Elbow Pain - HealthShare

1 Elbow pain HealthShare Information for Guided Patient Management Elbow pain Index Introduction 2. Lateral epicondylitis 3. What are the symptoms 3. What can be done to help? 3. wrist flexion stretches 4. Eccentric loading exercise programme 4. Medial epicondylitis 5. What is medial epicondylitis? 5. What are the symptoms? 5. What can be done to help? 5. wrist extension stretches 6. Eccentric loading exercise programme 6. Biceps tendonitis 7. What are the symptoms 7. What can be done to help 7. Accentric loading exercise programme 8. Osteoarthritis (OA)/loose body problem 9. What is Elbow osteoarthritis or a loose body problem? 9. What are the symptoms 9. What can be done to help? 9. Olecranon bursitis 10. What is olecranon bursitis 10.

2 What are the symptoms 10. What can be done to help 10. Contact us 12. [1]. Elbow pain Introduction The aim of this booklet is to provide you with information that may help you understand and treat your Elbow problem. It has been divided up into sections that cover the various issues that can occur with elbows. The Elbow consists of the upper arm bone (humerus) and two bones in the forearm (radius and ulna). It works in two parts. One part acts like a hinge allowing you to bend and straighten the Elbow . The second part provides rotation of your forearm ( ) palm facing up or down. There are a few issues that can occur with the Elbow joint and its surrounding soft tissues. These include: 1. Lateral epicondylitis (tennis Elbow ).

3 2. Medial epicondylitis (golfers Elbow ). 3. Biceps tendonitis 4. OA/loose body problem 5. Olecranon bursitis Synovial membrane Joint capsule Annular ligament Trochlea of the humerus Radius Joint cavity Olecranon process Olecranon bursa Articular Ulna cartilage [2]. Elbow pain Lateral epicondylitis What is lateral epicondylitis? This is often referred to as tennis Elbow but is rarely due to participation in the sport. Excessive overloading or prolonged wrist and hand gripping or twisting functions ( ) pruning the garden, painting, plastering, computer work in poor postures and repetitive tasks like lifting and squeezing can all be common causes. This is made worse if the tendon is degenerative and aged. Local trauma ( ) impact to Elbow going through a doorway, is a less frequent cause.

4 The tendons that control you wrist and gripping are attached to the lateral epicondyle (lumpy bit on the outside of your Elbow ) and they can become inflamed and painful causing weakness. Sometimes the symptoms include inability to fully straighten the Elbow in a morning. This can be due to tendons attaching close to the Elbow joint and inflammation can become thickened. Humerus (Upper arm bone). Area of pain Lateral epicondule Tendon Ulna (Forearm). What are the symptoms? The symptoms vary between patients but the most common include pain with gripping and twisting actions and repetitive movements coupled with a load. These can cause severe weakness and pain . You may get discomfort when you move your arm ( ) bending and straightening your Elbow .

5 Sometimes the pain may be severe enough to disturb your sleep. The outside of your Elbow can often feel tender to the touch and there can rarely be some swelling. You may also have pain that travels further down your forearm. If the inflammation is very bad then the pain can wake people at night. What can be done to help? There are many options in the treatment of tennis Elbow and these include: Local icing Medication Exercises stretches/strengthening. Reduction of overloading activities Use of a support called an Epiclasp Injections to improve the inflammation although these may only offer short term relief In severe cases surgery may be indicated Icing locally over the tender outside portion of your Elbow will help to reduce the pain , inflammation and any swelling.

6 [3]. Elbow pain Medications such as analgesics ( ) Paracetamol, Codeine and Non-steroidal anti inflammatories ( ) Ibuprofen, Naproxen or Diclofenac can help by reducing the body's pain levels and inflammation. It's important that they are taken on a regular basis and at the recommended dose to help you control the pain and allow you to continue with the exercises. You must not wait until your pain is severe before taking the medication. IMPORTANT: You shouldn't take ibuprofen or aspirin if you're pregnant or have asthma, indigestion or an ulcer until you've spoken to your GP or consultant. Exercises such as tendon and muscle stretching help to restore the length of the tissue and strengthening exercises help to improve the tendon loading capacity ( ) eccentric loading exercises.

7 wrist flexion stretches These can be used to gently restore the length of the muscle and tendon complex prior to the eccentric loading exercise programme. 1. Keep the Elbow straight and flex the wrist downwards, apply a little pressure by using the unaffected hand to gently stretch. 2. You should feel a mild stretch to the upper side of your forearm but this should be pain free. 3. Hold for approximately 10 seconds. 4. Repeat 10-15 times, four times daily. Eccentric loading exercise programme: 1. Seated in a chair, support the forearm over the edge of a table or over your knee and hold a weight in the hand with the palm facing down. 2. Maintain your wrist fully bent downwards. By using your unaffected hand lift your wrist up all the way back.

8 3. Then slowly lower the weight until the wrist is fully bent (flexed). 4. Repeat this movement to 15 repetitions. It is important you release the hand slowly downwards 5. After 15 repetitions rest for couple of minutes then do a further 15 reps. 6. Do 3 sets of 10-15 repetitions, twice daily. 7. You may feel sore and tender during or immediately after the exercises but don't worry this should gradually improve. 8. Remember you WILL NOT notice immediate results as it generally takes 8 to 12 weeks to improve. [4]. Elbow pain Reducing the aggravating/overloading activities will allow the body to reduce pain and inflammation and then help start the repair process. This may be difficult when in work situations but lifting objects with your palms up and elbows bent can reduce the load to the painful tendons.

9 An Epiclasp is useful for patients who perform lots of gripping, squeezing and lifting repetitions. Injections can often help when the pain is not settling along with medication, rest, ice and reduction of aggravating factors. They have a short term effect of reducing the inflammation in the tendon attachment which following a period of rest can allow you to continue the exercise rehabilitation programme. Surgery is rarely needed with tennis Elbow problems but if time and all other methods mentioned above are failing then an orthopaedic surgeon can assess to see if necessary. Medial epicondylitis What is medial epicondylitis? This is commonly referred to as golfers Elbow but again like tennis Elbow it is rarely to do with playing golf.

10 It is also less common that tennis Elbow . It occurs very much like tennis Elbow with excessive loading to the tendons but the pain is centred on the medial epicondyle (opposite side of the Elbow to the lateral epicondyle - lumpy bit on the inside of your Elbow ). Inflamed tendon wrist flexor muscles Inside of Elbow What are the symptoms? The symptoms include pain and weakness with lifting and gripping actions that involve the wrist , along with squeezing and turning actions. The pain limits the body from allowing the muscle to pull on the tendon fully, hence weakness. Local pressure on the medial epicondyle will also be uncomfortable. What can be done to help? There are many options in the treatment of tennis Elbow and these include: Local icing Medication Exercises - stretches/strengthening Reduction of overloading activities Use of a support called an Epiclasp Injections to improve the inflammation although these may only offer short term relief In severe cases surgery may be indicated [5].