Elbow Pain Physiotherapy in Bristol

The elbow is a hinge joint which connects the upper arm (humerus) to the forearm (radius and ulna). Its primary movements are to bend and straighten the elbow.

What are the common causes of elbow pain?

Common causes of musculoskeletal related pains tend to originate from bones, ligaments, tendons and muscles. These pains may be a result of an acute injury or a flare up of a long standing issue.

Common conditions of the elbow

Sprains and strains

Minor injuries to the elbow such as a mild sprain or strain should settle with time. They can often be managed very well at home.

A soft tissue injury to the elbow may result in the following:

Pain
Swelling
Bruising
Stiffness and loss of function

The pain can be particularly strong in the first three weeks as this is the inflammatory phase of your body healing itself. Typically, these injuries last 4 to 6 weeks depending on the severity.

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.

Up to date guidelines can be found on the NHS website:

Ibuprofen

Paracetamol

Go to an urgent treatment centre or emergency department if your arm:

has been injured and you heard a snapping noise or your arm has changed shape
is swollen and you have a very high temperature or feel hot and shivery
is extremely painful and difficult to move
tingles or feels numb

If:

the pain is severe or stopping you doing normal activities
the pain is getting worse and/or keeps coming back
the pain has not improved in any capacity after following the simple advice below
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Early Management of an elbow strain

Protect by minimising use of the affected arm and initially avoiding stretching the area which could cause further injury.

Rest can be beneficial in the very early stages of the injury (days 1-4). Complete rest, however, is not advisable. In the early stages, gentle active movements and specific exercises can help decrease pain and swelling, they also promote good tissue healing with less unwanted scar tissue and joint stiffness. It is important to move the shoulder and wrist gently so that these joints do not stiffen.

Ice pack/frozen peas wrapped in a damp cloth, placed on the swollen area for up to 20 minutes at a time, 3 times a day. So long as there is swelling you will need to continue ice therapy, often beyond the third week.

Please note only use ice if you have normal skin sensation
Check the skin regularly
Stop if there is excessive pain, numbness or tingling
Do not put ice directly on to the skin as this may cause a burn.

Compression of the elbow can be achieved by using a tubigrip or crepe bandage. It should compress firmly but not restrict blood flow and create a tourniquet. Remove if there are signs of poor circulation, or if you start to experience pins and needles or numbness.

Elevation. This is difficult for the elbow. If you have swelling in your arm sit on a chair and place your arm on cushions so it is supported.

Tennis Elbow

Pain felt on outside of elbow
Occasionally pain may travel down the forearm
Pain also felt during twisting forearm, opening a jar, and opening a door handle
Sometimes may feel difficulty in extending the arm

What is it?

Tennis elbow (lateral epicondylitis) is a condition that causes pain and tenderness around the outer elbow joint. It is called tennis elbow because it can be associated with repetitive forceful gripping activities such as encountered during racquet sports. It is also common amongst manual workers, although it can happen to anybody.

Usually, tennis elbow is caused by overloading the tendon that attaches your wrist muscles to your outer elbow joint. These muscles are the ones that cause your wrist to extend and twist, and fingers straighten. It is often aggravated by lifting, gripping and repetitive action of the wrist and hand.

Changes to the structure of the tendon cause pain to occur around the outer elbow joint, usually, close to where the tendon attaches to the bone, see picture below, discomfort can also be felt in the forearm.

Golfer’s Elbow

Pain felt on inside of elbow
Pain may travel down the forearm
Pain can be either on gripping the hand, flexing the wrist or rotating the forearm inwards.

What is it? 

Golfer’s elbow (medial epicondylitis) is a condition that causes pain and tenderness around the inner side of the elbow joint. The condition is called golfer’s elbow because it is associated with repetitive, forceful gripping and twisting activities of the wrist and fingers – a common activity with a golf swing. It also affects people who play sports that involve throwing such as cricket and baseball – as well as climbers or manual workers. However, the condition can affect anybody.

Usually, golfer’s elbow is usually caused by overloading the tendon that attaches the muscles in your forearm to the inner side of your elbow joint. These muscles are the ones that cause your wrist to bend and twist, and fingers curl. The pain is usually triggered by actions that require gripping such as bending the palm downwards and rotating the forearm inwards

Changes to the structure of the tendon cause pain and tenderness to occur around the inner elbow joint, usually, close to where tendons attach to the bone, but discomfort can also be felt into the forearm.

Pain on back of elbow, increases with elbow bending
Pain on leaning down on the elbow
Tenderness on the back of elbow
Noticeable swelling on back of elbow

Olecranon bursitis

What is it?

The olecranon bursa is a sac overlying the olecranon process (the bony tip) of the elbow beneath the skin. It reduces friction on movement between the skin, tendons, ligaments, and bone, and allows them to glide smoothly over one another.

Bursitis occurs when the bursa is irritated and inflamed. This can be as a result of overuse or trauma. It can be due to an infection within the bursal sac.

If there are any signs of infection (redness, heat, swelling and tenderness worsening or feeling unwell) this needs to be treated immediately.

Olecranon bursitis is more common in:

Young or middle-aged men.
People in jobs which involve risk of regular elbow trauma or pressure on the bursa. For example gardeners and mechanics.
Athletes who play sports which involve repetitive overhead throwing or elbow flexion and extension.

Most cases of olecranon bursitis resolve without complications; however, recurrent episodes may occur especially after recurrent minor trauma.

What are the common symptoms of olecranon bursitis?

Swelling over the elbow that appears over several hours to several days, may be tender or warm (but may be painless).
Movement at the elbow joint is painless except at full flexion when the swollen bursa is compressed.
There is a history of preceding trauma or bursal disease.
There is evidence of local skin abrasion.

Along with advice, manipulation, strapping, muscle stimulation and home exercises, The Storm Clinic can also offer you:

Acupuncture sessions could potentially improve joint mobility and reduce stiffness, allowing individuals to move more freely.
Bony spurs, or osteophytes, are bony outgrowths that often develop in osteoarthritis. Shockwave therapy is proven to help by breaking down calcifications or small bony growths, potentially reducing their size or impact on nearby tissues.
Laser therapy helps to accelerate the healing process, reduce pain and reduce swelling.

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