The elbow joint is what allows for the articulation of the forearm and provides stability and strength necessary to perform a wide range of actions such as lifting or throwing. Elbow conditions are injuries or diseases that cause pain, swelling, inflammation, and various other symptoms that can severely limit joint function and quality of life.

Elbow joint injuries and degenerative conditions can result from sudden trauma, wear and tear, or the progression of a disease like arthritis. These conditions can involve any of the bones, muscles, and connective tissues found in the elbow joint.

Elbow Anatomy

The elbow is a hinge-type synovial joint that is the point of articulation for three bones, the humerus of the upper arm as well the radius and ulna of the forearm. The articulating surfaces of each bone are separated by a layer of cartilage, with synovial fluid acting as a lubricant to provide smooth, frictionless movement. A synovial membrane encapsulates the entire elbow joint. The three bones in the elbow are connected to the arm muscles by ligaments that form the joint capsule.

The most important elbow ligaments are the medial collateral ligament, the lateral collateral ligament, and the annular ligament. The medial and lateral ligaments work to provide stability to the elbow joint, holding the humerus and ulna together, while the annular ligament holds the radial head close to the ulna.

The elbow bones are connected to arm muscles via tendons. The two key tendons are the biceps tendon and the triceps tendon. The forearm muscles cross the inside of the elbow and connect to the humerus in the upper arm.

Symptoms of Elbow Conditions

Common symptoms of elbow conditions include:

  • Dull aches and soreness in the elbow joint. Discomfort often gets worse at night or when at rest.
  • Loss in grip strength, or too painful to grip and lift objects (worse when the arm is outstretched).
  • Pain when trying to make a fist (known as golfer’s elbow).
  • Pain when opening the fingers outwards (known as tennis elbow).
  • Difficulty fully extending or raising the arm.

Common Elbow Conditions

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow describes inflammation or tearing of the tendons that connect the forearm muscles to the outside of the elbow. This injury typically occurs due to overuse and gradually gets worse over time, which is why it is associated with tennis players and other athletes who routinely activate this part of the body.

The symptoms of tennis elbow manifest slowly over time and can become exacerbated by continued activity. These symptoms include:

  • Pain or burning sensation on the exterior (outward facing) part of the elbow.
  • Weakened grip.
  • Pain during the evening or at rest.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform tennis elbow treatment surgery to help alleviate symptoms and return joint function.

Elbow Contracture

Elbow contracture (stiff elbow) describes a loss in range of motion of the elbow. This feeling of stiffness can severely impact a patient’s ability to perform tasks and engage in the same activities they are used to.

Symptoms of elbow contracture include:

  • Stiffness and inability to fully extend arm
  • Loss in range of motion
  • Inability to perform tasks

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform elbow contracture release surgery to help alleviate symptoms and return joint function.

Elbow Bursitis

The olecranon bursa is a small fluid-filled sac that sits at the tip of the elbow and serves to lubricate articulation. Elbow bursitis occurs when this sac becomes irritated or inflamed, leading to a buildup of fluid that expands the sac.

Common causes of elbow bursitis include sudden trauma, prolonged pressure, and infection. Signs and symptoms of elbow bursitis include:

  • Swelling at the elbow tip is usually the first sign of elbow bursitis. Because the skin at the tip of the elbow is loose, this swelling can take longer to become noticeable.
  • Increased swelling of the bursa eventually leads to elbow pain as the fluidic sac begins to stretch. The pain often gets worse when the elbow is bent or when any pressure is applied to it. As the pain worsens, it can limit range of motion.
  • Skin becomes red and warm if the bursa is infected, and this infection can spread around the body if not treated. The infected bursa can continue to swell until it opens and drains pus.

Bicep Tendon Tear at The Elbow

As the name implies, a bicep tendon tear at the elbow is when the tendon connecting the bicep muscle to the elbow becomes either partially or entirely torn (ruptured). This type of elbow injury is less likely to be chronic and is generally the result of sudden trauma.

Symptoms for this condition vary depending on severity. Common symptoms of a bicep tendon tear at the elbow include:

  • If the tendon ruptures, then an audible “pop” may be heard. This is usually followed by severe elbow pain that will subside over time.
  • Swelling and soreness at the front of the elbow.
  • Bruising of the inner elbow and forearm.
  • Weakness in bending the elbow and twisting the forearm (supination).
  • Bulge appearing in the upper part of the arm as the biceps muscle recoils.
  • A sunken gap in the front of the elbow where the tendon used to be attached. 

Triceps Tendonitis

Triceps tendonitis occurs when the tendon that connects the triceps to the humerus (funny bone) becomes inflamed. This condition typically results from overuse or sudden injury during physical activities.

Symptoms of triceps tendonitis include:

  • Pain and weakness felt in the triceps, shoulder, or elbow. Pain worsens when activating the triceps.
  • Clicking or snapping sensations in the elbow or shoulder.
  • Swelling at the rear of the elbow.
  • Limited range of motion due to pain felt when extending the arm.

Elbow Arthritis

Elbow arthritis can be both osteoarthritis and rheumatoid arthritis. Osteoarthritis diminishes the cartilage on the ends of the humerus, ulna, and radial head, which causes friction and elbow pain. Rheumatoid arthritis causes disease of the synovial joint lining and gradually diminishes bones and soft connective tissues.

Symptoms of arthritis affecting the elbow include:

  • Elbow pain that gets worse with the use of the arm (such as twisting or extending). If the pain worsens at night or at rest, then the arthritis is likely at an advanced stage.
  • Swelling of the joint.
  • Joint instability and stiffness with a severe impact on arm function.
  • Locking of the joint.

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform elbow arthritis surgery to help alleviate symptoms and return joint function.

Ulnar Nerve Compression (Cubital Tunnel Syndrome)

Ulnar nerve compression (also known as ulnar nerve entrapment) is when the ulnar nerve (which runs the entire length of the arm) becomes irritated or compressed. This condition frequently occurs at the elbow but can manifest anywhere along the arm, including the wrist and hand.

Compression of the ulnar nerve can occur for various reasons, such as leaning on the elbow for too long, bone spurs, arthritis, swelling, fluid buildup, and activities that require repeated bending and straightening of the elbow joint.

The symptoms of ulna nerve compression are typically felt in the hands and fingers, although they are frequently activated by elbow usage. Some of these symptoms include:

  • Tingling, numbness, and loss of feeling in the ring and pinkie fingers.
  • Reduced grip strength.
  • Difficulty performing precise tasks with fingers, such as typing on a keyboard or using a mobile phone.
  • Increased sensitivity to cold.
  • Elbow pain and tenderness, primarily on the inner side of the arm. 

Depending on your situation, your Melbourne Arm Clinic orthopaedic surgeon can perform ulnar nerve entrapment surgery to help alleviate symptoms and return joint function.

Elbow Fracture

Elbow fractures are a complete or partial break in one of the three bones that make up the joint. They are most often seen in the ulna as it is closest to the skin’s surface, with little muscle or soft tissue to protect it.

Elbow fractures usually occur due to direct trauma to the joint or by falling onto an outstretched arm. There is almost always intense pain and a ‘pop’ heard when the injury occurs, followed by other symptoms such as:

  • Pain and swelling at the site of the injury.
  • Bruising which can sometimes travel up or down the arm.
  • Tenderness of the area.
  • Numb sensation in one or several fingers of the affected arm.
  • Pain when trying to articulate the elbow, limiting function.
  • Joint instability and feeling as though the elbow will pop out of its socket.

Experiencing Elbow Pain?

If you are experiencing any of the issues listed above, you should seek medical diagnosis and treatment from an orthopaedic specialist. Contact Melbourne Arm Clinic to book an appointment or ask any questions about your issue and the treatment options available (such as total elbow replacement surgery).

Matthan Mammen
ELBOW, WRIST AND HAND SPECIALIST

Mr. Matthan Mammen

MS, FRACS (Orth)

Matthan is an internationally qualified orthopaedic surgeon, who is a Fellow of the Royal Australasian College of Surgeons and the Australian Orthopaedic Association.

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