Courtesy: Dr Michelle Ruiz Suares, President Mexico Shoulder and Elbow Society, Mexico city, Mexico
Elbow Pain – Causes, Diagnosis, and Treatment
Overview
- Elbow pain is a common clinical problem
- Causes vary widely — accurate diagnosis is essential
Key Concept
- Pain is best classified based on:
- Location
Classification Based on Pain Location
1. Anterior (Front) Elbow Pain
- Distal biceps tendon rupture
- Arthritis
2. Medial (Inner) Elbow Pain
- Golfer’s elbow (medial epicondylitis)
- Cubital tunnel syndrome
- Ulnar collateral ligament injury
3. Posterior (Back) Elbow Pain
- Olecranon bursitis
- Posterior impingement
4. Lateral (Outer) Elbow Pain
- Tennis elbow (lateral epicondylitis)
- Radial tunnel syndrome
- Ligament instability
Common Conditions Explained
1. Distal Biceps Tendon Rupture
Mechanism
- Sudden injury (e.g., heavy lifting)
Clinical Features
- Pain
- Swelling
- Bruising
- “Bulge” in arm
Treatment
- Often requires:
- Surgical repair (especially in active patients)
2. Arthritis of the Elbow
Features
- Pain
- Stiffness
- Reduced range of motion
Treatment
- NSAIDs
- Physiotherapy
- Injections
- Surgery (advanced cases)
3. Medial Epicondylitis (Golfer’s Elbow)
Cause
- Overuse of wrist flexor muscles
Features
- Pain over medial elbow
Treatment
- Rest and ice
- Physiotherapy (eccentric exercises)
- Injections
- Surgery (rare)
4. Cubital Tunnel Syndrome
Cause
- Compression of ulnar nerve
Symptoms
- Tingling in ring and little fingers
- Weak grip
Treatment
- Avoid pressure
- Splinting
- Physiotherapy
- Surgery (if severe)
5. Ulnar Collateral Ligament (UCL) Injury
Common In
- Throwing athletes
Features
- Elbow instability
Treatment
- Rest + rehabilitation
- Surgery (e.g., reconstruction)
6. Posterior Impingement
Cause
- Repetitive elbow extension
Symptoms
- Posterior elbow pain
- Locking or clicking
Treatment
- Mostly conservative
- Surgery rarely needed
7. Olecranon Bursitis
Features
- Swelling over tip of elbow
Causes
- Repetitive pressure
- Trauma
Treatment
- Rest and padding
- Aspiration (if needed)
- Antibiotics (if infected)
8. Lateral Epicondylitis (Tennis Elbow)
Most Common Cause of Elbow Pain
Cause
- Overuse of wrist extensor muscles
Symptoms
- Pain over lateral elbow
- Worse with:
- Gripping
- Lifting
Treatment
- Rest and activity modification
- Ice therapy
- Physiotherapy (eccentric strengthening)
- Bracing
- Injections (steroid or PRP)
- Surgery (last option)
Important Clinical Point
Not All Lateral Pain = Tennis Elbow
Always rule out:
- Radial tunnel syndrome
- Cervical radiculopathy
- Elbow arthritis
- Ligament instability
Diagnosis
Clinical Evaluation
- Detailed history:
- Occupation
- Sports
- Duration
Physical Examination
- Resisted movement tests
- Palpation
Imaging
- X-ray
- MRI (for soft tissue/nerve pathology)
General Treatment Approach
First-Line (Most Patients)
- Rest
- Activity modification
- Ice
- NSAIDs
- Physiotherapy
Second-Line
- Bracing
- Steroid or PRP injections
Last Resort
- Surgical intervention
Key Takeaways
- Elbow pain is:
- Common but multifactorial
- Location of pain:
- Guides diagnosis
- Tennis elbow:
- Most common, but not the only cause
- Most cases:
- Improve with non-operative treatment
Lateral elbow Pain
Leave a Reply