Elbow Conditions

Dr. Donnelly and his staff know how critical healthy elbows are to our patients. The elbow serves a wide variety of functions. When an elbow fails, the quality of your life can be significantly compromised.

Below you’ll find more information about the common elbow conditions we see, how they are diagnosed and how they are treated.

What Are Elbow Fractures?

The elbow joint is composed of the arm bone (humerus) and two forearm bones (the radius and ulna). The elbow is typically fractured at the olecranon, which is the tip of the ulna. Causes of fractures include:

  • A direct blow to the elbow
  • A fall on the elbow
  • A fall on an outstretched arm with the elbow locked in extension

Symptoms may include any, all, or any combination of the following:

  • Sharp, intense pain
  • Swelling
  • Bruising
  • Tenderness
  • Numbness in the elbow, forearm, hand, and/or fingers

Treatment depends on the severity and location of the fracture.

How Are Elbow Fractures Treated?

When the fractured bone maintains its alignment and integrity (a non-displaced fracture), nonsurgical treatment options can be used. Typically, the fractured elbow is put in an anatomical position and placed in a long arm splint or cast that extends from the hand to the upper arm.

Surgical treatment may be needed for displaced fractures that involve improper bone alignment and/or multiple pieces of fractured bone. An open reduction internal fixation procedure is used to reduce the fracture and then fixate it using a plate and screws.

What is Radial Tunnel Syndrome?

The radial nerve runs from the neck to the hand. At the elbow, the nerve passes through a narrow tunnel known as the radial tunnel. When the nerve is compressed or pinched in the tunnel, radial tunnel syndrome presents as a dull, aching pain. Other symptoms include:

  • Swelling
  • Forearm weakness
  • Forearm fatigue

How is Radial Tunnel Syndrome Treated?

The goal of treatment is to decrease inflammation, pain, and swelling, and prevent symptoms from reoccurring. Nonsurgical treatment options are effective. They usually include a combination of:

  • Anti-inflammatory medications
  • Immobilization devices, such as braces, splints, or casts
  • Physical therapy

And in some cases, corticosteroid injections.

Because surgery is rarely used to treat radial tunnel syndrome, interested patients should discuss surgical options with an orthopedic hand surgeon.

What Are Distal Biceps Tendon Tears?

The bicep muscle inserts distally at the elbow. When it is torn, usually due to being forced straight against resistance (i.e. lifting too heavy an object), the following symptoms may present:

  • Severe pain
  • Swelling
  • Bruising
  • A noticeable bulge in the upper arm

Tears are categorized as partial or complete.

How Are Distal Biceps Tendon Tears Treated?

Complete tears generally require surgical intervention. During a tendon repair procedure, an orthopedic surgeon attaches the torn tendon to the bone using a special anchor and sutures.

Partial tears may successfully heal using nonsurgical treatment options dictated by the orthopedic surgeon treating the injury.

What Are Triceps Tendon Tears?

The triceps tendon attaches the triceps muscle to the elbow. It can be partially or completely torn due to:

  • Overuse
  • Throwing activities
  • Hammering
  • A blow
  • The arm being suddenly pulled straight

Typically, symptoms include:

  • Pain
  • Swelling
  • A popping noise
  • A bulge in the upper arm

Treatment depends on the severity of the tear.

How Are Triceps Tendon Tears Treated?

Partial tears may heal using nonsurgical treatment options, such as:

  1. Activity modification. Slowing down or stopping activities that involve using the elbow.
  2. Physical therapy. Stretching and strengthening the triceps muscle and tendon.
  3. A strap, brace, or spint.

Complete tears are rare and may require surgical intervention. An orthopedic surgeon performs a triceps tendon repair to attach the torn tendon to the bone. Following surgery, the elbow is immobilized for 2-4 weeks. Following immobilization, physical therapy is used to stretch and strengthen the muscle, and prevent future injury.

What is Elbow Bursitis?

The bursae are small fluid filled sacs that cushion and protect the joints. When they become irritated and inflamed, the condition is known as bursitis. Common causes of elbow bursitis are:

  • Overuse
  • A blow to the elbow
  • An infection due to a bite or puncture wound

Presenting symptoms include:

  • Swelling
  • Pain
  • Red, warm skin (when infected)

Treatment depends on the severity of symptoms.

How is Elbow Bursitis Treated?

Usually, a combination of the following nonsurgical treatment options is used to decrease inflammation, swelling, and pain:

  1. Activity modification. Slowing down or stopping activities that cause bursitis flare-ups.
  2. Anti-inflammatory medications. Decrease inflammation and pain.
  3. A tiny needle is inserted into the bursae and drains excess fluid.
  4. Medications used to treat an infection.

In severe cases, bursitis may be treated using surgical intervention. During an outpatient procedure, the bursa is drained or removed—bursitis does not return.

What Are Elbow Ligament Injuries?

Strong connective tissues known as ligaments connect the bones of the elbow. They are commonly injured due to repetitive throwing motions made by:

  • Baseball players
  • Javelin throwers
  • Football quarterbacks
  • Racquet sport players

And in some cases, manual laborers. Typical symptoms of elbow ligament injuries may include:

  • Pain
  • Popping, catching, grinding
  • Swelling
  • Tenderness
  • Weakness
  • Pain when making a fist

Treatment depends on the type and severity of the injury.

How Are Elbow Ligament Injuries Treated?

Elbow ligament sprains and partial tears are treated using conservative, nonsurgical treatment options, such as:

  1. Slowing down or stopping painful activities.
  2. Activity modification. Changing the throwing motion to take stress off the ligaments.
  3. Nonsteroidal anti-inflammatory drugs. Over-the-counter and prescription medications used to decrease inflammation and pain.
  4. Bracing or splinting.

And possibly, corticosteroid injections.

When nonsurgical treatments do not work or when ligaments are severely damaged, surgical intervention may be necessary. An arthroscopic procedure uses a tiny camera and special instruments to locate and repair the damaged ligaments. Recovery consists of immobilization and physical therapy.

 

 

What is Elbow Stiffness?

Elbow stiffness typically occurs after an injury. An extended period of immobilization or damage to the elbow joint can cause the elbow’s soft tissues, ligaments, and tendons to stiffen. Pain may be associated with stiffness. Luckily, both symptoms are easily treatable.

How is Elbow Stiffness Treated?

Anti-inflammatory medications are used to treat inflammation and pain. Physical therapy is used to stretch and strengthen the ligaments, tendons, and muscles of the elbow. Elbow stiffness that is serious enough to require surgery is typically caused by a fracture or severe arthritis. Interested patients should consult an orthopedic surgeon.

What is Elbow Arthritis?

Arthritis is a chronic condition characterized by the inflammation of joints due to age and/or injury. Arthritis of the elbow is generally caused by osteoarthritis (“wear and tear” of the joint) or rheumatoid arthritis (an immune system disorder where the body attacks its own cartilage). Typical symptoms of elbow arthritis may include:

  • Pain
  • Swelling
  • Weakness
  • Stiffness
  • Tenderness
  • Decreased range of motion
  • Catching or locking of the elbow

Although arthritis can not be cured, numerous treatment options are used to help manage symptoms.

How is Elbow Arthritis Treated?

When elbow arthritis is diagnosed and treated early, nonsurgical treatment options are very effective. They include:

  1. Activity modification. Slowing down or stopping activities that involve painful movements.
  2. A removable strap, brace, or splint.
  3. Nonsteroidal anti-inflammatory medications. Medications that decrease inflammation and pain.
  4. Physical therapy. Stretching and strengthening exercises.
  5. Corticosteroids.

Cases of severe elbow arthritis may require surgery. A total elbow replacement is a procedure where an orthopedic surgeon removes arthritic bone and replaces it with metal and plastic components—creating a new, non-arthritic joint.

What Causes Elbow Pain?

Elbow pain is common amongst athletes and active individuals. It is frequently caused by:

  • A fracture
  • A stress fracture
  • Bursitis
  • Instability/Dislocation
  • A Nerve injury
  • Golfer’s elbow
  • Tennis elbow
  • A strained muscle
  • A sprained ligament
  • Tendinitis
  • Osteoarthritis
  • Rheumatoid arthritis

Symptoms that may accompany elbow pain include:

  • Swelling
  • Tenderness
  • Bruising
  • Weakness

Treatment depends on the cause of elbow pain.

How is Elbow Pain Treated?

Elbow pain can be treated nonsurgically using any, all, or any combination of the following:

  1. Activity modification. Slowing down or stopping activities that involve painful movements.
  2. A removable brace or splint.
  3. Nonsteroidal anti-inflammatory medications. Medications that decrease inflammation and pain.
  4. Physical therapy. Stretching and strengthening exercises

Injections may also be used.

Surgical treatments for elbow pain are prescribed on a case-by-case basis and should be discussed with an orthopedic surgeon.

What is Tennis and Golfer’s Elbow?

Tennis players and golfers flex their forearm muscles—which insert on the lateral (outside) and medial (inside) portion of the elbow—throughout their swing. Upon impact with the ball, the flexed muscles and their tendons experience a great deal of force. When impact swinging motions are repeated over and over, the tendons can become irritated and inflamed, which causes pain.

  1. Tennis elbow presents as pain on the lateral portion of the elbow.
  2. Golfers Elbow presents as pain on the medial portion of the elbow.

How is Tennis and Golfer’s Elbow Treated?

Tennis and golfer’s elbow are treated using any, all, or any combination of the following:

  1. Activity Modification. Slowing down or stopping pain producing activities helps speed up recovery.
  2. A removable brace supports the forearm muscles and tendons.
  3. Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter and prescription medications that are used to decrease inflammation and pain.
  4. Physical therapy. Passive and active treatment is used to decrease inflammation and pain, and improve muscle flexibility and strength.
  5. Corticosteroid injections. Fast acting, powerful anti-inflammatory medication can be administered via injected directly into the inflamed area.

Patients with tennis and/or golfer’s elbow can expect symptom relief and a return to activity/competition when they adhere to treatment plan and recommendations prescribed by their orthopedic specialist.