Elbow Pain

The elbow is a commonly injured joint, and a lot of people experience pain because of these injuries. Elbow injuries can happen for many different reasons, ranging from a traumatic event to frequent overuse. Sporting events are often one of the biggest causes of elbow pain because of the rigors that they demand on the body. In this article we are going to go over some of the most common causes of elbow pain.

Some of the most common causes of elbow pain are as follows: lateral epicondylitis, medial epicondylitis, olecranon bursitis, little league elbow, and osteochondrosis.

Lateral epicondylitis might be the most common cause of elbow pain. It is often referred to as tennis elbow. While lateral epicondylitis can be commonly found in tennis players, it is certainly not limited to them. Many different types of athletes develop lateral epicondylitis. Most often lateral epicondylitis is due to a repetitive motion from a sport, but it could also be due to occupational undertakings. Generally speaking lateral epicondylitis is due to small tears happening in the extensor carpi radialis longus tendon. As such lateral epicondylitis could be considered a tendinopathy. When one presents with lateral epicondylitis the outside of the elbow is often very tender to palpation. The condition can be evaluated and diagnosed using the patients history and through orthopedic tests. Lateral epicondylitis is effectively treated using conservative treatments. Initially PRICE is applied to the elbow. Followed by therapies such as stretches, exercises, manipulation, and myofascial release. These therapies are often effective at treating tennis elbow. Sometimes further treatment may be warranted such as injections.

Medial epicondylitis, most commonly called golfers elbow, is very similar in pathology to lateral epicondylitis. Medial epicondylitis is often due to repetitive activities such as swinging a golf club, or serving a volleyball. It can also be due to work related activities. Medial epicondylitis, just like lateral epicondylitis, is considered a tendinopathy. For medial epicondylitis the tendons most commonly effected are those of the wrist flexors. Evaluation and diagnosis can be made using the patients history and through the use of orthopedic examinations. Reverse mills test is a good orthopedic test that is used to diagnose medial epicondylitis. The treatment for medial epicondylitis is the same as it is for tennis elbow. Conservative treatment methods are often effective at treating this injury, and as such are the first line of treatment for this injury.

Olecranon bursitis is a swelling of the bursa that is just past the elbow. The olecranon is the pointy tip of the elbow, and it has a bursa that protects it from injury. This bursa protects the elbow when it comes in contact with objects. When one falls on their elbow the bursa takes the brunt of the impact and as a result swells up. Another way olecranon bursitis can be caused by the elbow dragging over surfaces. This injury is more common in sports that do not require elbow protection such as martial arts, and wrestling. Olecranon bursitis can be diagnosed easily. The patient will present with a big egg shaped swollen area around their elbow. It will usually be tender to palpation. Olecranon bursitis usually resolves with conservative management following the PRICE protocol. In some cases further treatment may be needed to get the fluid out of the elbow. Techniques such as soft tissue work may be enough to do this, though in some cases aspiration with a needle may be used.

As one can tell from the name little league elbow is a common injury for youth baseball players. Little league elbow can result in pain to either the medial or lateral side of the elbow. The condition presents from those who perform repetitive valgus stressing activities. In other words activities that put a lot of tension on the medial side of the elbow. Most often this would be from throwing a baseball. This repeated stress causes the stretching of the ulnar collateral ligament. Therefore small tears can develop in the ligament. In addition to that there may be excessive growth of the medial epicondyle epiphysis at the elbow. The condition will present with tenderness found on both the medial and lateral sides of the elbow. Valgus stress test of the elbow can help clue in to the diagnosis but x-rays and possibly an MRI will be needed to make the diagnosis. If this condition is seen on imaging the proper treatment would require a surgical consult.

Osteochondrosis is often called Panner’s disease. This condition is another one that commonly occurs in youth athletes. Osteochondrosis will likely present with stiffness and pain in the patients lateral elbow. This condition usually happens in the patients primary arm. Osteochondrosis in the elbow is often due to a loss of vascularization to the capitellum, which is at the distal end of the humerus. This can occur for several different reasons including trauma or overuse. To diagnose this condition x-rays are needed. The condition may be treated with PRICE procedures, however surgical referral may be necessary.

Treatment for most of the conditions of the elbow can be performed using conservative therapies such as those used at Tauberg Chiropractic & Rehabilitation. The proper evaluation and diagnosis, must be made to ensure that further treatment is not necessary. If you live in the greater Pittsburgh, Fox Chapel, or surrounding areas please give us a call at 412-517-8124 to see if we can help with your elbow pain today!

References

• Souza, T. A. (2016). Differential Diagnosis and Management for the Chiropractor. Burlington: Jones & Bartlett Learning.