The elbow is subjected to daily use through normal, everyday activities as well as during participation in sports activities. It’s not surprising that problems can develop in the elbow over time. Trauma, overuse, aging, and degenerative disorders, such as arthritis, can affect your elbows.
The elbow is a hinge joint where three long bones meet in the middle portion of the arm. The bone of the upper arm (humerus) meets the inner bone of the forearm (ulna) and the outer bone of the forearm (radius). The bicep muscle is the major muscle that flexes the elbow hinge. The tricep muscle is the major muscle that extends the elbow hinge. A fluid-filled sac (bursa), which serves to reduce friction, overlies the tip of the elbow. The elbow can be affected by inflammation of the tendons or the bursa, or conditions which affect the bones and joints, such as fractures, arthritis, or nerve irritation.
Many conditions that cause elbow pain can be managed without surgery through a treatment plan prepared by your orthopaedic doctor. Some of the more common problems are:
Most often these problems can be treated non-surgically. However, there are some conditions which may cause you to explore surgical options if you are experiencing elbow pain.
- Tendinitis, sometime referred to as “tennis elbow” occurs when the tendons attached to the elbow from the muscles of the forearm become injured, resulting in inflammation.
- Injury to the “funny bone” (ulnar nerve)
- “Golfer’s elbow”, inflammation at the point where the tendons of the forearm are attached to the bony prominence of the inner elbow.
- Bursitis, inflammation of the bursa at the tip of the elbow.
The bones of the elbow can break (fracture) into the elbow joint or adjacent to the elbow joint. Fractures generally require immobilization and casts, pinning or open joint surgery.
Arthritis of the Elbow
Inflammation of the elbow joint (arthritis) can occur as a result of many systemic forms of arthritis, including rheumatoid arthritis, gouty arthritis, psoriatic arthritis, and reactive arthritis. Range of motion of the elbow is decreased with arthritis of the elbow because the swollen joint impedes the range of motion. Generally, this is associated with signs of inflammation of the elbow joint, including heat, warmth, swelling, pain, tenderness, and decreased range of motion.
Elbow spurs are usually precipitated by years of overhead activities (pitching, tennis, etc.) which produced swollen bone linings that have developed spurs.
Fragments or loose “bodies” are usually caused by a trauma-related condition that causes decreased in blood supply, bone collapse, and cracking. “Bodies” already broken free from a cracked surface can be arthroscopically removed; however, the resulting pre-arthritic condition may leave the elbow unable to tolerate the stress of high-impact activities like gymnastics or baseball.
When possible, arthroscopic surgery is preferred by surgeons for spur removal and removal of bone fragments because traditional inpatient surgical techniques tend to produce significant loss of motion after the recovery period. In contrast, arthroscopic surgery is usually successful in restoring almost all motion and allowing a return to activities after the recovery period.
In some cases, total elbow replacement is necessary. During elbow replacement surgery, the damaged elbow areas are replaced with artificial parts (prosthesis). One part fits into the upper arm (humerus), and the other party fits into the forearm (ulna). The two parts are then connected and held together by a pin. The resulting hinge allows the elbow to bend. Successful joint replacement surgery may relieve your pain and stiffness, and allow you to resume some of your normal daily activities that otherwise you have been unable to do.
If you require total elbow replacement, you should take these points into consideration to ensure the success and longevity of your elbow replacement:
It is always important to stay healthy and active, but consult with your surgeon before beginning any new sport or activity, to find out what type and intensity of sport or activity is appropriate and its affects on your new elbow.
- Avoid repetitive lifting.
- Avoid “jamming” activities such as hammering.
- Avoid “impact” activities such as boxing, rugby or football.
- Avoid any physical activities involving quick stop-start motion, twisting or impact stresses on the operated elbow.
- Avoid pushing heavy objects.
The type of surgery you have, and your doctor’s recommendations, will determine how soon you can begin using your arm again after elbow surgery. Arthroscopic surgical patients may go home in a few hours after surgery, but will need to arrange to have someone drive them home because the pain medications and anesthesia are likely to make them sleepy. Total elbow replacement patients could remain in the hospital for one to three days.
Physical therapy is an extremely important part of the success of knee surgery and full participation by the patient is necessary for optimal outcome. Some degree of pain, discomfort, and stiffness can be expected during the early days of physical therapy.
The medical staff and therapist will teach you proper movements and exercises to do so that you can regain your strength and mobility in your elbow. Continue to move the way you were taught by the physical therapist and return to activity slowly. Don’t be surprised if you feel a little stiff at first, it may take a few months for a complete recovery. It is very important to keep all your scheduled follow-up visits with your surgeon.
For information on Chesapeake Orthopaedic & Sports Medicine Center physicians that specialize in the treatment of the elbow, click below.