The elbow is the joint that connects the forearm to the arm, allowing both flexion and extension as well as supination and pronation of the forearm.
It is a joint involved in numerous daily activities – from writing and talking on the phone to using the computer and cooking – and is also key in sports practice and creative activities. Given its importance in both daily life and in the sports field, any pain or injury can cause significant discomfort and affect the personal, professional, or sporting life of the person suffering from it.
In this article we will review the most frequent causes of elbow pain, from acute injuries due to trauma to damage from overuse or degeneration.
Common overuse injuries:
· Tennis elbow – Lateral epicondylitis, commonly known as tennis elbow, is the most common pathology causing lateral elbow pain. Despite its name, the population with the highest incidence of this pathology are people aged between 40-50 years within the working population, with the sectors of construction, manufacturing and commerce being the most affected. However, it can occur in people from other fields. It is characterized by localized pain on the outer part of the elbow, generally attributed to overuse or repetitive movements that cause inflammation or degeneration of the proximal extensor and supinator tendons of the forearm. Its symptoms can last between 6 months to 2 years, significantly affecting patients in their work or recreational life.
· Golfer's elbow – medial epicondylitis, or golfer's elbow, is the tendinopathy of the flexor and pronator muscles of the forearm. It presents symptoms similar to those of tennis elbow, but localized on the inner side of the elbow. Although its name associates it with golfers or throwing sports, the population with the highest incidence are people engaged in manual work that involves repetitive or forced gripping. It is less common than tennis elbow, but its management tends to be more complicated.
· Olecranon bursitis – olecranon bursitis is a common cause of swelling and discomfort at the back of the elbow, caused by the inflammation of the olecranon bursa. This condition can be triggered by repetitive mechanical irritation, direct trauma, infection or systemic inflammatory disorders. It can present in either septic or aseptic form, making it essential to distinguish between the two for safe and effective management.
Joint or nerve involvement:
· Arthritis – In the elbow, the most common type of arthritis is osteoarthritis, and it is due to the deterioration of the articular cartilage. It presents with pain and a possible reduction in mobility, with increased inflammation and crepitus during movement.
· Nerve compression syndromes – At the elbow, nerve compression syndromes can occur: cubital tunnel syndrome, due to compression of the ulnar nerve as it passes through the cubital tunnel, and radial tunnel syndrome, due to compression of the posterior interosseous nerve. Of the two, cubital tunnel syndrome is the most common. The usual symptoms of these nerve compression syndromes include numbness, tingling, and pain in the area innervated by the affected nerve. In the case of cubital tunnel syndrome, this is in the ring and little fingers and on the dorsal and ulnar side of the hand. In more advanced cases, grip weakness may appear.
· Referred cervical pain – Elbow pain does not always originate in the joint itself. Sometimes it comes from the cervical spine, either due to radiculopathy or mechanical involvement of the neck.
Traumatic injuries:
· Among the types of traumatic injuries, we find bone fractures, dislocations, tears or strains of muscles or ligaments. This can occur after a fall or blow in sports or an accident. The most common symptoms are immediate onset pain, swelling, bruising, and limitation of mobility; in more severe cases, there may be visible deformity or blockage of movement. Very intense pain, or changes in sensitivity or pulse in the hand, are warning signs and require urgent medical evaluation.
Each injury or pathology has its own characteristics and symptoms, so treatment does not follow the same protocol in all cases. In the event of elbow pain, seeking professional help is essential to obtain a differential and correct diagnosis and the most appropriate treatment.
References:
https://pmc.ncbi.nlm.nih.gov/articles/PMC6739751/
https://www.jshoulderelbow.org/article/S1058-2746(17)30791-7/abstract
https://pubmed.ncbi.nlm.nih.gov/30085542/
https://www.ncbi.nlm.nih.gov/books/NBK470291/
https://pubmed.ncbi.nlm.nih.gov/32474897/
