1. Tennis elbow (lateral epicondylitis)
Intro: Tennis elbow, also known as lateral epicondylitis, is a common cause of elbow pain occurring at the lateral epicondyle, a bony protuberance at the end of the arm bone (humerus). This condition stems from overuse of the forearm extensor muscles resulting in inflammation of the common extensor tendon originating from the lateral epicondyle.
Symptoms: Tenderness on palpation of the elbow and pain with extension of the wrist.
Treatment: Physical therapy, medication, and ice. A tennis/golfer’s elbow band worn two fingers distal to the lateral epicondyle during activity use may help as well. A steroid injection can provide relief. Regenerative treatment such as plasma rich platelet (PRP) injection, which promotes healing of the tendon, is another treatment modality for this condition. Surgeries such as arthroscopic tenotomy (cutting tendon) may be considered in refractory cases.
2. Inner Elbow Pain
A. <18-year-old baseball player with inner elbow pain – Little League Elbow
Intro: Little league elbow is a condition of the elbow among young baseball pitchers. . It is often due to stress on the growth plate of the inner elbow bone (medial epicondyle) while pitching, resulting in widening of the growth plate. It may also be due to stress of the ligament attached the arm bone to forearm bone (ulnar collateral ligament).
Symptoms: Tenderness over inner elbow and on pitching.
Treatment: Rest and physical therapy, followed by limiting number of pitching. If suspected, it is advised stop throwing and to seek medical attention for evaluation as soon as possible.
B. >18-year-old with inner elbow pain – Golfer’s elbow (medial epicondylitis)
Intro: Golfer’s elbow, also known as medial epicondylitis, is a common cause of elbow pain occurring at the medial epicondyle, a bony protuberance at the end of the arm bone (humerus). This condition stems from overuse of the forearm flexor muscles resulting in inflammation of the common flexor tendon originating from the medial epicondyle.
Symptoms: Tenderness on palpation of the elbow and pain with flexion of the wrist.
Treatment: Physical therapy, medication, and ice. A tennis/golfer’s elbow band worn two fingers distal to the medial epicondyle during activity use may help as well. A steroid injection can provide relief. Regenerative treatment such as plasma rich platelet (PRP) injection, which promotes healing of the tendon, is another treatment modality for this condition. Surgeries such as arthroscopic tenotomy (cutting tendon) may be considered in refractory cases.
3. Distal biceps tendonitis
Intro: Tendonitis of the distal biceps tendon involves inflammation of the tendon caused by repetitive motion (overhead especially) or overuse. There may be degeneration of the tendon (tendinosis) as well.
Symptoms: Tenderness on palpation of the elbow and pain with flexion of elbow.
Treatment: Physical therapy and medications. A steroid injection near the tendon may help with this condition. Regenerative treatment such as plasma rich platelet (PRP) injection, which promotes healing of the tendon, is another treatment modality for this condition. Surgery may be considered in refractory cases.
4. Olecranon bursitis
Intro: Olecranon bursitis is a condition where the bursa located on the bony prominence of the elbow is swollen. There may be no obvious cause for the swelling or with associated injury.
Symptoms: Swelling with or without pain.
Treatment: It can be left alone if symptoms aren’t bothersome. Compression and sometimes needle aspiration can be done. Recurrent cases may require surgery. Occasionally, there may be infection of the bursa which will cause the bursa to appear red and feel warm. It is recommended to visit a physician as soon as possible for antibiotic treatment and drainage in this case.