The elbow is really three joints. Each of the two bones (radius and ulna) of the forearm form joints with the humerus (funny bone) - the upper arm bone. The radius and ulna together also form a kind of swivel joint which allows turning of the hand. Around each of these joints is a membranous capsule which contains the lubricating and nutrient joint fluid.
The knobbly bits (epicondyles) either side of the elbow are anchorage points for groups of forearm muscles.
Two major nerves which run past the elbow are sometimes involved in elbow pain: the ulnar nerve which roughly supplies the little finger side of the hand and the radial which goes to the thumb side.
Causes of Elbow Pain
Pain in the elbow region can arise out of disease or damage to the joint itself or to the surrounding and supporting structures: ligaments or tendons or nerves. In addition nerve entrapment in the neck region – from a prolapsed disc for example – can produce pain in the elbow area.
Damage to the Elbow Joint
- Trauma: the joint ligaments and capsule can be damaged from trauma. Such injuries are common in sport.
- Arthritis: several types of arthritis can manifest in the elbow. Rheumatoid arthritis can attack almost any joint including the elbow, leading to pain, swelling and stiffness. Gout, although classically seen in the big toe may also cause pain and swelling in the elbow. Osteoarthritis does not usually occur in the elbow except in a previously injured joint.
- Infections: bacteria seem to thrive in joints if given the chance. Wounds to the elbow can readily turn septic. Infections from elsewhere in the body may spread to the elbow.
Tennis and Golfer’s Elbow
These are probably responsible for the majority of painful elbow problems and most of these arise from some kind of misuse of the joint.
Tennis and golfer’s elbow are both due to damage at the insertions of the forearm muscles onto the bone at the elbow. The features are pain and tenderness at the epicondyles of the joints. In tennis elbow the tenderness is on the outer epicondyle (with palms facing front) and golfer’s is felt at the inner epicondyle.
The usual causes are not golf or tennis but micro-trauma from repetitive action. Do it yourself activity such as hammering or frequent use of a screwdriver are the usual candidates. Some sports of course also involve much repetitive arm use.
Bursitis
A bursa is a small fluid-filled sac that acts as a cushion to protect bone and tendon. The olecranon bursa of the elbow lies over the bony projection at the back the elbow.
This is susceptible to inflammation from repeated friction which leads to the bursa becoming very tender and swollen. Bursae can also become infected by bacteria which will also cause tenderness and swelling.
Nerve Damage
The ulnar nerve which runs near the surface at the back of the elbow is the most prone to injury. A blow to the nerve in this area causes the characteristic ‘funny bone’ pain. More serious injury can lead to pins and needles or loss of feeling on the little finger side of the hand and sometimes loss of power in that area.
The radial nerve can also become damaged and this affects the thumb side of the hand. Both of these nerves can be damaged by fractures or dislocation.
This article is for information only. If you have any health concerns you should consult the appropriate health professional.
Resource:
Soft Tissue Pain and Disability: Rene Cailliet. Pub.F A Davis and Co. 1988
John Richard Roberts - I am a practicing osteopath and acupuncturist living and working in the UK. I hold a Master's degree in Clinical Neuroscience. I have ...
