Elbow Injuries
Topic OverviewEveryone has had a minor elbow
injury. You may have bumped your "funny bone" at
the back of your elbow, causing shooting numbness and pain. The funny-bone
sensation can be intense, but it is not serious and will go away on its own.
Maybe your elbow has become sore after activity. Elbow injuries can be minor or
serious and may include symptoms such as pain, swelling, numbness, tingling,
weakness, or decreased range of motion. Home treatment often can help relieve
minor aches and pains. Injuries are the most common cause of elbow
pain. Some people may not recall having had a specific injury, especially if
symptoms began gradually or during everyday activities.To better understand elbow injuries, you may want to review the structure and function of the elbow. See a picture of the elbow.
Elbow injuries occur most commonly
during: - Sports or recreational
activities.
- Work-related tasks.
- Work or projects around
the home.
- Falls.
Most elbow injuries in children occur during activities, such
as sports or play, or are the result of accidental falls. The risk for injury
is higher in contact sports such as wrestling, football, or soccer, or
high-speed sports such as biking, in-line skating, skiing, hockey, snowboarding, or
skateboarding. Elbows, forearms, wrists, hands, and fingers are the most
affected body areas. Any injury in a child or teen that occurs near a
joint may injure the growing end (growth plate) of long bones and needs to be
evaluated. Older adults have a higher risk for injuries and
fractures because they lose muscle mass and bone strength (osteoporosis) as they age. They also have more
problems with vision and balance, which increase their risk for accidental
injury. Sudden (acute) injuryAn acute injury may be caused
by a direct blow, penetrating injury, or fall or by twisting, jerking,
jamming, or bending an elbow abnormally. Pain may be sudden and severe.
Bruising and swelling may develop soon after the injury. Acute injuries
include: - Bruises from a tear or rupture of small
blood vessels under the skin.
- Injuries to
ligaments, the ropy fibers that connect bones to
bones around joints.
- Injuries to
tendons that connect muscles to
bones.
- Injuries to joints (sprains) that
stretch or tear the ligaments.
- Pulled muscles (strains) caused by overstretching
muscles.
- Muscle tears or ruptures, such as your biceps or triceps
in your upper arm.
- Broken bones (fractures) of the
upper arm bone (humerus) or the forearm bones (ulna or radius) at the elbow
joint.
- Dislocations of the elbow joint (out of its normal
position).
Overuse injuriesOveruse injuries occur when too much
stress is placed on a joint or other tissue, often by overdoing an
activity or through repetition of an activity. Overuse
injuries include: - Bursitis.
Swelling behind the elbow may be
olecranon bursitis (Popeye elbow).
- Tendinosis, which is a series of microtears in the
connective tissue in or around the tendon.
- Soreness or pain felt on the outside
(lateral) part of the elbow may be
tennis elbow (lateral epicondylitis). This is the most
common type of
tendinopathy that affects the elbow and most often is
caused by overuse of the forearm muscles. This overuse may occur during sports,
such as tennis, swimming, golf, and sports involving throwing; jobs, such as
carpentry or plumbing; or daily activities, such as lifting objects or
gardening.
- Soreness or pain in the inner (medial) part of the elbow
may be
golfer's elbow. In children who participate in sports
that involve throwing, the same elbow pain may be described as
Little Leaguer's elbow.
- Pinched nerves, such as ulnar nerve compression, which is the
pinching of the ulnar nerve near the elbow joint. This usually occurs with
repeated motions.
An
infection of the elbow may cause pain, redness,
swelling, warmth, fever, chills, pus, or swollen
lymph nodes in the armpit on that side of your body.
"Shooter's abscess" is an infection commonly seen in people who inject illegal
drugs into the veins of their arms. Elbow injuries such as bruises, burns, fractures, cuts, or punctures may be caused by abuse. Suspect possible abuse when an injury cannot be explained or does not match the explanation, repeated injuries occur, or the explanations for the cause of the injury change. TreatmentTreatment for an elbow injury may include
first aid measures; application of a brace, splint, or cast;
physical therapy; medicines; and in some cases,
surgery. Treatment depends on: - The location, type, and severity of the
injury.
- How long ago the injury occurred.
- Your age,
health condition, and activities, such as work, sports, or hobbies.
Check your symptoms to decide if and when
you should see a doctor. Check Your SymptomsDo you have an elbow injury? How old are you? Less than 5 years Less than 5 years 5 years or older 5 years or older Has it been more than a month since the elbow injury? Yes Elbow injury over a month ago No Elbow injury over a month ago Have you had elbow surgery in the past month? If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it. Yes Elbow surgery in the past month No Elbow surgery in the past month Have you had a major trauma in the past 2 to 3 hours? Yes Major trauma in past 2 to 3 hours No Major trauma in past 2 to 3 hours Do you have symptoms of shock? Are you having trouble moving your arm? Pain or swelling can limit movement. Can you move the elbow at all? Yes Able to move the elbow No Unable to move the elbow Have you had trouble moving your arm for more than 2 days? Yes Difficulty moving arm for more than 2 days No Difficulty moving arm for more than 2 days Is there any pain in the elbow? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 5 to 10: Moderate to severe pain Moderate to severe pain 1 to 4: Mild pain Mild pain Has the pain: Gotten worse? Pain is increasing Stayed about the same (not better or worse)? Pain is unchanged Gotten better? Pain is improving Do you have any pain in your elbow? How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Has the pain: Gotten worse? Pain is getting worse Stayed about the same (not better or worse)? Pain is unchanged Gotten better? Pain is getting better Has the pain lasted for more than 2 days? Yes Pain for more than 2 days No Pain for more than 2 days Is the arm blue, very pale, or cold and different from the other arm? If the arm is in a cast, splint, or brace, follow the instructions you got about how to loosen it. Yes Arm blue, very pale, or cold and different from other arm No Arm blue, very pale, or cold and different from other arm Was the elbow twisted or bent out of its normal position, even if it is back in place now? Yes Elbow is or was out of its normal position No Elbow is or was out of its normal position Do you have weakness, numbness, or tingling in your arm or hand that has lasted more than an hour? Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness. Yes Numbness, weakness, or tingling for more than 1 hour No Numbness, weakness, or tingling for more than 1 hour Do you think that the injury may have been caused by abuse? Yes Injury may have been caused by abuse No Injury may have been caused by abuse Do you think the problem may be causing a fever? Some bone and joint problems can cause a fever. Are there red streaks leading away from the area or pus draining from it? Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area? "Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps. Yes Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area No Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area Is there any swelling or bruising? Did you have swelling or bruising within 30 minutes of the injury? Yes Swelling or bruising within 30 minutes of injury No Swelling or bruising within 30 minutes of injury Has swelling lasted for more than 2 days? Yes Swelling for more than 2 days No Swelling for more than 2 days Have you had symptoms for more than a week? Yes Symptoms for more than a week No Symptoms for more than a week Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
Major trauma is any event that can
cause very serious injury, such as: - A fall from more than
10 ft (3.1 m) [more than
5 ft (1.5 m) for children under
2 years and adults over 65].
- A car crash in which any vehicle
involved was going more than
20 miles (32 km) per
hour.
- Any event that causes severe bleeding that you cannot
control.
- Any event forceful enough to badly break a large bone (like an arm bone or leg bone).
With severe bleeding, any of these may
be true: - Blood is pumping from the wound.
- The
bleeding does not stop or slow down with pressure.
- Blood is quickly soaking through bandage after bandage.
With moderate bleeding, any of these may
be true: - The bleeding slows or stops with pressure but
starts again if you remove the pressure.
- The blood may soak through
a few bandages, but it is not fast or out of control.
With mild bleeding, any of these may be
true: - The bleeding stops on its own or with
pressure.
- The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Symptoms of infection may
include: - Increased pain, swelling, warmth, or redness in or
around the area.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood
supply to the area. This can be serious. There are other reasons
for color and temperature changes. Bruises often look blue. A limb may turn
blue or pale if you leave it in one position for too long, but its normal color
returns after you move it. What you are looking for is a change in how the area
looks (it turns blue or pale) and feels (it becomes cold to the touch), and
this change does not go away. Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. - Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.
- Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.
- Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.
Pain in children 3 years and older - Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.
- Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.
- Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury. Symptoms of shock (most of which will be present) include: - Passing out (losing consciousness).
- Feeling very dizzy or
lightheaded, like you may pass out.
- Feeling very weak or having
trouble standing.
- Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly
after a sudden illness or injury. Symptoms of shock in a child may include: - Passing out (losing consciousness).
- Being very sleepy or hard
to wake up.
- Not responding when being touched or talked to.
- Breathing much faster than usual.
- Acting confused.
The child may not know where he or she is.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Put direct, steady pressure on the
wound until help arrives. Keep the area raised if you can. Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Postoperative Problems Elbow Problems, Noninjury Home TreatmentMost minor injuries will heal on
their own, and home treatment is usually all that is needed to relieve your
symptoms and promote healing. But if you suspect that you have a more severe
injury, use first aid measures while you arrange for an evaluation by your
doctor. First aid for a suspected broken bone- If a bone is sticking out of your skin, do not
try to push it back into your skin. It is better to leave the bone alone and
cover the area with a clean bandage.
- Control bleeding
from your injury.
- Remove all rings, bracelets, watches,
or any other jewelry from the injured arm immediately. It may be hard to
remove the jewelry if swelling occurs, which in turn can cause other serious
problems, such as nerve compression or restricted blood flow.
- Splint your injured arm without trying to straighten
it. Loosen the wrap around the splint if you develop signs that indicate the
wrap is too tight, such as numbness, tingling, increased pain, swelling, or
cool skin below the wrap. A problem called
compartment syndrome can develop.
If a cast or splint is applied, it is important to keep it
dry and to try to move the uninjured part of your arm as normally as possible
to help maintain muscle strength and tone. Your doctor will give you
instructions on how to
care for your cast or splint. Home treatment for a minor injuryHome treatment may
help relieve pain, swelling, and stiffness. - Remove all rings, bracelets, watches,
or any other jewelry that goes around your wrist or fingers of the injured arm.
It will be more difficult to remove the jewelry later if swelling increases.
- Use
rest, ice, compression, and elevation (RICE) to treat pain and swelling.
- Wear a
sling for the first 48 hours after the injury if it
makes you more comfortable and supports the injured area. If you feel you need
to use a sling for more than 48 hours, discuss your symptoms with your
doctor.
- An elbow support, such as an elbow sleeve, forearm wrap, or
arm sling, may help rest your elbow joint, relieve
stress on your forearm muscles, and protect your joint during activity. A
counterforce brace may be helpful for tennis elbow
symptoms. Follow the manufacturer's directions for using the
brace.
- Gently massage or rub the area to relieve pain and encourage
blood flow. Do not massage the injured area if it causes pain.
- For
the first 48 hours after an injury, avoid things that might increase swelling,
such as hot showers, hot tubs, hot packs, or alcoholic
beverages.
- After 48 to 72 hours, if swelling is gone, apply
heat and begin
gentle exercise with the aid of moist heat to help
restore and maintain flexibility. Some experts recommend alternating between
hot and cold treatments.
- If applying ice to your elbow does not
reduce the swelling, talk with your doctor about hydrocortisone gel treatments
(phonophoresis) with a physical therapist.
- Start exercises using
the MSA process (gentle exercise). MSA stands for movement, strength, and
alternate activities.
- Movement. Resume a
full range of motion as soon as possible after an injury. After 24 to 48 hours
of rest, begin moving the injured area. Stop any activity if it causes pain, and
give the injured area more rest. Gentle stretching will prevent the formation
of scar tissue that may decrease movement.
- Strength. Once the swelling is gone and range of motion is
restored, begin gradual efforts to strengthen the injured area. Hand grip
exercises can help you regain elbow strength. Using a small ball, such as an
old tennis ball, squeeze the ball 20 to 25 times holding each squeeze for about
5 seconds. After 2 to 3 weeks of hand grip exercises, you may begin forearm
exercises of extending or bending the elbow.
- Alternate activities. After the first few days but while the
injury is still healing, slowly add in regular exercise, such as activities or
sports that do not place a strain on the injured area. If certain activities
cause pain, stop doing those activities but continue doing your other
exercises.
- Do not smoke or use other tobacco products.
Smoking slows healing because it decreases blood supply and delays tissue
repair. For more information, see the topic Quitting Smoking.
Medicine you can buy without a prescription Try a nonprescription
medicine to help treat your fever or pain: |
---|
Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine. | Safety tips Be sure to follow these
safety tips when you use a nonprescription medicine: |
---|
- Carefully read and follow all directions
on the medicine bottle and box.
- Do not take more than the
recommended dose.
- Do not take a medicine if you have had an
allergic reaction to it in the past.
- If
you have been told to avoid a medicine, call your doctor before you take
it.
- If you are or could be pregnant, do not take any medicine other
than acetaminophen unless your doctor has told you to.
- Do not give aspirin to anyone younger than age 20 unless your doctor tells you to.
| Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Pain or swelling does not improve or it gets worse.
- Signs of infection develop.
- Numbness; tingling; or cool, pale skin
develops.
- Symptoms become more severe or more frequent.
PreventionThe following tips may prevent elbow
problems or injuries. General prevention tips- Wear your seat belt when you travel in a motor
vehicle.
- Do not use alcohol or other drugs before participating in
sports or when operating a motor vehicle or other equipment.
- Don't
carry objects that are too heavy.
- Use a step stool. Do not stand on
chairs or other unsteady objects.
- Wear protective gear during
sports or recreational activities, such as roller-skating or soccer. Supportive
splints may reduce your risk for injury. Make sure your child also wears protective clothing to prevent sports injuries.
- Stretch before and after
physical exercise, sports, or recreational activities to warm up your
muscles.
- Do
stretching and range-of-motion (ROM) exercises with
your fingers and wrist to prevent stiffening of the tendons that affect your
elbows. Gently bend, straighten, and rotate your wrist. If you have any pain,
stop the exercises.
- Use the correct techniques (movements) or
positions during activities so that you do not strain your
muscles.
- Avoid overusing your arm doing repeated movements that
can injure your
bursa or tendons. In daily routines or hobbies,
examine activities in which you make repeated arm movements.
- Take
lessons to learn the proper technique for sports. Have a trainer or person who
is familiar with sports equipment check your equipment to see if it is well
suited for your level of ability, body size, and body strength.
- If
you feel that activities at your workplace are causing pain or soreness from
overuse, call your human resources department for information on alternative
ways of doing your job or to discuss equipment modifications or other job
assignments.
Reduce fallsPreventing falls will help you to avoid
elbow injuries. To prevent falls: Keep bones strong- Eat a nutritious diet that includes enough
calcium and
vitamin D, which helps your body absorb calcium.
Calcium is found in dairy products, such as milk, cheese, and yogurt; dark
green, leafy vegetables, such as broccoli; and other
foods.
- Exercise and stay active. Talk to your doctor about an
exercise program that is right for you. Begin slowly, especially if you have
been inactive. For more information, see the topic Fitness: Getting and Staying Active.
- Don't
drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink
a day if you are a woman. People who drink more than this have a higher risk
for weakening bones (osteopenia). Alcohol use also increases
your risk of injuries related to falls.
- Do not smoke or use other
tobacco products. Smoking puts you at a much higher risk for developing
osteoporosis. It also interferes with blood supply and healing. For more
information, see the topic Quitting Smoking.
- Cut down on
caffeine. Caffeine in coffee and soda pop may increase calcium loss from your
body and increase your risk for osteoporosis.
Possible abuseInjuries such as bruises, burns,
fractures, cuts, or punctures may be a sign of
abuse. Suspect possible abuse when an injury cannot be
explained or does not match the explanation, repeated injuries occur, or the
explanations for the cause of the injury change. You may be able to prevent
further abuse by reporting it and seeking help. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What are your main symptoms?
- How long
have you had your symptoms?
- How and when did the injury occur? How
was it treated?
- Have you ever had any injuries to the same area? Do
you have any ongoing problems because of the previous injury?
- What
activities related to sports, work, or your lifestyle make your symptoms better
or worse?
- What home treatment measures have you tried? Did home
treatment help?
- What prescription and nonprescription medicines
have you tried? Did they help?
- Do you have any
health risks?
CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as ofApril 7, 2017 Current as of:
April 7, 2017 Last modified on: 8 September 2017
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