Statistically, six people out of 1 million require elbow replacements. Elbow replacements are most frequently done for rheumatoid disease and other causes of arthritis in older individuals or after trauma associated with a fracture. For most people, however, elbow pain is caused by overuse injuries, such as lateral epicondylitis (Tennis Elbow) and medial epicondylitis (Golfer's and Baseball Elbow) and cubital tunnel syndrome.
Lateral epicondylitis (Tennis Elbow)
What is tennis elbow?
Lateral epicondylitis, commonly known as tennis elbow, is swelling of the tendons that bend your wrist backward away from your palm.
A tendon is a tough cord of tissue that connects muscles to bones. The tendon most likely involved in tennis elbow is called the extensor carpi radialis brevis. Tennis elbow is usually diagnosed in both men and women between the ages of 30 to 50 years.
What causes tennis elbow?
Tennis elbow, as the name implies, is often caused by the force of the tennis racket hitting balls in the backhand position. Your forearm muscles, which attach to the outside of your elbow, may become sore from excessive strain. When making a backhand stroke in tennis, the tendons that roll over the end of our elbow can become damaged. Tennis elbow may be caused by:
- Improper backhand stroke
- Weak shoulder and wrist muscles
- Using a tennis racket that is too tightly strung or too short
- Other racquet sports, like racquetball or squash
- Hitting the ball off center on the racket, or hitting heavy, wet balls
However, many people who suffer from tennis elbow do not play tennis. The problem can be caused by any repetitive movement. Other causes of tennis elbow include:
- Painting with a brush or roller
- Operating a chain saw
- Frequent use of other hand tools on a regular basis
- Using repeated hand motions in various professions, such as meat cutters, musicians, dentists, and carpenters
What are the symptoms of tennis elbow?
The following are the most common symptoms of tennis elbow. However, you may experience symptoms differently.
At first, you may have pain, burning, or an ache along the outside of your forearm and elbow. With time, the pain gets worse. If you continue the activity that caused your condition, the pain may spread down to your wrist, even at rest. Pain may also persist when you place your arm and hand palm-down on a table, and then try to raise your hand against resistance. You may also feel pain when you try to lift and grip small objects, such as a coffee cup. A weak grip is another symptom of tennis elbow.
The symptoms of tennis elbow may resemble other medical problems or conditions. Always see your health care provider for a diagnosis.
How is tennis elbow diagnosed?
Your health care provider can usually diagnosis your tennis elbow by a physical exam. In some cases, you may certain tests, such as:
- An X-ray to look at the bones of your elbow to see if you have arthritis in your elbow.
- Magnetic resonance imaging (MRI) can show your tendons and how severe the damage is. An MRI of your neck can show if arthritis in your neck, or disk problems in your spine are causing your arm pain.
- Electromyography (EMG) of your elbow may show if you have any nerve problems that may be causing your pain.
How is tennis elbow treated?
It’s important to avoid the movement that caused your injury in the first place. Treatment may include:
- Rest and stopping the activity that produces the symptoms
- Ice packs (to reduce inflammation)
- Strengthening and stretching exercises
- Anti-inflammatory medications (such as ibuprofen or naproxen)
If these treatments do not work, your health care provider may talk to you about:
- Bracing the area to keep it still for a few weeks
- Steroid injections to help reduce swelling and pain
- A special type of ultrasound (TENEX TX) that can help break up scar tissue, increase blood flow, and promote healing
- Surgery (rarely necessary)
Medial Epicondylitis (Golfer's and Baseball Elbow)
What is medial epicondylitis?
Medial epicondylitis is also known as golfer's elbow, baseball elbow, suitcase elbow, or forehand tennis elbow. It's characterized by pain from the elbow to the wrist on the inside (medial side) of the elbow. The pain is caused by damage to the tendons that bend the wrist toward the palm. A tendon is a tough cord of tissue that connects muscles to bones.
What causes medial epicondylitis?
Medial epicondylitis is caused by the excessive force used to bend the wrist toward the palm. This can happen when swinging a golf club or pitching a baseball. Other possible causes of medial epicondylitis include:
- Serving with great force in tennis or using a spin serve
- Weak shoulder and wrist muscles
- Using a too tightly strung, too short, or too heavy tennis racket
- Throwing a javelin
- Carrying a heavy suitcase
- Chopping wood with an ax
- Operating a chain saw
- Frequent use of other hand tools on a continuous basis
What are the symptoms of medial epicondylitis?
The most common symptom of medial epicondylitis is pain along the palm side of the forearm, from the elbow to the wrist, on the same side as the little finger. The pain can be felt when bending the wrist toward the palm against resistance, or when squeezing a rubber ball.
The symptoms of medial epicondylitis may look like other medical problems or conditions. Always see your doctor for a diagnosis.
How is medial epicondylitis diagnosed?
The diagnosis of medial epicondylitis usually can be made based on a physical examination. The doctor may rest the arm on a table, palm side up, and ask the person to raise the hand by bending the wrist against resistance. If a person has medial epicondylitis, pain usually is felt in the inner aspect of the elbow.
Treatment for medial epicondylitis
Treatment for medial epicondylitis includes stopping the activity that produces the symptoms. It is important to avoid the movement that caused the condition in the first place. Treatment may include:
- Ice pack application (to reduce inflammation)
- Strengthening exercises
- Anti-inflammatory medicine
- Corticosteroid injections
- Surgery (rare)
Cubital Tunnel Syndrome
Cubital tunnel syndrome occurs when the ulnar nerve, which passes through the cubital tunnel (a tunnel of muscle, ligament, and bone) on the inside of the elbow, is injured and becomes inflamed, swollen, and irritated.
Cubital tunnel syndrome causes pain that feels a lot like the pain you feel when you hit the "funny" bone in your elbow. The "funny" bone in the elbow is actually the ulnar nerve, a nerve that crosses the elbow. The ulnar nerve begins in the side of your neck and ends in your fingers.
What causes cubital tunnel syndrome?
Cubital tunnel syndrome may occur when a person frequently bends the elbows (when pulling, reaching, or lifting), leans on their elbow a lot, or has an injury to the area.
Arthritis, bone spurs, and previous fractures or dislocations of the elbow can also cause cubital tunnel syndrome.
- The most common symptom of cubital tunnel syndrome is numbness, tingling, and pain in the hand and/or ring and little finger, especially when the elbow is bent.
- Cubital tunnel syndrome can be treated with rest and medicines to help with pain and inflammation. Exercises may help too. In some cases, surgery may be done.
Next steps to take for your elbow pain.
Call (402) 717-0820 for an appointment with a CHI Health Orthopedic specialist.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.