Conditions That Affects the Elbow and its Treatment

Conditions Affecting the Elbow - Part II

Dr.Surya Rao Poodipeddi profile Authored by Dr.Surya Rao Poodipeddi on 23 May 2014 - 16:25.

In the Conditions affecting the elbow joint article, we covered about the Broken Elbow.

In this article as a continuation of the first part, we will discuss various other conditions that affect the elbow.

These include:

  • Epicondylitis
  • Golfer's elbow
  • Repetitive Strain Injury
  • Tennis elbow
  • Thoracic outlet syndrome
  • Ulnar nerve injury
  • Arthritis

However, some of these conditions are similar to those already covered under the topic: Conditions affecting the Elbow Joint. Some of these conditions are synonyms (other names for the same condition) like Tennis elbow is also similar to epicondylitis (both medial and lateral types) This part of the article will cover in brief those conditions which though presetting with few similar symptoms are altogether different from those described earlier.

Golfer’s elbow: This condition affects mainly those who regularly play a game of Golf. Professional golfers have less chance of developing this condition for the simple reason that they are already aware of such a possibility and adopt preventive techniques to avoid this condition. Golfer’s elbow is almost similar to tennis elbow except that faulty techniques used while playing golf is the main cause for a sudden sprain in the elbow joint while exerting pressure in hitting the ball with force.

The muscle ends are made of tendons which are attached to the bone. The points of insertion of the tendon on the bone are often pointed prominences. The medical names of Tennis Elbow (lateral epicondylitis) and Golfer's Elbow (medial epicondylitis) come from the names of these bony prominences where the tendons insert, and where the inflammation causes the pain.

Repetitive Strain Injuries: As the name implies these injuries affecting the elbow joint are mainly due to repetitive use of the elbow joint, common in games like tennis, rowing games and swimming besides computer professionals. The nerves controlling the fingers pass through the elbow joint and when it constantly hurts the elbow joint it affects it.

Thoracic outlet syndrome: This condition affects those parts supplied by the nerves from the brachial plexus which passes from the outlet for the thorax to the upper limb via the armpit. The main nerves coming from the thoracic outlet is known by several names as it passes through several areas. When in the armpit it is known as axillary nerve.

As it passes from the axilla to the arm it becomes the brachial nerve which continues its path downwards and divides into two nerves at the level of the elbow joint namely the radial nerve and the ulnar nerve which pass downwards to supply the forearm, the hand and the fingers. Any pressure on the main nerve as it passes through the outlet will reflect on the functions of the particular nerves concerned leading to numbness, tingling and severe cases loss of function which may include both sensory and motor functions.

Ulnar nerve Injury: As the name implies this nerve may get involved in any injury affecting the elbow as it passes from the arm to the fore arm. Usually this nerve is affected in a disease called leprosy leading to loss of sensation over the fingers which are supplied by the nerve.

The initial warning sign is a thickening of the nerve which can be felt under the top of the ulnar bone in the tunnel through which it passed. This can be examined by passing the fingers over the nerve with the elbow bent. In normal persons there will be tingling sensation as we roll the nerve under the bony prominence.

Treatment depends on the cause. If the ulnar nerve is affected due to leprosy one can notice that the ring and little fingers supplied by the ulnar nerve are bent towards the palm of the hand in what is usually known as a typical ulnar claw hand.

Arthritis: Like any other joint in the body the elbow joint can also get affected by arthritis which means inflammation of the joint. Treatment depends on the cause.

However, there are few other conditions which can directly or indirectly affect an elbow joint. These conditions only need a mention with only a brief explanation of each condition. These conditions include:

  • Radio Humeral Bursitis: Bursa is a small sac that contains fluid to lubricate moving parts such as joints, muscles and tendons. Inflammation of a bursa is known as bursitis. Inflammation of the bursa over the radio humeral area is known as radio humeral bursitis.
     
  • Osteoarthritis: The cartilage in the joint becomes brittle and starts splitting. Sometimes the broken pieces of the brittle cartilage may even float around inside the synovial fluid leading to inflammation.
     
  • Referred pain: Injuries to the bones of the spine called vertebrae may irritate the nerves meant to serve the arm leading to referred pain around the elbow joint.
     
  • Nerve entrapment: The radial nerve is the main nerve of the arm. It is meant to move freely. If its movements are hindered it may lead to pain when the arm is stretched out. The radial nerve may get pinched by vertebrae or the elbow joint itself. There is evidence to suggest that nerve entrapment contributes to pain in cases of tennis elbow in some cases.
     
  • Ligament sprain: Tough bands of connective tissues called ligaments bind a joint and hold the bones together. If the ligament passing over a joint gets torn for whatever reasons it leads to sprain causing pain over the affected joint.
     
  • Bone fracture: Already discussed in detail in the earlier parts on the elbow joint. There may be a simple crack, a complete fracture or even a complicated fracture involving other parts in the area of the fracture.
     
  • Avulsion fracture: A very powerful contraction of a muscle may sometimes can wrench a tendon free from its bony attachment and pull out a piece of bone leading to avulsion fracture.
     
  • Osteochondritis dissecans: In this condition which usually affects younger people. A piece of cartilage and bone can become loose with in the joint leading to pain in the affected joint.
  • Osteochondritis dissecans - in younger people, a piece of cartilage and bone can become loose in the joint.

Whenever the elbow joint is affected, one needs to consult a doctor, sports physician or a physiotherapist depending on the nature of occupation and the type of the injury.

Regardless of whom you decide to consult, it is very important to remember the following points when confronted with any injury of the elbow joint.

  • The most commonly encountered elbow problem is known as tennis elbow a condition which always affects sports persons.
  • First aid recommendations include rest to the part and application of ice to the area involved
  • In some cases taping the elbow and forearm might give some relief.
  • If there is no relief and if you notice that the problem recurs often it is time for you to consult your doctor and/or physiotherapist.
  • Always remember that other caholding the hands. This will invariably lead to dislocation of the elbow joint. Special care should be taken especially when dealing with complicated fractures or double fractures since the process of healing is usually delayed.

The best thing to do is to avoid an injury to the elbow joint which is possible if we can avoid a fall on the outstretched hand. However, if the injury has already taken place one needs to consult a doctor immediately to avoid avoidable complications.

 

*Disclaimer: This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.