Just like our shoulders and knees, we use our elbows every day. They are involved in the most basic actions, such as making a phone call, putting on a sweater, scratching our head or typing on the computer.
As a result, various types of conditions and injuries can affect this joint. Epicondylitis (tennis elbow), medial epicondylitis (golfer’s elbow), or bursitis of the elbow, and short-term or long-term pain (chronic pain), this guide reviews some of the most common conditions.
A closer look at the different movements of the elbow
The elbow is a joint that connects the bones of the forearm (radius and ulna) to those of the arm (humerus). Thanks to various muscle groups, the elbow and the wrist can perform different movements: extension/flexion, and pronation/supination.
When the palm of the hand is facing the ground, extension is the action of raising the hand, while flexion is the action of lowering the hand.
Pronation is the act turning the wrist in such a way that the hand is on its back side (like when typing on a computer). Supination is the act of turning the wrist so the palm of the hand is visible (when you are handed an object for example).
I feel pain when I lean on my elbow: how do I identify the pain?
Pain at the tip of the elbow, in the forearm, inside the elbow, swelling…
The outside of your elbow hurts when you perform certain very specific movements, and you wonder if you have tendinitis or bursitis?
It can be difficult to identify a problem when your symptoms can be indicative of different conditions.
Let’s take a look at an example. Tendinitis, which affects the tendons of the epicondylar muscles, and radial tunnel syndrome, which affects the radial nerve, can produce similar symptoms including pain on the outer elbow and forearm and/or loss of muscle strength.
Does the inside of your elbow hurt? Have you noticed any swelling? Does it hurt at certain times when you perform a particular movement?
How can you identify the origin of your elbow pain in order to treat it? Determining the cause of your pain on your own is extremely difficult. Consulting a health care professional is the best way to know the severity of your condition for sure.
Different conditions that can affect the elbow
Epicondylial tendonitis, external/lateral epicondylitis or tennis elbow: what are the causes? What are the symptoms? How to treat it?
Tendinitis affects the tendons of muscles. It is commonly referred to as tendinitis when inflammation is assumed, in the first few days, and then as tendinopathy, once the inflammation has passed.
Lateral epicondylitis, on the outside of the elbow, is a condition also known as tennis elbow, which affects athletes and non-athletes. It is an inflammation of the group of muscles that attach to the small bony ball on the outside of the elbow.
It is usually caused by the overuse of the muscle, or a high stress on the extensor muscles of the forearm, which are involved in the movements of the hand and wrist.
It is commonly associated with tennis players, because of its causes: repetitive jerky movements (such as throwing), or repetitive gestures (wrist extension).
However, lateral epicondylitis is not limited to athletes, since people whose professional activity requires significant mobilization of the wrist are also at risk.
For instance, this is the case for people who work in an office and/or in front of a computer, with an non-ergonomic workstation.
The main symptom of tennis elbow is pain on the outside of the elbow. Pain on the outside of the elbow is the main symptom of tennis elbow. It is often intermittent at first, i. e. it appears only during an effort or a movement, but it can settle over time and become constant, even when resting.
It may be painful to touch around the painful area, or to press on the outer side of the elbow.
The symptoms may include a decrease in grip strength (the ability to grasp and hold an object in your hand) and reduced elbow and wrist mobility.
When you experience symptoms similar to those of epicondylitis, it is recommended to limit the activity or movement that is causing pain as much as possible.
If this provides relief, you can also practice self-massage.
Once the inflammation phase is over, you can gradually resume your activities.
As soon as symptoms appear, or if the pain persists after several weeks and you do not feel any improvement, you may want to consult a healthcare professional.
Medial elbow tendonitis or golfer’s elbow
Medial epicondylitis is a tendonitis that affects the tendons of the flexor muscles of the wrist and fingers. The medial epicondyle is the name of the small bony protrusion on the inner side of the elbow. So, the pain is felt locally on the inner side of the elbow, and not externally as in the case of lateral epicondylitis.
Medial epicondylitis is caused by repeated flexion and pronation movements, which is why it affects many athletes, including golfers. This is why this condition is occasionally referred to as golfer’s elbow.
As with lateral epicondylitis, athletes are not the only ones affected. Working environments also play a role in this condition. Workers who have to handle objects like gardeners or labourers are particularly at risk.
Localized pain on the inside of the elbow is the main symptom of medial epicondylitis. When symptoms appear, the pain is often felt on impact, when performing the gesture in question.
Over time, the pain may settle and even be present when resting. In some cases, it may disrupt daily activities (due to the difficulties in grasping and holding an object), and the quality of sleep.
Bursitis
Bursitis is a condition that affects the bursae. Bursae are small sacs of fluid that ensure fluidity of movement around a joint. They also ensure the protection of bones and tendons. They can be compared to little cushions.
Bursitis occurs when these small sacs become inflamed.
In the elbow, bursitis is called olecranon bursitis, from the name of the inflamed bursa, which is located between the skin and the olecranon (the bony eminence at the tip of the elbow). This bursa is located on the tip of the elbow and has very little protection, so it can be easily injured.
Olecranon bursitis or elbow bursitis can be caused by a direct blow (impact or fall), repeated pressure on the elbow (on a desk at work for example), or repeated movements at work or while playing sports.
The main symptom is pain when the elbow is compressed or moving, but bursitis is easily recognized by the swelling it causes at the tip of the elbow. This small bump can be warm to the touch, appear right after the impact and sometimes last for days afterwards.
The sooner the bursitis is treated when symptoms appear, the more successful the healing process will be.
Osteoarthritis: what does it look like?
Osteoarthritis is a chronic disease that involves a progressive degeneration of the cartilage, which causes stiffness in the joint.
Risk factors include age and activities that put excessive strain on the elbow, as well as surgery.
A history of injury or trauma can also contribute to the development of the disease.
Osteoarthritis develops gradually. The impact on daily life can vary depending on the progression of the disease and the person affected. In the long term, it can lead to a loss of joint mobility.
One of the first symptoms of osteoarthritis is morning stiffness that goes away with moving or warming up the affected joint. Thereafter, pain could appear systematically during similar efforts/movements, and persist at rest.
Osteoarthritis can also lead to a loss of joint mobility and weakness.
It should be noted that symptoms of osteoarthritis can be experienced years after the onset of the disease.
How to relieve elbow pain?
If you start to feel pain in your elbow when performing specific movements or even when resting, the first thing to do is to limit as much as possible all pain-inducing efforts or movements.
If the pain is related to your job, take regular breaks during the day and try to stretch when the pain occurs. However, if these measures are not enough to control the pain, a leave of absence from work could be a good idea to prevent the condition from getting worse.
It is important to understand the difference between partial rest, which is recommended, and complete rest over a long period. The latter should be avoided, as complete rest for a long period of time may stiffen your joint. Partial rest however, allows you to maintain joint mobility within your tolerance, and thus to start and optimize the healing process.
You can also apply heat or cold, if it helps to relieve the pain. It is important to do this in short periods of time. To avoid burning or irritating the skin, always use a towel around it.
If partial rest works and your pain decreases, you can gradually resume your activities, while adapting the mechanical stress inflicted on your elbow.
As soon as symptoms appear or if they persist after several weeks, you should make an appointment with a healthcare professional. Physiotherapy and occupational therapy are both available to treat elbow pain.
How do you treat elbow pain? Physiotherapy or occupational therapy treatment
If you experience elbow pain or associated symptoms such as decreased mobility or strength, make an appointment with a healthcare professional to get the help you need.
When it comes to elbow pain, there are two possible scenarios. If the injury has just occurred, physiotherapy will be used to control and reduce the pain and prevent the injury from worsening, and then to rehabilitate the movement and strengthen the weakened muscles.
When returning to daily activities at home or at work, occupational therapy can then be recommended.
A physiotherapy or occupational therapy follow-up always begins in the same way, with an evaluation. Its purpose is to determine the extent and severity of your condition and to understand how it affects your daily life.
The assessment is the basis for developing your treatment plan. Remember that this plan is not set in stone; it can be adapted over time as the condition evolves.
Again, depending on the condition, its evolution and the patient’s pain tolerance, a treatment can include taping, stretching, muscle relaxing or strengthening
If you are currently experiencing elbow pain that interferes with the movement of your hand, forearm and wrist, make an appointment directly with one of our therapists.