PAIN AND ORTHOPAEDICS · Health guide
What Causes Elbow Pain? Treatment and Rehabilitation
Elbow pain, tennis elbow and golfer’s elbow: problems with gripping and loading, nerve symptoms, assessment and rehabilitation.
Updated: · General information
Who is affected?
Elbow pain is very common, particularly in relation to injury of the soft tissues adjacent to the elbow. The pain may arise from the joint itself, from the surrounding tissues, or be referred from the neck, shoulder or wrist. Those more often affected include racket-sport players, computer users, people who lift heavy loads, and those who use vibrating tools or work in jobs requiring repetitive wrist movement (homemakers, painters, carpenters); it is generally seen between the ages of 30 and 50 and in both sexes.
Causes
The principal causes are tendinopathies, bursitis, inflammatory arthritis (rheumatoid arthritis, gout), soft-tissue rheumatism, osteoarthritis, post-traumatic fractures, nerve entrapments and pain referred from other joints. The most frequent causes are lateral (tennis elbow) and medial (golfer’s elbow) epicondylitis.
Diagnosis and treatment
Further investigations such as blood tests, electromyography (EMG) and imaging may be needed in cases that are chronic, resistant to treatment, associated with a history of trauma, suspected of inflammatory disease, or thought to involve nerve entrapment or referred pain. Most patients improve with conservative measures such as rest, medication, physical therapy, exercise and local injection; supports that limit wrist movement may be used in the early stage. Avoiding repetitive and strenuous wrist and elbow movements, not resting the elbow on hard surfaces, limiting heavy lifting, exercising regularly and using an elbow support during the relevant activities can help with prevention.
The effect of repetitive gripping movements
Using hand tools, carrying loads or playing racket sports can aggravate certain tendon symptoms. Tennis elbow is not confined to people who play tennis. Whether the pain lies on the outer or inner side, the movement of the elbow, and symptoms provoked by resisted wrist movement are assessed together during examination.
Should the load be stopped altogether, or adjusted?
The aim is to identify the loading that aggravates the problem, reduce it to an appropriate level and then increase tolerance in stages. Work technique, equipment and rest breaks may be included in the programme. If there is numbness in the fingers or loss of hand strength, nerve involvement is investigated as well as the tendons.
Your questions
Patient information
Is an injection essential for tennis elbow?
No. Options such as adjusting activity and appropriate exercise are considered. The need for an injection, its benefit and its risks vary from person to person.
Does an elbow brace work for everyone?
In some people it can provide support during loading, but it does not replace diagnosis and rehabilitation. Any product that causes numbness or presses uncomfortably should be reassessed.
