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Download Versus Arthritis Elbow pain Elbow pain information booklet Contents How does the elbow work? 4 What causes elbow pain and stiffness? 6 Should I see a healthcare professional? 8 What can I do to help myself? 9 How are elbow problems diagnosed? 12 What treatments are there for elbow pain? 14 Specific elbow conditions 18 Glossary 26 Research and new developments 27 Keeping active with elbow pain 28 Where can I find out more? 32 We’re the 10 million people living with arthritis. We’re the carers, researchers, health professionals, friends and parents all united in Talk to us 33 our ambition to ensure that one day, no one will have to live with the pain, fatigue and isolation that arthritis causes. We understand that every day is different. We know that what works for one person may not help someone else. Our information is a collaboration of experiences, research and facts. We aim to give you everything you need to know about your condition, the treatments available and the many options you can try, so you can make the best and most informed choices for your lifestyle. We’re always happy to hear from you whether it’s with feedback on our information, to share your story, or just to find out more about the work of Versus Arthritis. Contact us at [email protected] Words shown are explained in the glossary on p.26. Registered office: Versus Arthritis, Copeman House, St Mary’s Gate, Chesterfield S41 7TD in bold Registered Charity England and Wales No. 207711, Scotland No. SC041156. Page 2 of 36 Page 3 of 36 Elbow pain information booklet How does the elbow work? Muscles attached to the outside of the humerus help you straighten your wrist and fingers. These are connected to the brain and nervous The elbow joint is where the long bone at the top of your arm, system through the radial nerve, which travels on the outside of the known as the humerus, meets the two bones in your forearm – elbow. called the radius and the ulna. It’s a hinge joint, and it allows you to bend your arm. The upper part of the radius can rotate so you Muscles attached to the inside of the humerus help you bend your can twist your forearm. wrist and fingers, and let you grasp objects. These muscles are connected to the brain and nervous system through the median The end of the humerus has two bony parts that you can feel at nerve, which runs in front of the elbow. either side of your elbow. These are: The ulnar nerve, which is on the inside of the elbow is mainly • the lateral epicondyle on the outside of your arm responsible for the movements of the small muscles of the hand (see • the medial epicondyle on the inside of your arm (see Figure 1). Figure 2). These are useful for precise and delicate hand movements. The feeling of hitting your funny bone is caused by the ulnar nerve Figure 1. Bones in the elbow being pinched. There are also strong cords in the elbow that help to hold the joint in place. Tendons attach muscles to bones and ligaments link bones together. Humerus Figure 2. Nerves in the elbow Median nerve Lateral Medial epicondyle epicondyle Ulnar nerve Radius Ulna Radial nerve versusarthritis.org Page 4 of 36 Page 5 of 36 Elbow pain information booklet What causes elbow pain and stiffness? Arthritis of the elbow Most elbow pain has a simple cause and clears up within a few days. The elbow can be affected by various types of arthritis. The pain usually comes from strained or inflamed soft tissues such Osteoarthritis is the most common form of arthritis. It starts with the as tendons or ligaments. You can normally treat these spells of pain loss of cartilage, which is a thin protective layer that covers bones yourself, with pain relief you can buy from a chemist or supermarket, in a joint. In response the body can grow bony spurs within the joint and a few days’ rest. You may not need to see your doctor. and there can be an increase of fluid in the joint space. This can Sometimes elbow pain may be caused by a medical condition. happen without you feeling any symptoms. But it can cause pain, swelling and stiffness in a joint. A number of things can cause stiffness in your elbow, including arthritis (arth-rye-tus). Stiffness can happen due to problems with the Osteoarthritis is not very common in the elbow unless you’ve injured elbow joint itself or with the muscles, covering of the joint, or ligaments. it in the past, for example if you’ve previously broken a bone. In some situations, such as after an injury or operation, soft tissue The following types of arthritis can also affect the elbow: can form into scar tissue. This can cause elbow stiffness. • rheumatoid (roo-ma-toyed) arthritis – an autoimmune condition Occasionally, the elbow may lock in a fixed position. This is often that can cause pain and swelling in joints. Joints can be red, hot, short-lived but may be due to a loose bit of bone or cartilage in the stiff and tender to touch joint. The loose fragments may need to be washed out in surgery. • psoriatic (sorry-atik) arthritis – an autoimmune condition associated with the skin condition psoriasis (so-rye-a-sis), that causes patches of red, raised skin with white or silvery flakes. It can cause pain and swelling in and around joints • gout – a type of arthritis that causes pain and swelling in joints. It’s caused by a build-up of crystals of the waste product urate in the joints. Affected joints can be very painful, and the skin can sometimes be red and shiny. For more information see the Versus Arthritis booklets: Osteoarthritis; Rheumatoid arthritis; Psoriatic arthritis and Gout You can view all our information online at: www.versusarthritis.org Page 7 of 36 Elbow pain information booklet What can I do to help myself? There are several ways you can help yourself if you have elbow pain. These include taking painkillers, applying heat or ice packs, changing your movements and exercising. Changing your movements The first thing to do if you have elbow pain is to change, or possibly stop, any movements that might be causing your symptoms or making them worse. Flare-ups of some conditions, where the symptoms become suddenly worse, can be eased by avoiding bending the elbow into certain positions. If you do any tasks for work that involve repetitive movements such as using a screwdriver or painting, it’s worth discussing this with an occupational therapist. These are healthcare professionals who can suggest how to change your movements and ways to support your elbow while it’s healing. Should I see a healthcare professional? A GP can refer you to an occupational therapist, or you can see Most cases of elbow pain will get better on their own or with simple one privately. self-help treatments. You should see a doctor if: If your workplace has an occupational health department, they • your pain doesn’t improve after two weeks of taking painkillers should be able to help. and resting your elbow, and you haven’t had an injury or infection To find out more information visit: • you have tingling, numbness or weakness in your arm or hand. www.nhs.uk/conditions/occupational-therapy You should visit a hospital’s accident and emergency department straight way if: Drugs to reduce pain • you notice symptoms such as severe pain that stops you from Drugs such as paracetamol may help to ease pain. You should moving your arm, swelling, fever, heat and redness. These can use them as and when you need them, but it’s best to take them sometimes be signs of infection. before the pain becomes very bad. • you think you’ve fractured your elbow – this will probably follow an Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs obvious injury such as a direct impact or fall onto an outstretched that can help ease pain, swelling and stiffness. A common NSAID is hand. A fracture will cause pain and usually bruising and swelling. ibuprofen, which you can buy at chemists and supermarkets. versusarthritis.org Page 8 of 36 Page 9 of 36 Elbow pain information booklet If you have stomach problems after using pain relief or NSAIDs, you Splints should stop taking the tablets and see your doctor. There are also For some conditions, such as tennis elbow, using a splint to support anti-inflammatory creams or gels you can rub onto your elbow, which your elbow may ease the strain when you’re doing certain activities don’t cause stomach problems. that cause it to flare up (see Figure 3). They’re available from chemists, sports shops and physiotherapists. They’re also known as For more information see the Versus Arthritis booklets: epicondylitis clasps. Ask a healthcare professional or a pharmacist if Painkillers and non-steroidal anti-inflammatory drugs a splint would help you, and when and how you should wear it. (NSAIDs) You can view all our information online at: Figure 3. An epicondylitis clasp www.versusarthritis.org Exercises To prevent your elbow joint stiffening and your arm muscles weakening it’s best not to rest for more than a few days. Start some gentle exercise as soon as the pain begins to ease. Simple exercises can help restore your range of movement, maintain your strength and ease stiffness. There are some examples of simple stretching and strengthening exercises at the back of this booklet.
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