm and heavy gripping

     
  • Ice – Using a cold pack around the area of pain and swelling can help manage your symptoms.

     
  • Compression – Using a soft tubi-grip bandage can help manage the swelling.

     
  • Elevation – when resting, keeping the arm elevated can help manage the swelling.

It may be appropriate to manage your symptoms with appropriate pain relief. You can discuss what medication is most appropriate for you with a pharmacist at your local pharmacy. If these medications do not provide adequate relief then you may need to see a GP to discuss prescription pain medications.

 

I have had a problem for over 3 months that is not getting better …

If symptoms persist for more than 3 months this still does not mean that there is damage to the structures in the elbow. We know that there are a number of reasons as to why pain can persist for longer than three months without structural damage. If this is the case then there are ways to manage the symptoms:

  • Commence gentle exercise – this could be specific for the arm or general cardiovascular exercise. The NHS recommends 150 minutes of moderate aerobic exercise and 2 to 3 days of strengthening exercise per week for people between the ages of 19 and 64 years of age. Muscles and joints need regular movement to remain healthy.
  • Pain medication – Pharmacists at a local pharmacy will be able to advise you on over the counter pain medications that will be most appropriate to you. If these do not provide adequate relief then you may need to speak with a GP to discuss prescription medications.

 

When should I seek medical attention?

If you have sustained a trauma to the elbow which is accompanied by heavy bruising, high levels of pain and a reduced ability to move the elbow then the injury may warrant further investigations and a trip to the local walk-in-centre or A & E may be required.

If elbow pain and restriction of activities of daily living continue to be problematic then a review with your local general practitioner may be required to discuss future management options.

 

What treatments are available?

Often the first line of treatment is through self-help – (see section How can I help myself? For more details)

Medical treatment will vary depending on your symptoms and likely diagnosis. Often your general practitioner will refer you directly to physiotherapy where exercise therapy, manual therapy and taping may be of benefit.

Occasionally a review with an Extended Scope Practitioner or Orthopaedic Consultant is required which may lead to further treatment options such as Injections or surgery.

 

How do I get help?

If you wish to seek further advice and help in the diagnosis and management of your elbow pain then you will need to make an appointment to see your GP. Your GP can then make a decision with you about what would be the next steps going forward in managing your pain. At this time your GP may consider sending you for investigations including x-ray, or they may wish to refer you to the Surrey Integrated Musculoskeletal service at Ashford & St Peter’s Hospitals, or to a physiotherapist.

 

Helpful links

Link to website
 

NHS Choices

NHS Choices was launched in 2007 and is the official website of the National Health Service in England.

 
Link to website
 

Arthritis Research UK

Arthritis Research UK is the leading UK funder of research into the cause, treatment and cure of arthritis