The elbow is a hinge joint consisting of three bones. The upper part of the hinge is at the end of the upper arm bone (humerus), and the lower part of the hinge is at the top of the two forearm bones (radius and ulna) which are side by side. When the elbow is bent, the ends of the two forearm bones rub against the end of the humerus.
Elbow pain can have causes that aren’t due to underlying disease. Examples include prolonged pressure or leaning on elbows, trying a new exercise such as tennis, local trauma, desk work, sprains, or strains.
Although the elbows are not weight-bearing joints, they are considered to be most important for the functioning of the upper limbs. Hence, even minor trauma or disease affecting the elbow may cause pain and limit the movements of the upper limbs. Arthritis is one of the common disease conditions affecting the elbow joint.
Treatment can include conservative options such as medications and steroid injections to relieve pain, activity modification, and use of splints. Surgery is usually considered if nonsurgical treatment fails to give relief. Total elbow replacement is a surgical procedure used to restore the function and relieve the pain in elbows affected by arthritis. In total elbow replacement surgery, the damaged regions of the elbow joint are replaced with artificial components.
Tennis elbow is the pain you feel on the outside of your arm where your forearm connects to your elbow. It’s linked with tears in the tendons and muscles of your forearm. The tears cause inflammation and place stress on the other parts of your arm, which further causes pain when you want to grip or lift things.
This condition is caused by overuse or repetitive stress. Activities that strain the muscles around the elbow can cause tennis elbow. In tennis, if you hit the ball with a backhand, you can place stress on your muscles, which contract repeatedly as you move the racquet to hit the ball. Other activities that can cause tennis elbow include:
• Activity modification: Initially, the activity causing the condition should be limited. Limiting the aggravating activity, not total rest, is recommended. Modifying grips or techniques, such as use of a different size racket and/or use of 2-handed backhands in tennis, may relieve the problem.
• Medication: anti-inflammatory medications may help alleviate the pain.
• Brace: a tennis elbow brace, a band worn over the muscle of the forearm, just below the elbow, can reduce the tension on the tendon and allow it to heal.
• Physical Therapy: may be helpful, providing stretching and/or strengthening exercises. Modalities such as ultrasound or heat treatments may be helpful.
• Steroid injections: A steroid is a strong anti-inflammatory medication that can be injected into the area. No more than (3) injections should be given.
• Shockwave treatment: A new type of treatment, available in the office setting, has shown some success in 50-60% of patients. This is a shock wave delivered to the affected area around the elbow, which can be used as a last resort prior to the consideration of surgery.
Surgery is only considered when the pain is incapacitating and has not responded to conservative care, and symptoms have lasted more than six months. Surgery involves removing the diseased, degenerated tendon tissue. Two surgical approaches are available; traditional open surgery (incision), and arthroscopy—a procedure performed with instruments inserted into the joint through small incisions. Both options are performed in the outpatient setting.