Elbow pain has several common causes from ligament and tendon injuries to arthritis.
Tennis and Golfer’s Elbow
Two common causes of elbow pain are Tennis Elbow and Golfer’s Elbow. Tennis elbow involves the tendons from the muscles in the forearm on the outside, or lateral, part of the elbow. Tennis Elbow involves the muscles used for extending the wrist. It is named after the motion of a backhand swing in tennis. Golfer’s Elbow affects the inside, or medial, part of the elbow. The muscles involved in Golfer’s Elbow are used for flexing the wrist. It is named after the motion in a golf swing. Tennis and Golfer’s Elbow can occur from any type of repetitive overuse of either the extensor or flexor muscles in the forehand, though.
Both Tennis and Golfer’s Elbow initially develop as tendonitis. The repetitive overuse of the muscles involved in the respective motions of the wrist cause the tendons to become inflamed, thus resulting in pain. This pain can be treated conservatively with rest, bracing, ice, and NSAIDs. If these treatments don’t work, then a steroid injection can be performed. If the pain is prolonged and severe enough, surgery is also an option. These injuries can usually be diagnosed without any imaging. If surgery is being considered, then MRI or ultrasound may be ordered.
Eventually, if there are repeated bouts of acute tendonitis to these tendons the injury will transform into chronic tendinosis (or tendinopathy). Over time, the inflammation that was originally present and causing pain has caused the tendons to degenerate. At this point, there is no longer an inflammation. As a result, chronic tendon injuries will not respond to the same treatments as acute tendonitis. In this case, Platelet-Rich Plasma (PRP) can help heal the chronically damaged tendons. The PRP will actually help treat the underlying cause of pain here in order to heal the injury and avoid surgery.
Ligament Sprains or Tears of the Elbow
Elbow sprains can occur when the ligaments that support the bones in the elbow joint are stretched or torn. The Ulnar Collateral Ligament (UCL) is commonly injured in athletes and usually requires surgery to repair it in order to heal. This ligament is located on the inside, or medial, part of the elbow. This injury can be diagnosed with MRI or ultrasound. If it is not fully torn, then it may be treated conservatively with rest, bracing, ice, physical therapy and pain medications. Regenerative Medicine injections can play a role here, as well. Platelet-Rich Plasma (PRP) or Stem Cell Therapy can help heal the injured ligament.
Elbow pain can also be caused by arthritis. Arthritis typically develops as we get older. The wear and tear on the joint causes the cartilage to wear out. This puts additional stress on the joint and can lead to pain. X-ray can help diagnose elbow arthritis. Gout is another type of arthritis that can affect the elbow joint. Elbow pain from arthritis can be treated conservatively with rest, NSAIDs, ice, bracing, and physical therapy. Steroid injections can also be performed if needed to help reduce pain.
Tendon injuries are another type of soft tissue injury that results in joint pain. There are two main types of tendon injuries that can be classified as either acute or chronic. Acute means for a short period of time such as days to months, whereas chronic means for a long period of time such as months to years. Acute tendon injuries are known as tendonitis, which literally means inflammation of the tendon. This is because acute tendon injuries result in inflammation as the mechanism of injury. That is why treatment is aimed at reducing inflammation including rest, ice, and NSAIDs. On the other hand, chronic tendon injuries are termed tendinosis or tendinopathy. The reason there is no “-itis” in the chronic tendon injury is because there is no longer inflammation present. Multiple acute injuries eventually result in chronic degeneration of the tendon rather than inflammation. That is why treating a chronic tendon injury with rest, ice, and NSAIDs like it’s an acute injury will no longer help.
Once the injury transitions to chronic from repeat acute insults to the tendon, then it is time to consider other treatment options. This is the primary indication for Regenerative Medicine. Platelet-Rich Plasma (PRP) can help heal damaged tendons. Platelets are rich in growth factors and other proteins that promote a healing response. When an injected at the site of an injury they can help the body heal itself.
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