Elbow Pain

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Your elbow is an integral part of your day to day activities from getting up out of bed, washing, dressing and household tasks! The last thing you want is for your elbow to be painful as it’s so important to our daily function.

From hitting your funny bone, golfers elbow, tennis elbow, osteoarthritis, hyperextension injuries, bursitis…..there are many ways and reasons why you can develop elbow pain. The key to recovering from elbow pain is knowing what is causing the problem, the anatomy involved and how to manage the symptoms.

The elbow is a pretty small joint but with so many cases it may be difficult for you to come to a conclusion as to why you have your symptoms – let this article give you the guidance you need to educate, inform and help you on the way to a solution to your problem!

 

General Anatomy

 

The elbow is a complex hinge joint which means it acts exactly a hinge allowing 2 main movements of flexion and extension. The elbow also allows for some rotation helping the wrist to pronate and supinate (internal and external rotation).

The bones that make up the elbow joint include the humerus which is the upper arm bone and this then fits on to the forearm bones called the ulnar and radius.

Some finer points of the elbows anatomy of the bones include the olecranon which is the term for the head of the ulnar and this fits perfectly into the end of the humerus to form the point bit of your elbow.

On the end of all the bones, we have articular cartilage which is the smooth/firm covering that helps the joints to move easily and keeps the joints well lubricated.

The ligaments which hold the elbow together include the radial collateral, ulnar collateral, annular ligament and the accessory collateral ligament. There is also a joint capsule which holds the elbow together and makes it secure.

Muscles are a really important part of the elbow for movement but also they can be the source of a lot of the elbows pain – which we will touch upon later in the article. The elbow is extended by the triceps which sits on the back of the humerus, flexion is controlled by the bicep muscle and this sits on the front of the humerus. The muscles that pronate and supinate the forearm and elbow are the brachioradialis, pronator teres, flexor carpi radialis & ulnaris.

Bursas are the final piece of the elbows anatomy which are key to mention. Bursa are fluid-filled sacks which sit around the joint and help to cushion the elbow to protect it from trauma. There is a particular bursa which can cause an issue in the elbow and this is the olecranon bursa.

Symptoms

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Elbow symptoms can be quite diverse, dependent on what is causing the symptoms but here is a list of issues you may come across if your elbow hurts.

 

Swelling

 

If you have suffered some trauma like impact to the elbow or hyperextension, then the joint may swell to help it heal. This will make the elbow look larger as the fluid fills up the joint space.

Swelling can also be painful and slightly warm – if you develop any serious hotness in the joint then it may be a sign of infection – in which case you should proceed to the emergency department.

 

Loss of Movement/Range

 

This is a typical symptom with a lot of elbow pain. You may have severe loss of movement or just a minimal loss – it all depends on the cause. If the elbow feels particularly stiff or blocked, it may indicate a more serious injury which may need further attention.

 

Pain

 

Elbow pain can be present within the joint or the soft tissues which sit around the outside. If the pain is from the joint, you won’t be typically able to press and feel it as it sits inside but if the soft tissues around the outside of the elbow then these may be tender to touch.

 

Reduced function/strength

 

When your elbow is painful, it can lose its strength and ability to perform its tasks. Obviously depending on what is causing your problem will decide how severe your loss of function in the elbow is.

Causes

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Let’s look more closely at how the elbow can be hurt and why it develops symptoms.

Trauma is the most obvious cause. If you hit the elbow directly or hyperextend the arm then this can cause damage to the bone and soft tissues. Fractures of any of the 3 elbow bones can result in a loss of movement and high levels of pain.

Avulsion fractures are when a piece of bone from the elbow is torn off by a tendon. This can happen due to sudden increases in force through the elbow or an increased load, for example, someone trying to lift more weight than usual.

Bursitis is when the sacks of fluid that help to protect the joint swell in size. This can typically result in the elbow looking like it has a golf ball, or in some cases, a tennis ball-sized swelling at the point of the elbow. This impedes on function and can be painful to touch.

Golfers and Tennis elbow are essentially the same problems.  The tendons that sit on the outside and inside of your elbow help to operate flexion, pronation, supination and extension of the wrist.

When there is a sudden increase in amount, intensity or load and weight with wrist-based tasks such as lifting, gripping and sports (tennis and golf) – the tendons can become painful due to tiny microscopic tears. This results in pain, loss of power and reduced ability to perform your tasks normally.

Osteoarthritis is common throughout most joints once we pass 50 years of age. It doesn’t necessarily mean that we will have pain, however. Osteoarthritis is where the joint can become worn down and lack a smooth surface – we may find that during the ageing process that we develop pain into the elbow because of this. These flares of pain will come and go and settle with exercise and pain relief.

Bone spurs can be a tricky problem for the elbow – trauma to the elbow or a history of manual work or even sporting activity can mean there may be a loose piece of bone floating in your elbow joint. This can mean you will experience an unpredictable onset of pain.

Supplements

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Pain relief from the chemist can be a good starting point for reducing elbow pain but there are some more natural methods which you could use to help heal your elbow and reduce your pain. Always check with your doctor or pharmacist as to what’s the best and most safe option for you to take. If you can’t use medication or you want something a bit more natural then have a look at the list below.

Natural supplements can help to reduce your inflammation levels and it has been shown that turmeric in high doses can have very positive effects. Curcumin is the active ingredient in turmeric that has been found in many studies to have positive anti-inflammatory effects on the body and also to promote circulation to vital structures which are key when you have elbow pain.

Omega fish oils including cod liver oil including omega 3 fatty acids are thought to be essential for helping to reduce inflammation due to them thought to affect the body’s production of prostaglandins in a similar way to what turmeric does.

Bromelain has proteolytic enzymes (protein-digesting enzymes) found in fruit such as pineapple – has had some research to show that it has a natural effect on tenderness and swelling – this could be another natural addition to help ease symptoms of elbow pain.

Glucosamine and chondroitin have had many studies published showing the benefits for joint health – this could be a vital addition if you have arthritic elbows and you wish to preserve the joint health. The aim of this supplement is to reduce inflammation in the joint and improve the lubrication of the elbow joint.

Exercises

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Here is a range of exercises which can be performed to help ease elbow pain and also to help reduce future chances of developing elbow pain.

 

Active Range of Movement Exercises

 

This is the simplest of all exercises that can be performed but also one of the most important. If your elbow does not have full movement then this is a good starting point.

If you have pain which is coming from the elbow joint itself then this is the perfect exercise. Elbow movement helps the joint to become lubricated and for the pain to decrease. The exercise is simply bending and extending the elbow gently repeatedly to its maximum range of motion – if you are restricted then don’t worry – take it to the edge of the discomfort and slowly work until you gain full range.

 

Active range of movement – pronation/supination

 

As mentioned before – gaining full movement is key to a healthy elbow. The pronation and supination movement involves holding your hands out in front of your and turning them over one way so your palms face up then turning the other way until it faces down. This addresses the rotation aspect of the elbow.

 

Bicep Curls

 

A classic exercise that everyone will be familiar with. Part of having a strong elbow joint is to make sure the bicep muscle which performs a lot of lifting and flexing of the joint is in good condition. Simple use a dumbbell or barbell and with a straightened elbow, flex the weights towards you in a controlled manner, slowly lower until the elbow is extended and continue again.

You could start with tins of food or water bottles and build to heavier weights.

 

Overhead Triceps Extensions

 

Using a weight in either one hand or holding with both hands – with the elbow flexed behind your head – straighten the elbow and extend the weight over your head to work the triceps.

 

Press Ups

 

Another classic example and a great way to work the elbow joint and triceps. This exercise should only be performed when the elbow is healthy – if you have pain, stop immediately.

 

Pull-Ups

 

A more advanced exercise which involves lifting your bodyweight. This is a true test of your elbow and is a bit more advanced. There are good ways to start performing pull-ups such as using elastic bands to help assist your body weight or using an assisted machine at the gym to carry some of your weight.

Pull-ups are self-explanatory and should always be performed slowly and controlled. There are many variations of the pull up that you can perform.

 

Resisted Wrist Supination/Pronation

 

This exercise is good for tennis and golfers elbow. Using a small dumbbell with your wrist supported over the edge of a surface, slowly turn the dumbbell and rotate your elbow and wrist. Aim for long slow repetitions of the exercise until the elbow is a bit achy – this is great for strengthening painful tendons.

 

That concludes the guide to elbow pain which has covered anatomy, cause, symptoms, supplements and even exercises which can help to make your elbow less painful and more functional. We hope that you have found this useful!