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The elbow consists of the elbow joint, which consists of the humerus and the two forearm bones Elle and spoke. Numerous muscles, nerves and vessels run through the elbow joint and can be injured or diseased.
Accidents or prolonged strain on the elbow are the most common cause of pain in the elbow. But everyday activities such as shopping also strain the elbow and can cause pain in the long run. For a specific therapy, the exact diagnosis of persistent pain is necessary, so the diagnosis should be made by a doctor.
The causes of a painful elbow are also differentiated from acute from chronic or trauma-related from degenerative causes. Acute causes that can cause pain in the elbow include all trauma and injury that can result in sudden elbow function loss. Fractures after severe falls or severe bruises after falls often cause severe pain in the area of the elbow for days. In addition, the pain intensifies as soon as an attempt is made to bend or stretch the arm. Chronic causes are mostly degenerative in nature or are signs of chronic stress on the arm and elbow.
In addition to the causes of overload, incorrect posture during movement can also lead to persistent pain in the elbow. Arthrosis in the elbow joint should be mentioned here, which is rare but does occur. In addition to classic complaints such as pain in the fingers and restricted movement, rheumatoid arthritis can also lead to pain in the elbow if it is affected by a rheumatism. Metabolic diseases, such as gout, can also affect the elbow in the event of a seizure with sharply increasing uric acid and lead to very severe pain. Bursitis in the elbow joint is much more common and sometimes accompanies the overload syndrome. The so-called bursitis often occur after overuse and sometimes lead to very severe pain. In addition to the bursae of the elbow, the bursae of the other joints, such as the knee, are also often affected.
There are numerous other causes of pain in the elbow joint. With the so-called shoulder-arm syndrome, there is an anatomical constriction in the area of the shoulder. Both nerves running there and muscles pulling down the arm are thus narrowed. If the arm is moved upwards, the nerves are compressed so much that they trigger a pain in the elbows. With the so-called ulnar sulcus syndrome, there is a constriction in the elbow. The ulnar nerve that passes through this narrowness is compressed and triggers pain in the little finger. Especially when sitting for long periods with your elbows on the table, there may be permanent irritation of the nerves and pain in the elbows and hands.
Some of the people described the pain as very severe. Depending on the cause, weaker pain that can be controlled quickly can occur if it is merely a question of irritation of the periosteum, etc. If there were fractures or it has been arthrosis that has been developing for years, the pain can become so severe that it can only be done with pain plasters or the like. are manageable. The pain is mostly described as developing at the elbow and then pulling into the upper and lower arm.
Many forms of elbow pain quickly go away on their own and do not require special diagnostics. However, if the pain persists, a doctor should be consulted. A detailed medical history is particularly important here. Pain character, pain localization and pain duration are important information.
Numerous underlying diseases such as rheumatological diseases, diabetes or neurological diseases should also be mentioned in the doctor's consultation. Special strain on the elbow should also not go unmentioned. The elbow, its mobility and painful pressure points are then checked. This gives the doctor information on whether mobility is restricted or whether the elbow is overheated or red. The doctor also checks whether the joint is swollen or there is an effusion. If there is suspicion of certain causes, such as inflammation or injury, further examinations are carried out. If there is a broken bone or serious muscular injuries, an X-ray is taken.
If inflammation is suspected, the inflammation parameters are determined in the laboratory. An ultrasound examination of the joint can represent a joint effusion that can be punctured in the context of the ultrasound. If chronic joint wear is suspected, joint mirroring (schoulder arthroscopy) should be performed. The joint can be examined closely and at the same time intervened therapeutically.
For more precise imaging, there is the option of magnetic resonance imaging of the elbow (MRI), which makes the muscles and nerves visible. Pain caused by the soft tissues in particular can be well visualized by an elbow MRI.
Tension or tears in the ligaments, but also muscle tension or muscle injuries can occur traumatically and cause pain.
In the event of an accident or fall, the upper arm or forearm bones can break.
But the elbow joint itself can also break and restrict movement in the joint. In addition, there is severe pain.
As a result of incorrect movement or an accident, the elbow joint can slip out of the socket (dislocation). This also leads to acute pain and the need for quick therapy to relieve the pain.
Likewise, a capsule tear on the elbow, primarily caused by external violence, leads to severe pain.
Long-term strain on the elbow can cause the tendons to become inflamed due to constant friction. This is called tendovaginitis. The joint itself can also become inflamed due to long-term stress or an infection. This is called arthritis.
This form of inflammation is often accompanied by other local symptoms. As a rule, arthritis develops over time and does not appear acute. The form of rheumatoid arthritis can also cause pain. Here, however, it is not an overload or infection that is the cause of the pain, but an innate rheumatic disease that is chronic and cannot be cured.
As a further structure, there is a bursa in the area of the elbow joint. This can also infect through heavy use or germs. This is called bursitis olecrani.
Bursitis can also cause elbow pain.
This leads to an inflammatory reaction of the bursa, which forms the fluid-filled plain bearing between all muscles and bones of the joint.
This inflammation can have many causes: Often, bursitis is the result of overwork, for example constantly leaning the elbow on a table.
This happens e.g. while reading - that's why a bursitis on the elbow is also popularly referred to as "student elbow".
The cartilage layer in the elbow joint can wear out due to long-term overload. This is called osteoarthritis. This arises from years of incorrect stress and leads to slowly increasing pain when moving. Over time, the pain appears particularly at rest and improves briefly with light movements. The disease is usually chronic and difficult to treat. Repetitive strain injection can also arise from everyday work on the computer, which requires the same movement in the elbow joint for years.
One form of nerve irritation is the irritation of the elbow nerve (ulnar nerve), for example due to an impact on an edge. It is the "musicians' bone", as the pain is felt in the entire forearm. However, this form of pain quickly disappears and cannot be compared to other neurological diseases. These are chronic diseases of the nerves, which prevent the transmission of information about the nerves or trigger excessive pain in the nerves without a recognizable external cause. This form of the disease usually affects not only the elbow, but is particularly common on the legs.
Pain when propping up the elbow mainly occurs with bursitis.
Due to the inflammatory reaction in the elbow bursa, this site is particularly sensitive to pain due to the inflammation mediators released in the tissue.
If there is a touch here, for example when the tip of the elbow is supported on a table, it causes incredibly severe pain.
If pain occurs when bending or stretching the elbow, it is mostly the muscles responsible for these movements or their associated tendons that are responsible.
The biceps muscle is responsible for flexing the elbow joint.
If this is irritated or cramped due to overload, pain can occur when bending the elbow.
A painful stretch speaks for an irritation of the triceps muscle or its tendon. For the most part, this performs the stretching movement in the elbow joint.
In both cases, i.e. pain when bending and stretching, the joint should first be spared from the painful movement and the joint should be allowed to rest so that there is improvement.
If there is no improvement due to the immobilization during bending and stretching, pain and anti-inflammatory drugs, e.g. NSAIDs are used.
If pain in the elbow is particularly noticeable at night, it can be an elbow arthrosis (cubital arthrosis).
This is a degenerative wear of the cartilage in the elbow joint, so that the movement in the joint is no longer smooth.
Elbow arthrosis is particularly caused by stress at work or by strong sporting activity (e.g. as a handball player), and usually causes stress-related pain.
In a more advanced stage, pain also occurs at rest and at night.
Rheumatoid arthritis (rheumatism), on the other hand, should be considered when the elbow hurts in the morning. These pains are associated with morning stiffness of the affected joint.
Morning stiffness is due to the fact that mobility is restricted by the longer immobilization of the joint during the night after getting up in the morning. In the course of the day, mobility improves again.
The therapy is different and depends on the corresponding disease. In the case of fractures in the area of the elbow, conservative therapy can be chosen, which consists of pain treatment and immobilization, or surgical therapy can be selected using screws, plates or nails. A conservative approach is usually preferred for arthrotic changes. In the case of nerves involved, it may be necessary to relieve the compressed nerves by surgery. Pain in the elbow, which arises due to overloading (tennis elbow or golf elbow), should be treated by not doing the triggering sport for a while. Furthermore, the pain should be treated symptomatically with cold application or pain medication.
Many forms of elbow pain are harmless and subside after a short time. With muscular causes, bandages or ointment bandages are often sufficient to relieve the pain. If there is a broken bone or the joint has been severely injured, surgery may have to be performed to straighten the bones in some cases. Even if the elbow has been strained for a few days, the pain usually goes away on its own.
These are often acute, moderately severe pain, for example with a tennis elbow, which decrease after a few days of immobilization. Anti-inflammatory drugs such as acetylsalicylic acid or diclofenac can be used to inhibit pain and inflammation with medication. However, this should not be permanent medication, but should only be used in the acute phase. If there is pain in the joint, medications containing cortisone or local anesthetics can be injected into the joint space. If there is chronic elbow pain, an inpatient stay in a hospital may be necessary. Brachial plexus anesthesia can be performed there. This is the interruption of the large nerve network in the armpit area, which blocks the transmission of pain.
Joint mirroring (arthroscopy) can eliminate some of the causes of joint problems. In more severe cases, an artificial joint replacement may be necessary if the joint is too worn. In any case, physiotherapy, heat or cold treatments, muscle training, electrotherapy or ultrasound therapy and orthopedic aids can be used. In the case of long-lasting complaints, a doctor should decide which form of therapy makes sense in order to achieve successful therapy.
