Elbow Pain

Elbow Conditions

Here you will find a list of different elbow problems and treatment options. Click each link below for more information.

ELBOW PAIN

ELBOW ARTHRITIS

ELBOW FRACTURES

DISTAL BICEPS RUPTURE

POSTERIOR IMPINGEMENT ELBOW

TENNIS & GOLFERS ELBOW

ULNAR NERVE COMPRESSSION

OLECRANON BURSITIS

Treatments Offered

Complex Elbow Conditions & Treatments Offered

REVISION ELBOW REPLACEMENT

COMPLEX ELBOW RECONSTRUCTION

DISTAL BICEPS RECONSTRUCTION USING ALLOGRAFT FOR CHRONIC TEARS

FRACTURE SEQUELAE SURGERY

LIGAMENT RECONSTRUCTION FOR INSTABILITY

Elbow Pain

Elbow Arthritis
Distal Biceps Rupture
Elbow Fractures
Elbow Instability
Loose Bodies
Olecranon Bursitis
OCD Elbow
Posterior Impingement Elbow
Stiff Elbow
Tennis & Golfers Elbow
Ulnar Nerve Compression

Elbow Arthritis

Arthritis refers to inflammation and degeneration of the lining and surface of the joint. Rheumatoid arthritis of the elbow is more common than wear and tear or osteoarthritis.

Previous injury can also result in elbow arthritis. The main symptoms are pain, swelling, stiffness, instability, locking, loss or range of movement.

Management of Elbow Arthritis:

Investigation: X rays, CT scan or MRI scan

The following treatments are available

The initial treatment involves use of simple pain killers and anti inflammatory tablets.

Physiotherapy- This is useful in initial stages, prevent stiffness and maintain the range of movement.

Joint Injection- Steroid local anaesthetic injections are useful. This is done as an outpatient procedure in clinic.

Osteocapsulectomy / Synovectomy- Removal of the diseased synovium (joint lining surface) is rheumatoid arthritis

Total Elbow Replacement- Joint replacement surgery

Distal Biceps Tendon Rupture

The biceps muscle is attached at the top in the shoulder to the radius bone by a tendon, just below the elbow joint.The tendon can rupture when the it is worn out due to wear and tear and injury. A ruptured tendon can cause pain, bruising, and a pop eye sign due to bunching of the muscle in the upper arm. If left untreated, it can result in elbow weakness and reduction in forearm twisting power.

Management of Distal Biceps Rupture:

Investigation: X rays, Ultrasound or MRI Scan

Treatment: Patient with low demand lifestyle (office based jobs, sedentary life styles) can be treated non surgically with sling for comfort followed by elbow mobilisation

Patient with high demand lifestyles, body builders, sports persons, surgical repair is indicated.

Early repair is technically easier, and some studies have shown that results are better.

Late repairs are possible for chronic rupture and this often needs reconstruction using allograft.

Elbow Fracture

Elbow fractures result from a direct impact to the elbow or following a twisting injury to the arm. Types of elbow fractures include, radial head fracture, olecranon fracture, coronoid fracture, capitellum fracture, distal humeral fracture and more complex fracture dislocations

Pain, swelling, bruising and stiffness in and around the elbow may be signs of a possible fracture.

Elbow Fracture Management:

X rays, CT scan

Simple fractures can be treated in plaster / splint followed by physiotherapy

Complex fractures and dislocation require surgery to fix the fracture fragments

Elbow Instability

Patterns of recurrent elbow instability

Posterolateral rotatory instability is the most common type of elbow instability and is often due to trauma to the elbow

Valgus instability is most often caused by repetitive stress as seen in overhead athletes (such as baseball pitchers). Like the other forms of recurrent elbow instability, it may also result from a traumatic event.

Varus posteromedial rotatory instability is typically caused by injury to the elbow

Symptoms

Locking, catching, or clicking of the elbow

Sense of the elbow popping out of place while pushing off from a chair

Management of Elbow Instability:

X rays / MRI scan

Nonsurgical treatment is effective in most patients with valgus instability

Complete tearing of the ulnar collateral ligament may require surgery to return to full function.

Posterolateral rotatory instability can also improve with nonsurgical treatment, but surgery may be needed in cases where there is chronic stress of the lateral collateral ligament.

Varus posteromedial instability almost always requires surgery

Activity Modification

Pain killers and anti-inflammatory medication

Physiotherapy

Elbow Braces

Surgery – Ligament Reconstruction

Loose Bodies

Loose fragments of bone or cartilage may form due to wear and heavy or repetitive activities and cause pain, locking or clicking sensation. It can also be association with elbow arthritis.

Management of Loose bodies- Elbow Arthroscopy:

Investigation

X rays, CT or MRI scans

Pain killers and anti-inflammatory medication

Physiotherapy

Surgery- Removal of loose bodies by arthroscopic (keyhole) surgery or open surgery

Olecranon Bursitis

Olecranon bursa is a thin sac at the back of the elbow between the olecranon and the skin. If it gets inflamed (bursitis), it becomes swollen, painful and irritated. More fluid may accumulate. It can also get infected by bacteria, resulting in pain, redness, warmth and sometimes discharge. It is caused by several conditions including repeated leaning on the elbow, gout, rheumatoid arthritis.

Management Olecranon Bursitis:

Investigation: X ray, Ultrasound scan, MRI scan

Treatment

Analgesics and anti inflammatory medication

Antibiotics in case of infection

Elbow pads, dressings

Surgery: When other measures fail, surgery is performed to remove the bursa and bone spurs (if present)

OCD (Osteochondritis Dissecans) Elbow

In this condition, the cartilage of the elbow fragments and sometimes separates. It can be caused by injury. It presents with pain, clicking and limitation on movements.

Managements of OCD:

Investigation – X ray, CT or MRI scan

Treatment depends on the severity of the fragmentation and separation and this condition does not always require treatment.

Surgery- Drilling, reattachment or removal are carried out by arthroscopic (key hole) or open surgery

Posterior Impingement of Elbow

This occurs due to repetitive forced straightening movements of the elbow associated with racket sports, resulting in inflammation of the joint lining, formation of bone spurs, injury to bone and cartilage of the joint and leading to impingement. It starts with pain at the back of the elbow during these movements progressing to swelling, locking, stiffness and inability to straighten the elbow.

Management of Posterior Impingement of Elbow:

Investigations: X rays, CT or MRI scans

Non operative treatment is often successful

Pain killers and anti-inflammatory medication- These relieve symptoms of pain and reduce inflammation

Physiotherapy- This is useful in increasing strength, movement and flexibility of the elbow.

Injection- Steroid local anaesthetic injections provide pain relief. This is done as an outpatient procedure in clinic.

Surgery- Arthroscopic (keyhole) surgery to remove loose bodies. This is carried out under general or regional nerve block anaesthesia as a day case procedure.

Stiff Elbow

Several factors can cause elbow stiffness, and these could either be within the joint itself (intrinsic) or outside the joint (extrinsic). Generally, loss of the ability to bend (flexion) can cause more difficulties than the loss of the ability to straighten (extension).

Intrinsic causes are arthritis (wear and tear osteoarthritis, rheumatoid arthritis) infection, injury. Extrinsic causes could be burns, formation of calcium deposits around the joints or congenital causes.

Management of Stiff Elbow:

The main aim of treatment is to give a pain free, stable elbow that is useful to the patient.

Physiotherapy

Splinting

Surgery- Arthroscopic (keyhole) or open surgery depending on the cause and severity of stiffness. Continuous passive Motion machine is used for few days postoperatively to maintain the range of movements achieved after surgery.

Tennis Elbow

This condition is also referred to as lateral epicondylitis and is caused by inflammation of tendons near the elbow joint. This is often associated with repetitive movements of the tendons that extend the wrist joint leading to wear and tear of the tendons. If often starts as dull pain outside of the elbow, leading to more severe or shooting pain and swelling made worse by straightening the wrist or lifting heavy objects.

Management of Tennis Elbow:

Investigation- X rays, ultrasound or MRI scans

Activity modification

Pain killers and anti-inflammatory medication- These relieve symptoms of pain and reduce inflammation

Splinting – tennis elbow brace

Physiotherapy- This is useful in reducing pain and inflammation

Injection- Steroid local anaesthetic injections provide short term pain relief but do not provide permanent relief. This is done as an outpatient procedure in clinic.

Surgery- Choice of surgery depends on the age of the patient, severity of the disease and presence of other associated shoulder problems

Golfers Elbow

This condition is also referred to as medial epicondylitis and presents as pain on the inner side of the elbow. This is often associated with repetitive movements of the forearm and wrist.

Management Golfers Elbow:

Investigation- X rays, ultrasound or MRI scans

Activity modification

Pain killers and anti-inflammatory medication- These relieve symptoms of pain and reduce inflammation

Splinting – tennis elbow brace

Physiotherapy- This is useful in reducing pain and inflammation

Injection- Steroid local anaesthetic injections provide short term pain relief but do not provide permanent relief. This is done as an outpatient procedure in clinic.

Surgery- Choice of surgery depends on the age of the patient, severity of the disease and presence of other associated shoulder problems

Ulnar Nerve Compression (cubital tunnel syndrome)

Ulnar Nerve Compression (cubital tunnel syndrome) The ulnar nerve travels under a tunnel (cubital tunnel) near the inner side of the elbow joint. Tightness in the tunnel can often result in compressions of the nerve, resulting in pain, discomfort or even tingling, weakness and clumsiness of the hand and numbness, most commonly seen in the ring and little fingers. Shooting pain and numbness is often noticed at night, when the elbow is bent, resulting in increased pressures in the cubital tunnel.