Elbow pain: information & elbow pain specialists

Elbow pain can vary in severity and can be acute or chronic. It is often caused by excessive or incorrect strain, but injuries and illnesses can also cause elbow pain. Here you will find further information as well as selected specialists and centers for elbow pain.

Anatomy of the elbow

The type and severity of elbow pain depends, among other things, on the affected structures of the elbow joint.

The elbow joint is made up of the three sub-joints

• Upper arm-elbow joint,
• humeral-radial joint and
• proximal ulnar-radial joint

together.

These three partial joints are surrounded by a common joint capsule. They connect the upper arm bone(humerus) and the forearm bonesulna (ulna) and radius(radius).

The elbow joint isstabilized and guided by three strong ligaments: the two collateral ligaments and the so-called annular ligament.

These structures enable the elbow to

• flexion and extension of the forearm in relation to the upper arm (ball and socket joint and hinge joint) and
• the rotation of the forearm and hand (pivot joint).

The elbow therefore plays a very important role in the movements of the arm in everyday life, sport and work.

The anatomy of the elbow joint © bilderzwerg | AdobeStock

Causes of pain in the elbow

In most cases, elbow pain is caused by incorrect or excessive strain on the arm. It often occurs

• during everyday activities such as carrying shopping bags,
• during sporting activities such as playing tennis or golf or
• working in an occupation where the arm and elbow are subject to heavy strain,

occur. In addition, injuries following an accident and diseases of the elbow can also cause pain.

Elbow pain caused by injury and strain

Elbow pain caused by injury and strain is caused, for example, by

• a dislocation (joint dislocation) of the elbow joint
• a bone fracture in or on the elbow
• injuries to the ligaments and tendons of the elbow joint, such as a torn ligament or a strain
• Muscle injuries or strains in the elbow area
• so-called tennis elbow
• the so-called golfer's elbow
• RSI syndrome (repetitive strain injury syndrome) due to repetitive activities and strain (e.g. "mouse arm" due to frequent computer work)

Elbow pain due to inflammatory diseases

Inflammatory diseases that can cause pain in the elbow include

• arthritis (joint inflammation) of the elbow joint
• rheumatoid arthritis (rheumatoid joint disease)
• bursitis in the elbow joint
• inflammation of the tendon sheath

Other causes of elbow pain

Other diseases that can cause pain in the elbow are

• osteoarthritis, i.e. joint wear and tear, of the elbow
• Osteoporosis (bone atrophy)
• free joint bodies in the elbow joint
• irritation of the ulnar nerve, for example due to the so-called musician's bone hitting an edge

Symptoms of elbow pain

Not all pain is the same. Elbow pain differs according to

• cause and
• affected structure and
• in severity and duration.

Elbow pain can manifest itself as

• an unpleasant feeling of pressure in the elbow,
• mild pulling or pressing elbow pain through to
• to very severe stabbing elbow pain.

can manifest itself.

A distinction is also made between acute and chronic elbow pain, depending on the duration of the symptoms.

Acute elbow pain usually occurs suddenly in the form of shooting, stabbing or pulling pain and disappears quickly.

Chronic elbow pain persists over a longer period of time or occurs repeatedly.

There are other symptoms that can occur in connection with elbow pain. They depend on the underlying cause or condition. These symptoms include

• limited mobility of the affected elbow
• Inflammatory swelling in the elbow area, e.g. in the case of bursitis of the elbow joint
• a stinging sensation in the elbow, e.g. in the case of tenosynovitis
• Pain on the inside of the elbow, e.g. with golfer's elbow
• Pain on the outside of the elbow, e.g. tennis elbow
• Pain that radiates from the elbow to the upper and lower arm so that the entire arm hurts
• Pressure pain on the outer forearm
• Pressure pain over the radial head
• Pressure pain at the elbow gap
• a feeling of warmth in the elbow area
• itching at the elbow, e.g. in the case of skin inflammation in the elbow area
• A cracking sensation in the elbow during certain movements

Diagnosis of elbow pain

For effective treatment, the cause of the pain must first be determined as part of the diagnosis. The diagnosis is usually based on

• taking a medical history (anamnesis),
• a physical examination and
• additional examinations such as an X-ray, ultrasound scan or magnetic resonance imaging (MRI).

Medical history for the diagnosis of elbow pain

As part of a medical history interview, the doctor will first take the patient's medical history. The questions the doctor will ask include

• How exactly does the elbow pain manifest itself, i.e. is it stabbing, pressing or pulling?
• Where exactly is the pain located, i.e. on the inside, on the outside, in the elbow gap, in the entire arm?
• When does the pain in the elbow occur, e.g. during certain movements?
• How long has the patient been suffering from elbow pain?
• What previous illnesses and injuries in the elbow area are known?
• Is there a possibility of overloading the elbow, e.g. by playing tennis or golf or working at a computer?

Physical examination

During the physical examination, the doctor will palpate the elbow joint. He checks whether the joint is swollen or warm and at the same time assesses its condition.

He will also carry out a number of movement tests to check the mobility and pain of the elbow joint. The other joints and body statics are also assessed as part of the physical examination.

Further examinations

The doctor can usually make a tentative diagnosis after taking a medical history and performing a physical examination. Additional examinations can then be used to confirm this suspicion.

These include the following examinations:

• X-ray: Can confirm the suspicion of bone damage
• Ultrasound examination (sonography)
• Magnetic resonance imaging (MRI)
• Computed tomography (CT)
• Arthroscopy (joint endoscopy)
• Blood test: Determines the inflammation values
• Joint puncture: removal of fluid from a joint effusion or swollen bursa for subsequent laboratory examination

Treatment of pain in the elbow

The treatment of elbow pain always depends on its cause. If this is known, the doctor, usually an orthopaedic surgeon, can recommend and carry out the appropriate therapeutic measures.

Acute pain caused by short-term misuse or overuse of the arm or elbow often disappears on its own without treatment.

All other types of elbow pain must be treated. In principle, there are

• conservative (non-surgical) and
• surgical (operative)

treatment methods are available.

Conservative treatment of elbow pain

Conservative, non-surgical treatment measures for elbow pain include in particular

• Immobilization of the affected arm or elbow joint with a plaster splint or an ointment dressing
• Physiotherapy (physiotherapy)
• Muscle training to strengthen and tone the muscles of the elbow
• Doing sports that put little strain on the elbow joint (e.g. swimming)
• Drug therapy with pain and anti-inflammatory medication, usually in the form of ointments or tablets
• Joint irrigation and joint injections with cortisone-containing medication or local infiltrations with the patient's own plasma (PRP)
• Cold or heat treatment
• Use of orthopaedic aids such as bandages
• electrotherapy
• Ultrasound treatment
• Shock wave therapy

Sometimes bandages can help with elbow pain © Robert Kneschke | AdobeStock

Surgical therapy for elbow pain

Elbow pain cannot always be adequately treated with conservative therapy measures. Surgical measures can then be considered. The following surgical treatment methods are available, among others:

• Arthroscopy (arthroscopy) of the elbow joint
• Osteotomy: cutting through bone or removing parts of bone, e.g. for elbow pain caused by osteoarthritis
• Implantation of an elbow prosthesis (artificial elbow joint)

Prevention of elbow pain

Not all causes of elbow pain can be prevented with prophylactic measures. For example, signs of wear and tear of the elbow joint such as elbow arthrosis can hardly be avoided in old age.

Nevertheless, there are a few tips and rules on how to prevent the development of elbow pain.

As a general rule, the elbow joint should not be subjected to excessive or even incorrect strain, especially over a long period of time.

Sports such as tennis or golf should therefore not be practiced too excessively. If they are already causing pain, they should not be continued unchanged, but the technique and intensity should be adjusted. Sometimes it is enough to change clubs.

Work that puts a lot of strain on the elbow or elbow joint on one side should also be avoided if possible. In addition, you should give preference to sports that place as little strain as possible on the elbow joint.

If you notice noticeable symptoms such as swelling or warming of the elbow joint, you should consult a doctor as soon as possible and seek treatment. In this way, the development of possible pain in the elbow with further complications can be counteracted at an early stage.