Elbow joint is a hinge joint of the arm where the bone of the upper arm (humerus) and the two bones of the forearm (ulna and radius) meet to form a hinge joint. Elbow joint holds both the upper and fore arm together, and allows the forearm to bend and extend and to roll from side to side. The elbow joint is a common site of injury, especially from sports. Elbow pain is an extremely common complaint in the people.
The elbow is a synovial joint which consists of three individual joints that enclosed within one synovial membrane:
- Humero-ulnar Joint
- Humero-radial Joint
- Superior Radioulnar Joint
The elbow hinge joint is flexed by the biceps muscle and the triceps muscle that extends the elbow hinge. A part of the humerus bone, lateral epicondyle is the outer bone of the elbow. Tendons are attached to this region. The inner portion of the elbow, medial epicondyle is a bony fame. To reduce friction between bones, a fluid-filled sac (bursa) helps which overlies the tip of the elbow (olecranon bursa). The elbow joint pain occurs due to inflammation of the tendons or the bursae (plural for bursa) or conditions that affect the bones and joints, such as fractures, arthritis, or nerve irritation.
Some of the conditions that can cause elbow joint pain are:
Tendonitis:
Two forms of tendonitis that cause pain in the elbow joint are:
- Tennis elbow
- golfer's elbow
Tennis elbow:
Tennis elbow, also called lateral epicondylitis, is a common cause of elbow discomfort. It is a tendon problem that mostly occurs in patients who never play tennis. Tennis elbow is the equivalent injury that occurs at the common extensor origin (the lateral epicondyle of the humerus).
In this condition, the tendons attached to muscles of forearm can be injured with repeated movements of the forearm. This can be happen in the persons who often use a manual screwdriver, wash windows and play tennis or musical instruments like violin. Elbow pain takes place due to repeated twisting motions or activities that strain the tendon.
Causes:
- Sports injuries
- overuse of the forearm in pronation / supination movements
- Direct blow to the lateral epicondyle
- Repeated micro-trauma to an area that already shows signs of degeneration
Golfer's elbow:
It is characterized by pain and tenderness over the inner elbow. In this condition, Repetitive motions like swinging a golf club affect and injure the tendons of the forearm that attach to the bone of the inner elbow. In Golfers Elbow, the tendon of the common flexor originates at the medial epicondyle of the humerus (the "inside" of the elbow). It is less common than Tennis Elbow.
Causes:
- Middle aged people whose sporting activity or occupation involves a strong hand grip and adduction movements (moving the forearm in towards the body)
- May occur in those people who have never played golf
Elbow Bursitis:
It is a common cause of swelling and inflammation around the elbow joint. In this condition, Elbow bursitis causes fluid to collect in a sac that lies behind the elbow, called the olecranon bursa. Due to this, the joint is inflamed and inhibits the movement of the elbow joint. Bursitis or inflammation of the bursa can occur from injury or minor trauma. It is usually treated by draining the swollen bursa. It is important that olecranon bursitis be evaluated by a physicain.
Causes:
- Spending too much time leaning on the tip of the elbow
- Direct blow to the tip of the elbow from a hard surface
- More common in those with Gout and Rheumatoid Arthritis
Fractures:
Elbow joint is combination of three bones and any combination of these bones may be involved in a fracture of the elbow. Patients who are able to fully extend their arm at the elbow are unlikely to have a fracture (98% certainty). In fractures, the bones of the elbow can break into the elbow joint or adjacent to the elbow joint causing pain in the elbow joint and surrounding areas.
Arthritis:
It is usually seen in individuals with rheumatoid arthritis or after fractures that involve the joint itself. Arthritis is a condition where the pain is severe. Joint replacement therapy or fascial arthroplasty may be considered when the damage to the joint is very severe.
Sprain:
When ligaments in the elbow area are stretched or torn, sprain occurs. This condition may take place due to impacts on the elbow or when the elbow is hyper extended. The extent of injury to a single ligament and the number of ligaments involvement will decide the severity of injury.
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