The elbow is a hinge joint that connects the upper arm and lower arm. It consists of three bones; the humerus, radius, and ulna. Each bone is capped with cartilage and a complex array of ligaments and tendons from various muscles cross over the joint. Its function is bending and extending the arm.
Overuse injuries are the most common cause of elbow pain. Overuse injuries can affect the tendons around the elbow (Golfer’s elbow, Tennis elbow), the cartilage (causing osteoarthritis), or the ligaments (Throwers elbow). Other, less common causes of elbow pain are traumatic injuries like a broken bone or dislocation, autoimmune disorders like rheumatoid arthritis, or infections.
The location and character of elbow pain symptoms may vary and give us clues as to what is causing the problem. These include:
In order to properly diagnose your elbow pain, first your physician must take a comprehensive history and physical exam. These are the most important pieces of information to help narrow down all of the causes of your pain
Next, an x-ray of the elbow can be important to understand the boney contours and alignment of the joint. You can identify misalignment of the joint, fractures, dislocations, and subluxations, and osteoarthritis, to name a few conditions that cause joint pain.
A CT scan is a more advanced kind of x-ray that gives much more detailed information about the bones and joint spaces. You can also get more information about soft tissue structures like muscles or blood vessels than with standard x-rays
An MRI uses magnetic fields to better detail all of the soft tissues structures of the shoulder like muscles, tendons, ligament, nerves, and blood vessels. You also get details on the quality of the cartilage and if there is stress in the bone potentially causing symptoms
Ultrasound is an imagined modality that uses sound waves to create pictures of all of the superficial structures in the elbow. The advantage of this modality is to get real-time information about the elbow; both while you are sitting still and while you are moving. All of the above image modalities cannot provide any of the same information an ultrasound can while you are moving!
Blood work can sometimes be useful to determine if there is an underlying medical issue causing your elbow pain, such as autoimmune conditions or infections.
Preventing elbow injury and strain by addressing risk factors: This includes correcting muscle imbalances/ weakness and addressing the way the entire body moves. By building the appropriate strength, conditioning, and flexibility throughout the body before playing your sport or working those long days, risk to injuring your elbow can be significantly decreased.
Physical Therapy: Once you have an elbow problem, physical therapy is vital in understanding how your body moves and compensates for the elbow problem, and what exercises need to be practiced to help reduce pain and improve function. Physical therapists can also use different modalities like ultrasound or E-stim to help reduce pain and swelling to facilitate activity
Pain medication: At times symptoms may be severe enough to warrant taking medications. NSAIDs like ibuprofen or naproxen are the medications of choice to treat the inflammation of elbow pain.
Steroid Injections: When oral medications aren’t enough, a corticosteroid injection, as well as an aspiration of joint fluid, may be needed to reduce symptoms. Corticosteroids are strong anti-inflammatory medications used to treat inflammatory pain associated mainly with arthritis or bursitis/tendonitis.
Regenerative medicine: PRP, Stem Cells, and Lipogems are some of the regenerative medicine techniques that can be used to treat a variety of elbow complaints. These medications are derived from the patient’s own body, minimally processed to isolate concentrated growth factors to stimulate healing when injected back into the site of injury.
Surgery: Ultimately, there are some elbow problems that require surgical intervention.
Dr. Niteesh Bharara
Director of Regenerative Medicine
Orthopedic Specialist - Non-Surgical Sports Medicine