Versus Arthritis elbow pain information booklet

Elbow pain

Elbow pain information booklet

We're the 10 million people living with arthritis. We're the carers, researchers, health professionals, friends and parents all united in 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 content@

Registered office: Versus Arthritis, Copeman House, St Mary's Gate, Chesterfield S41 7TD Registered Charity England and Wales No. 207711, Scotland No. SC041156.

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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

Talk to us

33

Words shown in bold are explained in the glossary on p.26.

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Elbow pain information booklet

How does the elbow work?

The elbow joint is where the long bone at the top of your arm, known as the humerus, meets the two bones in your forearm ? 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 can twist your forearm. The end of the humerus has two bony parts that you can feel at either side of your elbow. These are: ? the lateral epicondyle on the outside of your arm ? the medial epicondyle on the inside of your arm (see Figure 1).

Figure 1. Bones in the elbow

Humerus

Lateral epicondyle

Radius

Medial epicondyle

Ulna



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Muscles attached to the outside of the humerus help you straighten your wrist and fingers. These are connected to the brain and nervous system through the radial nerve, which travels on the outside of the elbow. Muscles attached to the inside of the humerus help you bend your wrist and fingers, and let you grasp objects. These muscles are connected to the brain and nervous system through the median nerve, which runs in front of the elbow. The ulnar nerve, which is on the inside of the elbow is mainly responsible for the movements of the small muscles of the hand (see Figure 2). These are useful for precise and delicate hand movements. The feeling of hitting your funny bone is caused by the ulnar nerve 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. Figure 2. Nerves in the elbow

Median nerve

Ulnar nerve

Radial nerve

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Elbow pain information booklet

What causes elbow pain and stiffness?

Most elbow pain has a simple cause and clears up within a few days. The pain usually comes from strained or inflamed soft tissues such as tendons or ligaments. You can normally treat these spells of pain yourself, with pain relief you can buy from a chemist or supermarket, and a few days' rest. You may not need to see your doctor.

Sometimes elbow pain may be caused by a medical condition.

A number of things can cause stiffness in your elbow, including arthritis (arth-rye-tus). Stiffness can happen due to problems with the elbow joint itself or with the muscles, covering of the joint, or ligaments.

In some situations, such as after an injury or operation, soft tissue can form into scar tissue. This can cause elbow stiffness.

Occasionally, the elbow may lock in a fixed position. This is often short-lived but may be due to a loose bit of bone or cartilage in the joint. The loose fragments may need to be washed out in surgery.

Arthritis of the elbow

The elbow can be affected by various types of arthritis. Osteoarthritis is the most common form of arthritis. It starts with the loss of cartilage, which is a thin protective layer that covers bones in a joint. In response the body can grow bony spurs within the joint and there can be an increase of fluid in the joint space. This can happen without you feeling any symptoms. But it can cause pain, swelling and stiffness in a joint. Osteoarthritis is not very common in the elbow unless you've injured it in the past, for example if you've previously broken a bone. The following types of arthritis can also affect the elbow: ? rheumatoid (roo-ma-toyed) arthritis ? an autoimmune condition

that can cause pain and swelling in joints. Joints can be red, hot, stiff and tender to touch ? 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:

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Should I see a healthcare professional?

Most cases of elbow pain will get better on their own or with simple self-help treatments. You should see a doctor if:

? your pain doesn't improve after two weeks of taking painkillers and resting your elbow, and you haven't had an injury or infection

? you have tingling, numbness or weakness in your arm or hand.

You should visit a hospital's accident and emergency department straight way if:

? you notice symptoms such as severe pain that stops you from moving your arm, swelling, fever, heat and redness. These can sometimes be signs of infection.

? you think you've fractured your elbow ? this will probably follow an obvious injury such as a direct impact or fall onto an outstretched hand. A fracture will cause pain and usually bruising and swelling.



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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. A GP can refer you to an occupational therapist, or you can see one privately. If your workplace has an occupational health department, they should be able to help.

To find out more information visit: nhs.uk/conditions/occupational-therapy

Drugs to reduce pain

Drugs such as paracetamol may help to ease pain. You should use them as and when you need them, but it's best to take them before the pain becomes very bad. Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs that can help ease pain, swelling and stiffness. A common NSAID is ibuprofen, which you can buy at chemists and supermarkets.

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