Elbow pain: causes and treatment
Pain in the elbows occurs quite often and does not always mean that there is a development of the pathological process in the elbow joint.The danger of this symptom is that the diagnosis of a true disease that provoked the appearance of pain in the elbows is late, and this automatically makes the treatment longer and more difficult, in some cases, there is no recovery and the person becomes disabled. For pain in the elbow joint, first of all, you need to contact an orthopedist or a rheumatologist.
The presented material will address the main causes of elbow pain and general principles of treatment.Contents: «Tennis elbow" "elbow golfer" Osteoarthritis of the elbow joint deforming type of disease inflammatory ulnar tunnel syndrome, neuritis of the ulnar nerve Bursitis olecranon herniated disc and low back pain injuries of the elbow joint is Charcot( arthropathy Charcot) Hemophilia chondromatosis synovialShulman's disease( diffuse fasciitis) Ulbar joint tumor
"Elbow of a tennis player", "golf elbow" - epicondylitis of an external or internal nadrumlye shoulder
These pathologies arise against overloads and the main reason will be the same type, repetitive movements - for example, a computer mouse control, work at their summer cottage, exercise and managing general any mechanisms that require voltage flexor / extensor muscle brush.
characteristic of these diseases would be:
- pain during palpation places the tendon attachment;
- pain with active flexion of the hand( inherent to internal epicondylitis);
- pain with active extension of the hand( inherent in the external epicondylitis);
- the spread of discomfort down on the forearm;
- limited movement in the elbow joint.
General principles of treatment of external and / or internal epicondylitis are as follows:
- complete elimination of stress on the elbow.
- Carrying out physiotherapy procedures - laser therapy, magnetotherapy, electrophoresis and ultrasound will be effective.
- In the case of chronic course of the disease, a course of shock wave therapy is prescribed.
- Admission of anti-inflammatory drugs in the form of tablets and ointments / gels / creams( topical preparations) - Celebrex, Movalis, Nimesil and Naise.
- Selection of special therapeutic gymnastics.
If the described methods do not have an effect, the patient may be given a blockade at a particular pain point with an anesthetic and a glucocorticosteroid.Surgical intervention for external and / or internal epicondylitis is extremely rare.
Osteoarthritis of the elbow joint deforming type
extremely rare disease occurs as an independent pathology( the only exception is the state of post-traumatic arthrosis), most often affects the elbows at polyarthrosis.The pain in this case will bother with the load - for example, when carrying weights.The characteristic signs of the deforming osteoarthritis of the elbow joint are the restriction of movements and crunching, deformation of the joint.
General principles of treatment of the disease under consideration:
- Restriction of physical activity.
- Massage of the upper limb.
- Purpose of anti-inflammatory drugs during periods of exacerbation of pain in the elbows.
- The course of physical procedures - for example, magnetotherapy, UHF or electrophoresis.
- Selection of a complex of exercises from medical gymnastics.
Note: with deforming osteoarthritis of the elbow joint is required to be appointed by drugs of chondroprotectors groups, which are able to improve the metabolic processes in the cartilage tissue.These drugs include Structum, Arthra and Alflutop.
Diseases of inflammatory nature
The elbow joint can be affected by inflammation in many diseases - for example, gout, infectious arthritis, rheumatoid arthritis, psoriasis.In this case, the patient will complain of pain in the elbow joint, which is amplified even with minor movements to him and at night.The doctor will note that the patient is trying to keep his hand in a half-bent position, thereby reducing the intensity of the pain syndrome, the elbow joint stiffness develops.
In addition to the characteristic pain in the elbow joint, inflammatory processes will have an increased temperature of the skin immediately at the site of the joint, redness of the skin, stiffness after a period of rest.And if the pain in the elbows is caused by gout, then they will form specific nodules - tofusi.
General principles of the treatment of inflammatory processes:
- Conducting therapy for the underlying disease.
- Purpose of anti-inflammatory drugs.
- Complete exclusion of physical activity.
- The course of physiotherapy is laser therapy and magnetotherapy.
If arthritis is diagnosed purulent, then the patient must be prescribed antibacterial drugs.After relief of acute inflammation, patients should be engaged in therapeutic gymnastics, attend massage courses and receive appointments for the use of chondroprotectors.
Elbow Tunnel Syndrome
This disease develops on the background of compression of the ulnar nerve in the area of its passage in the bone groove of the elbow joint.The causes of such compression can be very different - for example, too frequent bending / unbending of the elbow, trauma, bony outgrowths.Pain in ulnar tunnel syndrome starts from the elbow, spreads over the forearm and irradiates in 4 and 5 fingers of the hand.This symptom is always accompanied by numbness of the skin at the site of pain.
To diagnose "ulnar tunnel syndrome", the doctor conducts the simplest test - strikes with a hammer on the ulnar fissure, and the patient at this time appears tingling or lumbago on the forearm to the little finger.
General principles for the treatment of ulnar tunnel syndrome:
- The maximum possible limitation of loads, in some cases, the fixation of the joint by orthosis is required.
- Purpose of anti-inflammatory drugs, antidepressants and anticonvulsants.
- Taking vitamins of group B.
If the pain is too intense and simple therapy does not work, the patient is given a blockade with an anesthetic and a glucocorticosteroid directly into the area of nerve infringement.It is extremely rare, but there is a place to be, surgical intervention.
Neuritis of the ulnar nerve
This is an inflammation of the ulnar nerve, which can develop as a result of hypothermia, trauma or valgus deformity of the joint.The pain in this case will be localized directly in the elbow joint, it is, more often than not, aching.As a secondary symptom of the ulnar nerve neuritis - numbness of the 4th and 5th fingers of the hand, a decrease in strength in them.The treatment of the pathological process under consideration consists in the drug therapy ( vascular preparations, diuretics, analgesics, B vitamins, non-steroidal anti-inflammatory drugs).
.After relief of acute neuritis, the patient is prescribed massage, therapeutic gymnastics and physiotherapy( electrophoresis and phonophoresis).
At the top of the elbow joint is a subcutaneous bag that is filled with synovial fluid.If an injury occurs, or there is a constant rubbing of this area on the table, this bag can become inflamed.A similar pathological process can develop against rheumatoid arthritis and gout.
The diagnosis of bursitis of the ulnar process does not present any difficulties: with a bent arm, a rounded formation appears on the joint, which has a soft consistency and is not very painful.If bursitis develops purulent, the patient will complain of severe pain in the elbow joint, swelling and redness of the skin at the site of the lesion.
General principles of treatment:
- Absolute rest is provided to the joint, it is often necessary to apply a fixative bandage.
- Non-steroidal anti-inflammatory drugs are prescribed that will relieve pain and stop the progression of the pathological process.
- Local compresses with dimexid or alcohol are put.
- An antibiotic or glucocorticosteroid is injected into the cavity of the bag( with a severe bursitis of the elbow joint).
After acute inflammation has been stopped, physiotherapy is allowed.If the recurrence of bursitis is too frequent, the doctors prescribe surgical treatment - during the operation the bag is excised.
Intervertebral hernia and osteochondrosis
If a hernia or osteochondrosis develops in the upper thoracic and inferior part of the spine, then the pain in the elbow joint will be present because of the infringement of the nerve roots.The pain is very characteristic - burning or constantly aching, which depends on the level of the load on the arm.The patient can not bend his arm at the elbow, it becomes very weak, and the sensitivity of the skin is broken across the entire area of the forearm.
Treatment for osteochondrosis and / or intervertebral hernia is always complex - acupuncture, medication( non-steroidal anti-inflammatory drugs, blockades with anesthetics, B vitamins, chondroprotectors), massage, therapeutic gymnastics.If the therapeutic treatment does not give a positive result, then doctors recommend surgical treatment - surgery on the spine.
Injuries to the elbow joint
Implied injuries of the elbow joint, forearm dislocation, fractures of bones, rupture of the biceps tendon.It is worthwhile to know that in case of pain, swelling, joint deformity, restriction of movements in the elbow after trauma, it is necessary to consult a doctor for an accurate diagnosis, which can only be done by radiography.
Treatment of elbow joint injuries is carried out in a strictly individual order, but may include:
- Dislocation direction.
- Surgical intervention for rupture of the biceps tendon.
- Comparison of bone fragments by hand at fractures with displacement.
- Complete immobilization of the joint.
- Medication therapy - the appointment of analgesics and non-steroidal anti-inflammatory drugs.
It is compulsory in the recovery period to need rehabilitation - massage, medical gymnastics, physiotherapy.
Sharko joint( arthropathy of Sharko)
This pathology affects not only the elbow joint, 2-3 different joints can suffer at once.Most often, Charcot's arthropathy is observed in systemic diseases - for example, against the background of late stage syphilis, diabetes, syringomyelia.
Charcot's arthropathy is characterized by dystrophic changes of the elbow joint, it becomes edematous, unstable, its motor function suffers.
Treatment of the examined pathology consists in therapy of the underlying disease, complete restriction of mobility of the elbow joint with a rigid orthosis .If the symptoms of the pathology are expressed too intensively, the patient undergoes surgical intervention( endoprosthetics).
This disease is characterized by poor blood coagulability.Pain in the elbows can occur with a bruised joint - it will form a bruise, the joint cavity will fill with blood.The patient will note not only expressed pain, but also puffiness of the elbow joint, restriction of movement in it.
To avoid pain in the elbows with bruises on the background of hemophilia, you need not only to conduct blood aspiration in a timely manner from the joint cavity, but also to observe the prevention of injuries.
This is a disease of cartilaginous tissue, when the formation of cartilage is disturbed and free cartilaginous fragments are formed in the joint cavity.The development of this disease begins as early as childhood, the symptoms are deformation of the bones and shortening of the upper and lower extremities.
Pain in the elbow joint on the background of synovial chondromatosis will occur when the arm is bent and unbent.Over time, the pain becomes permanent, the elbow joint swells and becomes stiff.
Treatment in this case is only appropriate surgical, which consists in the removal of cartilage bodies .
Schulman's disease( diffuse fasciitis)
This is a disease of connective tissue.In the films that cover the periarticular muscles( fascia), a chronic inflammatory process develops.In addition to constant, pulling pain in the elbow, the patient complains of loss of mobility in the joint.
Treatment will be effective only if diffuse fasciitis has been diagnosed at an early stage of its development of .The patient is prescribed glucocorticoids and cytotoxic drugs within the framework of therapy, and after the acute inflammation is stopped, massage, therapeutic gymnastics and physiotherapy.
Traction of the elbow joint
Pain in the elbows in the tumor process first appears suddenly, has a short-term character and disappears without the intervention of doctors.But as the pathological process progresses, the syndrome becomes more pronounced, it is not removed even by powerful analgesics.In addition to the characteristic pain, the patient has a sharp weight loss, increased fatigue, minor, but constant increases in temperature - small signs of cancer.
Treatment of tumors of the elbow joint is only surgical, the volume and method of operation depends on the nature of the neoplasm( benign or malignant), the exact location of the tumor and its size .
Pain in the elbows is always a symptom of a progressive pathology.The sooner a true disease is diagnosed, the more effective the treatment will be.Therefore, doctors insist on immediate treatment in a medical institution, even with unstable and unexpressed pain in the elbows.
Tsygankova Yana Aleksandrovna, medical reviewer, therapist of the highest qualification category