Conditions of the Elbow
Common Causes of Elbow Pain
There are many different causes for elbow pain, including rheumatoid arthritis, repetitive stress, muscle tension, strained or torn ligaments or tendons and sudden trauma, resulting from a fall or accident. Elbow injuries are common among athletes such as tennis and baseball players. Some of the most common elbow injuries and conditions include:
Tennis elbow and golfer’s elbow are actually types of tendonitis or tendinosis (inflammation, damage or degeneration of the tendons) that is common among tennis players and golfers. The difference between the two is simply the specific tendon that becomes damaged or inflamed. With tennis elbow, or lateral epicondylitis, the tendon on the outside of the elbow and forearm becomes damaged due to repetitive use of the forehand and backhand. Golfer’s elbow, or medial epicondylitis, is a degeneration on the inner side of the elbow and arm, due to overuse of the forearm muscles, repeated lifting or other repetitive motions while the arm is extended (such as swinging a golf club). These two types of tendonitis are the most common causes of elbow pain (even among those who have never touched a racket or club).
What causes tennis & golfer’s elbow?
Tennis elbow is caused by the repetitive movement of the elbow while gripping with your hand (such as swinging a tennis racket). Golfer’s elbow occurs when the repetitive movement is done with the arm extended. It can also be caused by repeated twisting or flexing of the wrist. When these types of motion are done repetitively, the tendons can become inflamed or damaged, especially if improper body mechanics are used. Other activates that can cause tennis or golfer’s elbow include:
- Using shears or scissors
- Throwing a ball
- Weight lifting
- Labor that involves repetitive movements such as turning or twisting (typing, plumbing, or painting for example)
What are the symptoms?
Tennis elbow can cause pain at the insertion point (the spot where the tendon connects to the bone) of the bony know on the elbow. This pain can extend up or down the arm and often worsens when the sufferer is using his/her hands. Pain will also be felt when lifting, straightening the wrist, or making a fist or gripping.
Golfer’s elbow causes pain on the inside of the elbow when lifting, twisting or making a fist. Symptoms also include tenderness and stiffness or weakness in the elbow, hands or wrist.
What is a osteoarthritis?
Also known as degenerative joint disease, osteoarthritis is a degeneration of the cartilage and the underlying bone of the joint. Osteoarthritis of the elbow occurs when the cartilage of the elbow is damaged or becomes worn, oftentimes simply from normal wear and tear, as we age. When the cartilage is no longer to effectively cushion the joint, the bones begin to rub against each other, cause pain and swelling.
What causes osteoarthritis of the elbow?
The most common cause of osteoarthritis of the elbow, and elsewhere, is the normal wear and tear that occurs with age. Other common causes include injury to the area and overuse of the elbow. Repetitive activities, such as painting or throwing can increase the normal wear and tear, bringing about osteoarthritis, as well
What are the symptoms?
- Elbow pain or stiffness
- Difficulty bending or straightening the elbow
- Scraping or grating sensation in the elbow
- Bone spurs
- Instability or locking up of elbow joint
- Joint swelling
What is the ulnar collateral ligament (UCL)?
The ulnar collateral is the ligament that connects the ulna (lower arm bone) to the humerus (upper arm bone). Damage to this ligament will result in pain and/or inflammation.
How does the UCL become damaged?
The most common cause of damage to the UCL is repetitive motion, such as throwing. This is a common injury to baseball players. It can also be injured from trauma to the area, although this is less common. Oftentimes, those with a UCL injury will also have a flexor carpi ulnaris (FCU) injury. This can mimic the symptoms of carpal tunnel syndrome, causing numbness in the hand.
What are the symptoms?
- Pain on the medial side of elbow (pinky finger side)
- A ‘popping’ sensation in the elbow when the injury occurs
- Feeling of instability in the elbow
- Numbness or tingling in the ring and pinky fingers
Tommy John Surgery for UCL Damage
Tommy John surgery is common among athletes, who want to resume strenuous activity. This surgery consists of removing a tendon (called a ‘graft’) from somewhere else on the body, such as the toe, forearm, or Achilles tendon. Surgeons then drill tunnels into the ulna and humerus (arm bones) and pass the graft through, reconstructing the damaged ligament. Complication from this surgery occur from 5% to 20% of cases, with the most common being a damaged ulnar nerve.
Tommy John surgery usually requires about a year of rehabilitation, or sometimes, up to two years, for athletes to regain their former ability.
At the Magaziner Center for Wellness, we have treated patients with UCL damage without the use of surgery, for over 16 years, including a pitcher from the Philadelphia Phillies, who, after only one treatment was able to avoid surgery and return to the game within a week.
What is osteochondritis dissecans?
Osteochondritis dissecans (OCD) is a condition of the joints that occurs when the blood supply to the area is lost, resulting in the cartilage cracking and separating from the joint. It usually occurs in children and adolescents, and most commonly affects the elbow, knee and ankle joints. OCD can heal on its own, especially if the child is still growing. For older sufferers, the effects tend to be more severe and require treatment.
What causes osteochondritis dissecans?
The cause of osteochondritis dissecans is not entirely known. It is believed that is related to repetitive stress or trauma to the joint and is often seen in people who are active in high-impact sports. Over time, repeated movements or stress on the joint can slow or stop the blood flow to the cartilage.
What are the symptoms?
- Pain in the joint, particularly when fully extending or bending the elbow
- A popping sound when moving the elbow
- Difficulty moving the elbow
- Tenderness in the elbow
- Range of motion decreased
Treatment will vary, depending on the condition or injury causing the pain. Generally, traditional western medicine will treat elbow pain with medication– typically nonsteroidal anti-inflammatory drugs (NSAIDs)– physical therapy and possibly surgery. NSAIDs have powerful side effects and can cause secondary issues, such as stomach problems, including bleeding and ulcer, abdominal pain, fluid retention, kidney problems, heart problems, rashes and more. In fact, NSAIDs have recently been found to be more dangerous than previously thought. The FDA is now strengthening their warning that even the over-the-counter strengths can cause heart attacks or strokes. This course of treatment puts patients on a fast track to ever increasing doses of anti-inflammatories and pain-killers. These treatments have been shown in countless studies to accelerate arthritis and increase the need for total joint replacement.
When elbow pain (or any joint pain) is treated with a pain killer or anti-inflammatory drug, the patient may feel some relief, because the symptoms are being suppressed. This is not a solution, however, because it is not fixing the cause of the pain. Inflammation is not the cause of the pain, it is the body’s natural response to injury and the trigger for it to begin the healing process. By suppressing the inflammation, these drugs are preventing the body from healing itself. Painkillers are simply numbing the pain that results from the injury. If the injury is not treated, it may never properly heal and can even get worse as time goes on. Many of our patients have been on ascending does of pain medication for years, with no end in sight.
At the Magaziner Center for Wellness, we treat elbow pain holistically–by learning where the problem originated and working to heal it. We look at the entire elbow and the surrounding joints and tissue, as well as any other contributing factors. Through treatments such as prolotherapy, platelet rich plasma (PRP) and stem cell therapy, we stimulate the body’s natural healing process, giving it the tools it needs to heal itself, without surgery or side effects.
*The treatment that we will recommend depends on the type and severity of the injury or condition. Call 856-424-8222 or email to schedule a consultation and learn about the options that are right for you.
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