The elbow is centrally involved in the movement of the hands and (lower) arms and can become ill in different ways. Different types of elbow conditions can affect the muscles, tendons, ligaments, nerves and elbow joint. Sports injuries, inflammations or signs of wear and tear in old age become noticeable on the elbow and sometimes have a very restrictive effect in everyday life.
Classification of elbow conditions
In the following, you will find the most common diseases and elbow conditions, classified according to
- Inflammations at the elbow
- Illnesses as a result of overloading or wear and tear
- Injuries to the elbow
- Specific diseases of the elbow
- Elbow inflammation
An inflammation of the bursa at the elbow (also called bursitis olecrani) is a painful inflammation of the joints caused by incorrect loading. The main symptom is often a painful swelling, which is usually very sensitive to touch. The diagnosis is usually made based on the clinical symptoms, the chances of recovery are very good with adequate therapy.
Read more about Elbow bursitis: Causes, Symptoms, and Treatment
As a rule, the inflammation affects the long biceps tendon. The inflammation causes calcium salts to be deposited, which limits the movement of the biceps tendon. Certain physical activities can lead to inflammation of the biceps tendon. Professional athletes or people who engage in intensive sports are often affected. The diagnosis is made by the doctor and the therapy can be conservative and operative.
Read more about Biceps tendonitis: Causes, Symptoms, and Treatment
Arthritis describes the inflammation in the elbow joint. This can be caused by infection or non-infection. In infection-related arthritis, bacteria enter the elbow. Non-infectious arthritis, also known as rheumatoid arthritis, is a disease that belongs to the rheumatic group.
- Diseases as a result of overloading or wear and tear
- sickness due to overwork
- Arthritis in the elbow
The term arthritis refers to the group of chronic degenerative diseases. These are characterized by the wear and tear of the joint cartilage, which can occur on the one hand as a result of natural wear and tear during the aging process and on the other hand as a result of certain traumas. Therapy can be performed conservatively and surgically as on most of the elbow conditions.
Read more about Elbow Arthritis: Causes, Symptoms, and Treatment
Tennis elbow is a pain syndrome in the area of the origin of the hand and finger muscles at the bony outer attachments of the humerus. The main trigger is considered to be a permanent overstrain of the forearm muscles caused by monotonous movements without adequate relief. Most tennis elbows heal with the right therapy, only rarely does the limitation become chronic.
Read more about Tennis Elbow: Causes, Symptoms, and Treatment
The so-called golfer’s elbow is an inflammation of the tendon attachment of the flexors of the forearm muscles. Patients with golfer’s elbow complain of pain on the inside of the elbow where the tendons are attached, which increases in the wrist when the fist is closed and the wrist is bent. In most cases, the elbow pain radiates into the forearm and/or upper arm, so that the whole arm hurts. The therapy of the golfer’s arm is usually conservative, only in rare cases, an operation is performed.
Read more about Golfer’s elbow: Causes, Symptoms, and Treatment
The colloquial term “mouse arm” describes the unspecific clinical picture of the RSI syndrome (Repetitive Strain Injury). Behind the term, mouse arm are various clinical pictures, such as pain or inflammation in nerves, tendons and muscles of the shoulder, elbow and hand. Due to the mouse arm, the movements in the arm and hands are very painful and restricted by overloading.
Read more about Mouse Arm: Causes, Symptoms, and Treatment
Ligament injury of the elbow
Movements that exceed the normal level can lead to overload injuries such as torn ligaments. These manifest themselves mainly through pain and swelling. If a ligament tears in the elbow, the elbow joint is usually also dislocated. If a torn ligament occurs in general, a sports break should be taken immediately if it is a sports injury. Also, quick cooling is important.
Falling or sports accidents can dislocate the elbow joint, so that either no more movement is possible in the joint at all or if it is only possible to a very limited extent. In adults, dislocation of the shoulder is more likely, but small children, in particular, are more likely to suffer from dislocated elbows, as their ligaments are more elastic.
Read more about Elbow dislocation: Causes, Symptoms, and Treatment
Specific elbow conditions
The disease known as Panner’s disease is a bone necrosis that occurs in the area of the elbow joint. As a rule, it mainly affects children between the ages of 6 and 10 years of age who practice sports that place a heavy load on the elbow joint.
The cause of this disease is a circulatory disorder of the growth plate in the area of the lower humerus or other bony structures of the elbow joint
Elbow conditions causing pain
Pain in the elbow can be caused by falls, inflammation of the joint or bursa and can have various causes.
Very often pain occurs after trauma. Due to falls or accidents, muscles and ligaments can be pulled or otherwise injured or fractures (breaks) of the adjacent bones, i.e. humerus and forearm bones (radius or ulna), can occur. Furthermore, dislocations of the elbow are very often the cause of acute pain.
If the elbow joint is permanently overstressed, inflammation can be the cause of the pain. Very often, the tendons of the forearm extensor muscles and forearm flexor muscles – the tennis or golfer’s elbow – that originate at the elbow become inflamed.
In addition to the tendons, an inflammation of the bursa can also be the source of the pain.
In the case of chronic pain in the elbow joint, which also occurs in other small joints such as the finger joints, rheumatoid arthritis should also be considered.
In addition to inflammation, prolonged overuse or incorrect strain often results in arthrosis in the elbow joint, which is characterized by wear and tear of the cartilage. In contrast to the other causes of pain mentioned above, the pain here occurs after prolonged periods of rest and improves with movement.
In addition to an external examination, testing of mobility and palpation of the structures involved, an initial suspected diagnosis can be made by describing the time of occurrence, type and location of the pain. The diagnosis can be completed by further means such as X-ray, MRT, ultrasound or arthroscopy (joint endoscopy).
Blood tests can also help, especially in the field of rheumatological diagnostics.
An elbow dislocation occurs significantly less frequently than a dislocation of the shoulder. It often occurs when the external force is applied, such as falling onto the outstretched or slightly pronounced (palm is turned downwards) arm.
Very often a dislocation is accompanied by concomitant injuries.
In the case of a dislocation, the spoke head (caput radii) and/or the end of the ulna facing the body, the olecranon, slips off the distal (end facing away from the body) end of the humerus, so that the three parts of the bone are no longer in proper alignment – they are displaced.
In principle, a dislocation in the humeroulnar joint, i.e. the joint part between the humerus and ulna, is more common than a dislocation between the radius and the humerus.
Very common is a dislocation to the back or back outside. The ligamentous apparatus at the elbow joint can tear or tear off just like the capsule. It is not uncommon for fractures (broken bones) to occur in the humerus, the olecranon of the ulna or the radial head. Unpleasant complications are injuries to arteries, veins and nerves running near the joint.
The humerus slides backward or backward and outwards with its joint roller (trochlea humeri) out of the bony depression of the ulna, which is formed by the olecranon. At the same time, however, there is also a shift in the connection between the upper arm and the radius. In the process, the head of the radius slips with its joint surface from the humeral head.
Rather rarely a ventral dislocation takes place, in which the humerus moves in front of the ulna and radius.
Lateral or divergent dislocation is also rare – ulna and radius move to different sides of the humerus.
The restoration (repositioning) of the original joint position should be carried out within a few hours to avoid consequential damage. This takes place under general anesthesia, in which, depending on the type of dislocation, the joint is brought back to its original position with jerky movements. After a short period of immobilization (1-2 weeks), physiotherapy is performed.
In the case of possible concomitant injuries, such as ligament and bone damage, surgery is indicated to repair the damage.
A special form of elbow luxation is the dislocation of the radial head in small children. In this case, the caput radii slips out of its articulated connection and is trapped by a part of the ligamentous holding apparatus, the ligamentum anulare radii. This often happens when small children are held by their parents’ hands and are protected from falling. The force acting on the head of the radius cannot be held by the ligament apparatus, which is not yet very stable, and dislocation occurs. After such an incident, children hold the arm in a protective position in which the arm and hand are slightly not turned inwards (pronation), hence the name pronatio dolorosa (painful pronation).
No surgery is necessary to restore the original position of the radial head. It can be restored by an experienced doctor with a few simple steps.
Therapy for elbow conditions
Taping for irritation in the elbow is designed to help relieve pain and increase blood flow to the affected areas during various elbow conditions. The increased blood circulation is said to accelerate the healing process.
Taping at the elbow is often used in the course of overstraining.
One possible application is the tennis elbow – here the outer point of origin for the extensor muscles of the forearm is irritated (epicondyles lateralis). By sticking tapes over the back of the forearm from the flexed wrist to the outer side of the elbow, the extensor muscles are relieved.
If the origins of the forearm flexors on the inner side of the elbow (epicondyles medialis) are irritated, taping can also be used. In this case, the tapes are stuck to the inside of the stretched forearm along the flexor muscles up to the wrist.
In the event of further inflammation of the elbow, the muscle bellies of the upper arm extensors that are attached to the elbow can also be taped.
As a general rule, only persons who are familiar with the medical and anatomical basics at the elbow should tap. Incorrect use will not have a supportive effect and in rare cases the elbow conditions may worsen.
Read more about Taping a tennis elbow
The joint can be immobilized with a bandage so that problems can be prevented.
Many muscles and tendons for the hand and forearm originate in the elbow area. In case of irritation caused by one-sided movements or overloading, such as tennis elbow or golfer’s elbow, a brace on the elbow can have a supporting effect. The tendons and muscle origins are relieved and stabilized by the brace.
Besides, the elbow joint can be immobilized using a brace. The additional stability and immobilization can support the healing of an irritation.
Furthermore, a brace can have a preventive effect even before problems arise – it can be used prophylactically.
Read more about Elbow bandage for tennis elbow
- Abrams G. D., Renstrom P. A., Safran M. R. Epidemiology of musculoskeletal injury in the tennis player. British Journal of Sports Medicine. 2012;46(7):492–498. doi: 10.1136/bjsports-2012-091164. [PubMed] [CrossRef] [Google Scholar]
- Ciccotti M. Epicondylitis in the athlete. Instructional Course Lectures. 1999;48:375–381. [PubMed] [Google Scholar]
- Herquelot E., Bodin J., Roquelaure Y., et al. Work-related risk factors for lateral epicondylitis and other cause of elbow pain in the working population. American Journal of Industrial Medicine. 2013;56(4):400–409. doi: 10.1002/ajim.22140. [PubMed] [CrossRef] [Google Scholar]
- Jobe F. W., Ciccotti M. G. Lateral and medial epicondylitis of the elbow. Journal of the American Academy of Orthopaedic Surgeons. 1994;2(1):1–8. [PubMed] [Google Scholar]
- Morrey B. F., Sanchez-Sotelo J. The Elbow and Its Disorders. Elsevier Health Sciences; 2009. [Google Scholar]
- Nirschl R. P. Elbow tendinosis/tennis elbow. Clinics in Sports Medicine. 1992;11(4):851–870. [PubMed] [Google Scholar]
- Nirschl R. P., Pettrone F. A. Tennis elbow: the surgical treatment of lateral epicondylitis. Journal of Bone and Joint Surgery. 1979;61(6):832–839. [PubMed] [Google Scholar]8. Wadsworth T. G. Tennis elbow: conservative, surgical, and manipulative treatment. British Medical Journal. 1987;294(6572):621–624. doi: 10.1136/bmj.294.6572.621. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
- Stoeckart R., Vleeming A., Snijders C. J. Anatomy of the extensor carpi radialis brevis muscle related to tennis elbow. Clinical Biomechanics. 1989;4(4):210–212. doi: 10.1016/0268-0033(89)90004-1. [CrossRef] [Google Scholar]
- Calder K. M., Stashuk D. W., McLean L. Motor unit potential morphology differences in individuals with non-specific arm pain and lateral epicondylitis. Journal of NeuroEngineering and Rehabilitation. 2008;5, article 34 doi: 10.1186/1743-0003-5-34. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
- Brown W. F., Bolton C. F., Aminoff M. J. Neuromuscular Function and Disease: Basic, Clinical, and Electrodiagnostic Aspects. New York, NY, USA: Elsevier Health Sciences; 2002. [Google Scholar]
- Stålberg E., Nandedkar S. D., Sanders D. B., Falck B. Quantitative motor unit potential analysis. Journal of Clinical Neurophysiology. 1996;13(5):401–422. doi: 10.1097/00004691-199609000-00004. [PubMed] [CrossRef] [Google Scholar]
- Desmedt J. E., Borenstein S. Regeneration in Duchenne muscular dystrophy: electromyographic evidence. Archives of Neurology. 1976;33(9):642–650. doi: 10.1001/archneur.1976.00500090048010. [PubMed] [CrossRef] [Google Scholar]
- Gawel M., Jamrozik Z., Szmidt-Salkowska E., et al. Electrophysiological features of lower motor neuron involvement in progressive supranuclear palsy. Journal of the Neurological Sciences. 2013;324(1-2):136–139. doi: 10.1016/j.jns.2012.10.023. [PubMed] [CrossRef] [Google Scholar]
- Lee T.-F., Chao P.-J., Ting H.-M., et al. Using multivariate regression model with least absolute shrinkage and selection operator (LASSO) to predict the incidence of xerostomia after intensity-modulated radiotherapy for head and neck cancer. PLoS ONE. 2014;9(2) doi: 10.1371/journal.pone.0089700.e89700 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
- Lee T.-F., Fang F.-M. Quantitative analysis of normal tissue effects in the clinic (QUANTEC) guideline validation using quality of life questionnaire datasets for parotid gland constraints to avoid causing xerostomia during head-and-neck radiotherapy. Radiotherapy and Oncology. 2013;106(3):352–358. doi: 10.1016/j.radonc.2012.11.013. [PubMed] [CrossRef] [Google Scholar]
- Drzymala R. E., Mohan R., Brewster L., et al. Dose-volume histograms. International Journal of Radiation Oncology, Biology, Physics. 1991;21(1):71–78. doi: 10.1016/0360-3016(91)90168-4. [PubMed] [CrossRef] [Google Scholar]