Ankylosing Spondylitis

What is elbow pain?

Most elbow pain has a very simple cause and clears up within a few days. The pain usually comes from strained or inflamed soft tissues such as tendons. You can normally treat this pain yourself with over-the-counter painkillers and a few days’ rest, and you may not need to see your doctor.

It’s important not to rest for too long as lack of movement causes your joint to stiffen and the muscles around your elbow to weaken, which increases the chance that you’ll have further symptoms. Simple exercises can help to reduce the risk of future problems. Long-term elbow pain can be caused by arthritis.

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.

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. 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.

Causes

Most cases of elbow pain are due to strained or inflamed soft tissues such as tendons or ligaments.

These tend to get better after a few days with simple self-care you can do at home.

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). Arthritis simply means a joint that is painful and swollen, and there are a number of types of arthritis.

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. Autoimmune conditions are caused when your immune system, which normally protects you from illness and infection, gets confused and mistakenly attacks the body’s healthy tissue.
• 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.