Diseases of the musculoskeletal system are varied, so diagnosis of the underlying pathology often takes a long time. Therefore, pain in the elbow can be a manifestation of various diseases; it is possible to accurately determine the cause of damage to the joint only after undergoing a full examination by a doctor. Treatment of joints will allow you to avoid the development of serious pathologies.
The patient is examined with the participation of several related doctors, and after the diagnosis is established, the specialized doctor continues to care for the patient. If symptoms appear, you should seek medical help, as inaction will lead to the development of pathology. There is a high probability that changes in the joint will become irreversible. Then even treatment will not cope with the disease.
The structure of the elbow joint
In its anatomical design, the elbow joint is quite complex, since it is formed by three bones at once (the distal end of the humerus and the proximal ends of the radius and ulna).
Movements in the elbow joint can be carried out in several planes at once due to the fact that it includes several smaller joints:
1. The humeral joint is formed by the articular surface of the flattened head of the radius and the convex head of the humeral condyle. This joint produces rotational movements: pronation and supination.
2. The ulnohumeral joint includes the olecranon (a hook-shaped bony process) and the trochlea (the process of the distal part of the humerus around which the olecranon slides). Due to these formations, flexion movements are carried out and backward extension of the forearm is limited.
3. The radioulnar joint is formed between two parallel bones of the forearm, so contact occurs due to the lateral surfaces of their proximal parts. Also responsible for rotational movements.
All bones are connected and held together by certain ligaments that provide stability to the joint without limiting its range of motion.
So, the ligamentous apparatus of the elbow joint consists of:
1. The ulnar collateral ligament is a strand of connective tissue fibers connecting the internal condyle of the humerus and the trochlear notch of the ulna. Limits pathological mobility of the elbow in the frontal plane.
2. The radial collateral ligament has a more complex structure, since the bundle extending from the lateral condyle is divided at the end and, bending around the head of the radius on both sides, is then attached to the ulnar notch. Stabilizes the joint and prevents bones from moving outward.
3. The annular ligament is unique because it begins and ends on the same bone. It wraps around the head of the beam, as if in a loop, and is fixed at both ends to the ulna. This connecting cord prevents the bones of the forearm from diverging in the frontal and sagittal planes.
4. The quadrate ligament also holds the radius and ulna bones together, starting from their lateral surfaces.
The structure of this joint is complex; any damage to its elements immediately affects the functioning of the joint. Since the hands and the elbow joint itself usually bear a fairly intense and heavy load, patients quickly begin to notice disturbances in its functioning.
Where does the disease begin?
A characteristic crunch when stretching, after a long rest or during sudden movement is the first signal of a possible problem, which can already be found in young people. The cause is metabolic disorders or a lack of certain microelements for the implementation of synthetic processes within the body, various injuries.
Chondrocytes are elements of hyaline cartilage. In a healthy state, they produce hyaline matrix - a gelatinous substance that fills the intercellular space and gives a special structure to cartilage tissue.
Formed by proteoglycan molecules, threads of collagen and elastin, this matrix provides shock-absorbing properties of the articular surface. However, constant load requires continuous replenishment of its mass, so if chondrocytes cease to fulfill their role, the entire cartilage tissue suffers: the level of proteoglycans capable of holding water decreases markedly, and the cartilage itself becomes fragile and begins to deteriorate.
Pain in the elbow joint: causes
Pain syndrome can occur when any component parts of the elbow joint are affected (bones, muscles, nerves, ligaments, tendons and tendon sheaths, feeding vessels). However, when developing an examination plan and conducting differential diagnostics, one must remember that the cause of pain may not be localized in the elbow. This can happen when the spinal cord and brachial plexus are damaged.
Let's consider the main etiological factors that can lead to pain in the area of the elbow joint.
Previous trauma to this area
Trauma can lead to the development of hematomas, soft tissue bruises, dislocations, subluxations, damage to ligaments (their tears or even complete ruptures). Also, an unsuccessful fall on the elbow (or a direct blow to the olecranon area) may result in a fracture of the humerus or forearm bones. The most unfavorable is considered to be a fracture that passes directly through the articular surfaces of the bones, since in this case it is almost impossible to combine the fragments so that the function of the joint does not suffer.
As you can see, an injury can lead to completely different consequences, both in terms of severity and subsequent prognosis for the victim’s health and ability to work. Minor injuries such as bruises and hematomas are quickly treated and disappear without a trace. Severe pathology requires longer therapy and immobilization (in some cases, plaster or transdermal osteosynthesis is required).
— Microtraumas from improper static or dynamic load on the elbow joint
This can happen when you frequently wear heavy bags, when the straps pass just through the bend of the elbow.
Inflammation of the ligamentous apparatus
It can occur against the background of complete well-being, or against the background of previous microtrauma. Small tears can develop after intense exercise (especially when body weight or weights are unevenly distributed due to improper exercise technique).
— Radicular syndrome in severe cervical osteochondrosis
Despite the fact that the elbow joint is located quite far from the spinal cord, such symptoms can develop due to the peculiarities of the innervation of the upper limb. Osteochondrosis can be suspected if the patient has additional complaints of periodic headaches and neck pain, numbness in the arm, and periodic dizziness.
This disease cannot be neglected because later, as it progresses, the affected root may become pinched and become even more inflamed. Elbow pain may become more widespread and painful.
Arthrosis of the elbow joint
This is a very severe and serious disease, since it is characterized by the appearance of irreversible changes in cartilage tissue. In addition to pain, the patient may be concerned about dysfunction of the joint and significant limitation of its mobility. When performing flexion and extension movements, a characteristic crunching or clicking sound may occur.
In case of severe disorders, it is impossible to restore cartilage using conservative treatment methods, since cartilage is one of the slowest recovering tissues. Medicine offers the option of transplanting artificially grown cartilage or allograft (tissue taken from a healthy intact joint using arthroscopy).
Arthritis
This is a term that describes inflammation of a joint or its individual elements. With arthritis, the clinical picture is usually very pronounced. Patients usually describe elbow pain as coming on quickly. The pain syndrome can be combined with redness of the skin over the elbow, swelling of the soft tissues, and an increase in the volume of the affected joint (you should always compare it with a healthy arm).
When the synovial membrane is involved in the inflammatory process, increased exudation and accumulation of effusion in the joint cavity may occur. This condition requires puncture of the joint capsule to pump out excess fluid from there. If blood has accumulated in the cavity, then slowing down its evacuation can lead to its organization and fusion of the joint space with dense connective tissue.
This situation is unfavorable, since ankylosis develops (loss of the ability to perform active and passive movements in full).
Tendinitis
It is an inflammatory pathology that affects muscle tendons. When the tendons that are attached to the joint elements that make up the elbow joint (or are in close proximity to it) are inflamed, the pain in the elbow joint will be localized in the elbow area.
A characteristic feature of this disease is increased pain when performing active movements involving the affected muscles. When muscle fibers contract, the tendon cord is stretched, which leads to increased pathological symptoms. Often because of this, patients protect this arm and try not to move it at all.
Diffuse fasciitis
This is inflammation of the fascia of individual muscles. Fascia is a thin film that completely envelops the muscle. Typically, with this pathology, pain in the elbow is diffuse, but there may be cases where it is localized mainly in the elbow bend.
Malignant neoplasms of bones
With this severe pathology, the pain syndrome will be very pronounced. The sooner a patient is diagnosed, the greater the chance of treatment. The last stages of oncology cannot be treated due to the extent of the process and metastasis.
Benign tumors
Such formations by themselves cannot lead to pain. This syndrome occurs when a tumor compresses any nerve trunks or plexuses.
Under the influence of various factors, changes in the microvasculature can occur, which will ultimately lead to tissue ischemia and destruction. Age-related degenerative changes in cartilage tissue can lead to thinning of the lining of the articular surfaces.
Heart attack
Very rarely, in atypical forms of myocardial infarction, pain in the elbow joint may be the only sign of a cardiac catastrophe. This case is very difficult to diagnose and identify.
In order to suspect cardiac ischemia in a patient with such an atypical complaint, it is necessary to carefully examine him not only for the presence of pathology of the musculoskeletal system. The doctor should pay attention to the patient’s rapid breathing, shortness of breath and the appearance of cyanosis of the skin.
The nature of pain in the elbow joint and their classification
Pain in the elbow joint can vary significantly in different pathologies, and therefore requires careful differential diagnosis.
Let's consider what pain in the elbow joint can be like when affected, and what pathologies it is typical for:
1. Pain in the elbow, which occurs during movement, but practically does not bother the patient at rest, may indicate the presence of arthritis, tendonitis, tendovaginitis, deforming osteoarthritis and traumatic damage to the ligamentous apparatus of the elbow.
2. Limited, clearly localized pain in the elbow joint on the inner or outer surface of the elbow may suggest an isolated injury to one of the collateral ligaments.
3. More diffuse pain in the elbow, which has a clear connection with physical activity or sports training. May indicate muscle soreness or tendon damage due to improper exercise technique.
4. Elbow pain outside of physical activity can occur due to neurological problems. With such symptoms, the patient should be examined by a neurologist to rule out neuritis, plexitis or radicular syndrome.
5. Pain in the elbow joint, which occurs only when performing supination and pronation movements of the hand, usually occurs when the annular or quadrate ligaments are affected.
Features of diagnosing lesions of the elbow joint
A patient who complains that his elbow hurts in the joint should be examined quite carefully. At the beginning, he can be managed by several related specialists at once, who will prescribe additional examination methods.
First of all, you need to carefully examine the location of the disease: evaluate the color of the skin, the size of the joint (compared to a healthy one), and its pain on palpation. If no obvious pathology is identified, an x-ray examination can be prescribed, which allows for good visualization of the bones (however, it does not provide any information about the condition of the cartilage, ligaments and soft tissues).
If this research method turns out to be insufficiently informative, then computed tomography, magnetic resonance imaging, or densitomerism may be prescribed.
Of course, some laboratory tests will be needed to identify the presence of an inflammatory focus in the body, measure calcium concentration and find out whether the body has given a sufficient immune response.
Risk factors
Most injuries occur in the CL when throwing objects overhead, especially in baseball players. Typically, the injury is caused by repeated overuse, which ultimately weakens the ligament significantly and eventually leads to its rupture. Other risk factors include:
- Contact sports (football, rugby) and sports in which falls on an outstretched arm occur, which often leads to dislocations.
- Throwing sports such as baseball and javelin throwing
- Sports that involve overhead arm movements (volleyball and tennis)
- Poor physical condition (weak muscle strength and flexibility)
- Incorrect throwing mechanics
First aid for pain in the elbow joint
A situation may arise in which a patient with an injury to the elbow joint requires emergency medical care. What can be done to help a patient with an elbow injury:
1. First of all, carefully examine the limb. If after examination the presence of a fracture is visible, then the hand must be immediately immobilized. For immobilization, you can use special splints or, in their absence, available materials (boards, thick pieces of cardboard, sticks).
2. If the patient complains of very severe pain in the elbow, pain relief should be performed with any analgesic that is at hand.
3. Apply cold to the damaged joint. This will reduce pain in the elbow joint and swelling, and will also help stop bleeding into the joint cavity (if any).
4. Call an ambulance or take the victim independently to a medical facility, where he can receive the necessary specialized care.
Possible complications
In the absence of timely diagnosis, proper treatment or an unfavorable outcome of surgical intervention, a patient with a disease such as arthrosis of the elbow joint may face a number of complications, including:
- loss of the ability to hold the joint in an anatomically correct position;
- contracture (inability to fully bend/extend the joint);
- fusion of the joint space;
- complete loss of mobility.
Treatment of elbow pain
Different pathologies and nosological units require different patient management tactics. Before a final diagnosis is made, symptomatic therapy is usually prescribed, which is not able to eliminate the underlying pathology, but improves the patient’s condition. The most pronounced therapeutic effects are obtained by combining various therapeutic approaches.
You can combine conservative (medication and immobilization), surgical and physiotherapeutic tactics for patient management. The duration of treatment directly depends on the severity of the disease. Fractures and dislocations with ruptures of the ligamentous apparatus are always treated for a very long time, requiring complete immobility of the injured limb throughout almost the entire period of therapy. Immobilization can be carried out using a plaster cast or splint.
Diagnostics
The primary diagnosis of arthrosis is made during examination. In the future, a complex of physical and chemical methods is used to identify the extent of the disease, developmental features, causes, as well as research for problems with similar symptoms.
- Laboratory blood test (determination of rheumatoid factor, trace element content, exclusion of arthritis, etc.).
- X-ray to identify the stage of arthrosis.
- MRI and CT (depending on the cause and severity of the disease for a more accurate diagnosis).
- Ultrasound (to determine the thickness of the cartilage, the lumen of the joint capsule).
- Densitometry for the diagnosis of osteoporosis.
Drug therapy of the elbow joint
Drug therapy can alleviate the patient’s general condition, relieve unpleasant symptoms and influence the course of the underlying disease.
Main directions in conservative drug treatment:
1. Anti-inflammatory drugs. A group of non-steroidal anti-inflammatory drugs is commonly used.
2. Painkillers. They are needed to ease the patient’s well-being, because prolonged severe pain has a bad effect on a person’s emotional and mental state.
3. Chondroprotectors that improve the condition of cartilage tissue in the affected joint. They cannot restore completely destroyed cartilage lining, but they slow down the progression of destruction of healthy tissue.
4. Vitamin therapy.
5. Agents that improve blood flow in the microvasculature.
6. Muscle relaxants help relax pathologically spasmodic muscles.
7. Various anti-inflammatory and warming ointments and gels have a good effect.
Unconventional treatment of the elbow joint
Over many centuries, craftsmen who possess the secrets of traditional treatment have learned to effectively and quickly defeat many diseases. Alternative medicine has not ignored diseases of the musculoskeletal system.
You should not start the fight against the unpleasant symptom of pain in the elbow joint with home self-medication, since traditional recipes can complement the main course of therapy, but as an independent method they may not be effective enough. Before using any of the methods described below, you should consult your doctor on this matter, who will be able to assess the effectiveness, feasibility and safety of the described recipe.
So, to treat pain in the elbow joint, you can use the following methods and recipes.
Fresh cabbage leaf compresses
To make such a compress, you only need cabbage and a bandage for fixation. The leaf needs to be crushed a little so that it begins to release juice. Then the prepared cabbage is firmly fixed to the elbow with a bandage. It is best if the procedure lasts at least six hours (it would be ideal to do it before bed and leave it overnight). If desired, cabbage leaves can be replaced with burdock, this will also give the desired therapeutic effect.
— Ointments and rubs made from natural plant ingredients
Ointments containing mustard and hot pepper have a good effect. You can add a small amount of natural honey to them to enhance the anti-inflammatory effect. When applying such rubs to the skin, a pleasant burning sensation may occur. If the ointment bakes too much so that you begin to experience pain in the elbow joint, then you need to wash off the applied substance from the skin.
Treatment using medicinal clay and mud
It is also used with great success for joint diseases. Mud or clay application can be made at home. You will need healing mud and gauze or a wide bandage. You will receive a therapeutic effect from this procedure if you preheat the mud mass to a temperature higher than the temperature of the human body (this way, the beneficial molecules from the compress will penetrate faster and deeper into the lesion).
The process of making an application cake is extremely simple: evenly distribute the raw materials on the prepared gauze. Then gauze with dirt is applied to the damaged limb and wrapped with film or cellophane on top. To keep the mixture warm longer, you can wrap a down scarf or a thick towel on top. This compress can be kept until the mud has completely cooled.
Rubbing fresh celery juice
It will help in the fight against certain diseases of the elbow joint. The technique of this procedure is simple and does not require any additional equipment or tools. The affected area is massaged with celery juice, it is advisable to rub it in until it is completely absorbed. Remember that this juice can not only be used as a rub, but also taken orally. The rich vitamin composition will strengthen the immune system and increase the body's ability to fight inflammation.
If any unpleasant sensations occur during the procedure, you should immediately stop therapy and seek medical help.
All methods of alternative medicine must be agreed with your attending physician, and also combined with professional therapy. Self-medication can only suppress the symptoms and lead to the development of the existing disease!
Preventative measures for elbow pain
Not all diseases can be completely cured, so, of course, it is better to prevent their occurrence in the first place. Some diseases cannot be prevented in any way, especially if they are genetically determined pathologies. However, there are some preventive measures that will slow down the development of the disease or prevent it altogether (in cases where this is possible).
Preventive measures to help avoid damage to the elbow joint:
1. Proper balanced nutrition. Healthy food is rich in essential microelements and chemical components that are needed to build normal cartilage and bone tissue. For example, insufficient dietary calcium intake can lead to osteoporosis, a common precursor to pathological fractures.
2. Regular gymnastics helps keep all muscles toned, which helps improve blood flow not only in the muscles themselves, but also in adjacent tissues (ligaments, cartilage). Remember that exercise should be comprehensive and gentle; excessive load on the joint only worsens its condition. It is better if you work with a qualified trainer or at least undergo training under the supervision of a specialist.
3. If any prolonged discomfort in the joint occurs, immediately seek medical help in order to identify the pathology at the earliest stages.
Prevention
In order to prevent the occurrence of diseases and injuries to the elbow joints, it is recommended:
- When engaging in sports or heavy physical labor, it is reasonable to dose the load, be sure to use protective orthopedic bandages and not forgetting about a thorough warm-up before training or work.
- Adhere to a healthy lifestyle, which includes giving up bad habits, proper nutrition and moderate physical activity.
- Monitor your body weight, avoiding excess weight, which puts additional pressure on your joints.
- If you experience pain in your elbow, consult a doctor immediately. If you experience pain in your elbow, consult a doctor immediately.