Common Causes of Elbow and Arm Pain

Elbow and Arm Pain causes are typically mechanical in nature. In other words, the pain is almost always due to problems in position or movement. Mechanical problems in this area are commonly the result of injury or microtrauma. This is common in sports injury and motor vehicle accidents. Rarely is pain cause by anything as serious as a tumor, or organic pathology. The following is a description of the more common causes of elbow and arm pain.

Arthritis & Olecranon Bursitis

Although the elbow is generally fairly stable, mechanical instability can result from trauma and overuse injuries. The misalignment can result in abnormal wear and tear on the elbow joint leading to inflammation. If the inflammation occurs in the joint, we would call that an arthritis. If the inflammation occurs in the fluid containing bursa, we would diagnose that as bursitis. The two are not mutually exclusive.

The elbow joint is made of three bones. The humerus (upper arm bone), the radius (outside lower arm bone) and the ulna (inside lower arm bone). These three bones come together at the elbow to form three different joints: humerus-radius, humerus-ulna, and Radius-ulna. The connection allows for bending of the elbow and rotation. The first two joints are synovial…they are bathed in fluid and surrounded by a capsule. The latter is simply a fibrous connection between the ulna and radius. Arthritis is most common in the connection between the humerus and ulna that does the majority of bending action. Arthritis can also develop in the humerus-radius connection that allows for rotation. You may notice popping or clicking and pain with movement. Arthritis can be caused by non-mechanical factors such as metabolic disease, auto-immune disease, or infection. These need to be ruled out and would be addressed medically if suspected.

Bursa are sacs of fluid around joints and areas of friction. These structures reduce friction. If there is inflammation in the bursa around the elbow (olecranon bursitis), then the bursa enlarges. You may notice a bump behind the elbow with painful restricted motion. Bursitis is typically mechanical in nature and a result of abnormal wear and tear just as arthritis.

Arthritis and bursitis are treated with modalities and medicines intended to reduce swelling and therapies intended to improve the mechanics.

Tendinopathies That Cause Elbow and Arm Pain

Various tendons around the elbow are prone to injury and repetitive overuse. The triceps, biceps, and brachioradialis muscles are the more common culprits. This typically occurs in weight lifters and manual laborers. Not only are the tendons involved, but the surrounding connective tissue which the tendon inserts onto can become painfully irritated. This is particularly common of the biceps aponeurosis. Rest and ice are good initial approaches. Machines such as electro-stim and ultrasound can also be helpful to decrease pain, spasm, and inflammation. Trigger point injections are an excellent method as well as any soft tissue methods such as scraping or massage. These problems tend to heal given the chance, but you may have to modify your workout or work methods to avoid future irritation.

Tennis Elbow Causes Elbow and Arm Pain

If you have pain on the outside of your elbow and into the forearm, you may be suffering from Lateral Epicondylitis, commonly known as “tennis elbow”. However, this is really less of a problem with the elbow and more a problem with the muscles in the forearm. These muscles run all the way from the hand and inserts into the elbow. These muscles can become damaged with repetitive overuse extension of the wrist (back-hand swing): hence the name “tennis elbow.”

Tennis elbow typically affects 30 to 50 year-olds, but it is also common for younger people to acquire this issue especially those who are just beginning a racquet sport like tennis. But, it’s not just racquet sports that can cause the issue, any activity that requires repetitive or forceful extension of the wrist can damage the extensor muscles leading to tennis elbow. Sufferers of tennis elbow typically feel pain with wrist extension, point tenderness in the forearm near the outside of the elbow, and even experience weakness in the hand or wrist (for example opening a jar, turning a doorknob, or shaking hands).

I typically treat lateral epicondylitis with soft tissue techniques; ultrasound or electro stimulation; manipulation of the hand, wrist, and elbow; taping; splinting; and a series of stretches and exercises. Of course, it is wise to discontinue the inciting activity, at least temporarily.

Golfer’s Elbow Causes Elbow and Arm Pain

Also known as Medial Epicondylitis, Golfer’s Elbow is a repetitive type soft tissue injury of the forearm muscles that creates tension and pain on the inside of the elbow. Besides pain and muscle tension in the forearm, golfer’s elbow can also produce numbness and weakness in the forearm and hand. Tennis elbow is generally caused by overuse of the forearm muscles responsible for gripping and turning the wrist palm downwards (pronation). Constant tension pulls on the muscle’s insertion on the elbow creating inflammation and pain. This does not just happen to golfers. Any activity that overuses the gripping and wrist muscles can cause golfer’s elbow. This includes:

• Golf
• Racket Sports
• Yard Work
• Using Tools (hammer, axe, wrench, screw driver)
• Typing
• Cooking
• Throwing Sports
• Painting
• Weight Training

Risk factors include age more than 40, obesity, and smoking. Treatment of golfer’s elbow typically includes soft tissue work to the muscles, stretches, exercises, manipulation of the wrist and elbow, ultrasound, and electro-muscle stimulation. Habit modification is also recommended. At times an assessment of the offending activity is necessary to evaluate how these activities can be modified.

Cubital Tunnel Syndrome Can Cause Elbow and Arm Pain

Cubital Tunnel Syndrome is an entrapment neuropathy at the elbow. Have you ever hit your “funny bone”? That’s the spot. The ulnar nerve passes through the inside of the elbow. So, when you hit that spot, it sends a shock down the arm. This same phenomenon can occur during a nerve entrapment at this location. However, a person with cubital tunnel syndrome will have the pain to a more constant degree. Generally, the pain and numbness is worse when the elbow is bent. This is common in the case that the elbow is bent during sleep. Symptoms of pain and numbness occur from the inside elbow to the forearm and into the pinky and ring finger. Typically manipulation of the joint and connective tissue of the elbow is effective. Rehab may be necessary to balance the muscles about the elbow.