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Elbow pain
Definition:
Pain in the elbow other than from direct injury.
Alternative Names:
Pain - elbow
Considerations:
Tennis elbow is a common cause. It occurs as pain in the lateral (outer) portion of the elbow and upper forearm. The risk of acquiring or aggravating tennis elbow may be increased by rolling the wrist on contact to put top spin on the ball, by using a very stiff or tightly-strung racket, or excessive play. Using a two-handed backhand stroke may help prevent tennis elbow.

Less than half of cases of tennis elbow are actually associated with playing tennis. Tennis elbow usually results from work that requires a twisting motion of the arm, such as using a screwdriver.

Bursitis, another common cause, looks like a small egg at the end of the elbow. It is the result of inflammation of the bursa, a cushion in the joint.
Common Causes:


Home Care:
For tennis elbow, reduce playing time or time spent doing the activity that aggravates the elbow pain. Warming up slowly, stretching exercises, and applying ice after playing may help.

For bursitis, rest, ice, maintaining mobility, and strengthening (RIMS) are usually helpful. When first detected, the patient should apply ice for a half an hour, then leave it off for the next 15 minutes. Continue the cycle for 6 to 8 hours. Be careful not to freeze the skin. Then give the elbow complete rest for at least 2 days and do not return to the activity that caused the problem for at least 3 weeks. After the initial rest period, the person should begin to gradually strengthen the muscles around the elbow through exercise.

For strains, rest and analgesics will help.

For arthritis, physiotherapy (physical therapy) and analgesics may help.

For infections, antibiotic treatment under your health care provider's direction is recommended.
Call your health care provider if:
  • there is a prolonged case of tennis elbow that doesn't get better with home care. (Only rare cases need a doctor's help.)
  • the pain is due to an injury, and there is obvious deformity, or the pain prevents any use of the elbow.
  • there is fever, swelling and redness, or inability to use the joint.


What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting elbow pain in detail may include:
  • distribution
    • Are both elbows affected (symmetrical)?
    • Does the pain shift from elbow to other joints?
    • Is the pain over the outside bony prominence of the elbow?
  • time pattern
    • Did the pain begin suddenly and severely?
    • Did the pain begin slowly and mildly and then get worse?
    • Is the pain resolving spontaneously?
    • Did the pain occur following an injury?
  • other
    • What other symptoms are also present?
The physical examination will include a thorough examination of the elbow.

Intervention:
For chronictennis elbow, a pain reliever and corticosteroid (cortisone-like drug) injected into the painful area may be prescribed. Usually no more than 3 such injections are performed. Surgery should be a last resort.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to elbow pain, you may want to note that diagnosis in your personal medical record.
Review Date: 5/26/2001
Reviewed By: Kevin B. Freedman, M.D., Department of Orthopaedic Surgery, Rush-Presbyterian Medical Center, Chicago, IL. Review provided by VeriMed Health Network.

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