Patients may experience pain in either the medial (inner), lateral (outer) or posterior (back) aspect of the elbow. Elbow pain may be the result of either acute trauma or repetitive/overuse syndromes.
Acute Elbow Injuries
- Medial collateral ligament rupture (often associated with an elbow dislocation)
- Bicep/tricep tendon ruptures (rare)
What can Physiotherapy do?
Physiotherapy or medical review is required with these injuries. Treatment will depend on the type, location and severity of injury.
Some of the Most Common Causes of Elbow Pain:
Lateral Elbow Pain
The most common cause of lateral elbow pain is otherwise known as ‘Tennis elbow’ – a tendinosis of the extensor carpi radialis brevis (ECRB) tendon just below its attachment to the lateral epicondyle. Patients complain of pain around the lateral aspect of the elbow, often referring into the forearm muscles usually during activities that involve wrist extension (bending the wrist backwards) or gripping. It is more commonly an overuse syndrome associated with a change in sports training, equipment, technique or an increase in computer work or house renovations for example.
Other causes of lateral elbow pain include; posterior interosseous nerve entrapment, radiohumeral bursitis or radial head or capitellum osteochondritis in younger athletes.
Medial Elbow Pain
‘Golfers elbow’ is the medial equivalent of ‘tennis elbow’ and a tendinosis of the forearm flexor muscles. Patients complain of pain over or just below the medial epicondyle with tenderness and tension through the forearm flexor muscles.
Medial collateral ligament sprain may occur following trauma or as a result of repetitive valgus stress in throwers. Patients are tender over the ligament, possibly have swelling and instability on testing.
Patients experiencing posteromedial elbow pain with pins and needles in the forearm extending into the pinky and ring fingers of their hand may have ulnar nerve compression.
Posterior Elbow Pain
Olecranon bursitis occurs when the bursa at the back of elbow fills with blood and fluid. This may occur following direct or repeated trauma or sustained pressure on the posterior elbow.
Triceps tendinopathy, impingement and olecranon bursitis are the main causes of posterior elbow pain.
What will a Physiotherapist do?
Physiotherapists will thoroughly assess the elbow, wrist, neck, middle back and neural structures to identify involvement of other structures that may be contributing to your elbow pain. Treatment involves a combination of treatments including; pain management/advice, activity modification, joint mobilisation, massage techniques, acupuncture, bracing/taping and patient specific stretching and strengthening exercises. Corticosteroid injections or autologous blood injections may be required. Surgical review may be indicated in some cases.