The elbow joint is surprisingly resilient to both wear and tear and injuries – but when elbow problems occur, they can be very disabling.
Simon Moyes and the Capital Orthopaedics team treat elbow conditions including Tennis Elbow, Golfer’s Elbow, loose bodies and elbow instability. Our arthroscopic surgeons, physiotherapists, radiologists and nurses provide expert diagnosis and treatment options that are based around minimal intervention and quick recovery times.
Your elbow is a hinge joint that connects your forearm bones (radius and ulna) to your humerus (upper arm bone). Like all joints, it is stabilised and mobilised by a system of tough fibrous ligaments and stretchy tendons. Other soft tissues and layers of cartilage provide cushioning and enable smooth movement. Nerves pass around the elbow, and are particularly exposed on the point of your elbow (your ‘funny bone’).
Many common elbow conditions are caused by wear and tear, but can also be caused by traumatic injuries such as a fall, high impact or wrenching movement.
This is chronic inflammation of the tendons on the outside of the elbow caused by overuse, typically in racquet sports. You are likely to feel pain and weakness, as well as difficulty holding or gripping objects.
Treatment: Most patients can be treated with physiotherapy, forearm supports and injections to reduce inflammation and promote healing. Shock wave therapy is also used to speed up the recovery process. Only very rarely is surgery required.
Golfer’s elbow is chronic inflammation of the tendons attached on the inside of the elbow. The condition is caused by overuse or repetitive strain of the tendons.
Treatment: A careful history and examination is performed and the diagnosis confirmed by a clinical assessment and normally an ultrasound scan. Patients will normally settle with rest, physiotherapy, splints and occasional injections or shock wave therapy. Surgery is very rarely needed.
Osteoarthritis is a degenerative bone disease often caused by repetitive actions or a traumatic injury. The slippery layer of cartilage on the joint surfaces gets worn away or torn. The friction caused by exposed bone and frayed cartilage leads to the bone wearing down, sometimes causing bony outgrowths (bone spurs or osteophytes). Symptoms include pain, swelling and reduced range of motion.
Rheumatoid arthritis is caused by an immune system reaction, where the joints become inflamed and the body attacks healthy tissue. It can also lead to cartilage and bone degeneration.
Treatment: earlier stages or minimal arthritis can be treated with physical therapy to improve mobility and strength around the joint. We also provide steroid or blood plasma injections to reduce inflammation and promote healing. More serious arthritis can be treated surgically by smoothing the rough surfaces and repairing any related tissue damage – or rarely with joint replacement.
Elbow instability causes the joint to feel weak, loose, unstable and painful. There are various types of instability requiring careful clinical assessment and imaging.
Treatment: Non-operative treatment involves exercise-based strengthening, avoidance of aggravating factors and bracing to restrict movement. For more complex and severe cases, elbow ligament reconstruction surgery may be required.
This is caused by overuse of the elbow joint and commonly affects people who play racquet sports, throw and box. You feel pain and tenderness at the back of the elbow when you try to straighten the joint. There may also be weakness and loss of power. For example, tennis players may notice their serving speed slows down.
Treatment: This condition is often treatable with physical therapy and steroid injections. If there is degenerative disease, then Hyaluronic Acid Analogue injections may be required to encourage healing. In more severe cases, keyhole surgery may be performed.
The distal biceps tendon attaches your biceps muscle to the radius bone of your forearm. It can get frayed and torn as a result of repetitive lifting motions (such as biceps curls) or it can completely rupture (suddenly lifting a very heavy weight). The symptoms are weakness in the upper arm, pain and swelling inside the elbow joint. A complete rupture can result in your biceps muscle detaching and bunching up in your upper arm.
Treatment: this condition is usually treated with a period of rest, followed by physiotherapy and injections to reduce inflammation and encourage healing. Complete tears may need surgical repair.
Pain, swelling and redness at the tip of your elbow is usually caused by damage to the soft, fluid filled sac called a bursa that provides cushioning in your joint. Also known as ‘student’s elbow’, it can be caused by repeated overhead throwing actions, a blow to the back of the elbow or repeated mild injury such as leaning your elbows on a desk. It can also be the result of an infection.
Treatment: anti inflammatory injections can reduce the pain and swelling. In some cases, the excess fluid can be drained using a syringe. In some cases, surgery may be necessary to remove the bursa.
The ulnar nerve passes through your elbow joint – if it gets pinched or injured, it causes pain around the inside of your elbow. It can be caused if you repeatedly lean on your elbow or bend your elbow for sustained periods – such as talking on the phone.
Treatment: rest and anti-inflammatory injections can help reduce inflammation. If symptoms persist, surgery may be necessary to release the nerve.
These are normally caused by trauma from a fall. You will usually hear or feel a snap or a crack in your elbow joint. The elbow will then become immediately painful, difficult to use and will swell rapidly. Any or all of the three main bones which make up the elbow joint (humerus, radius and ulna) can be involved in a fracture.
Treatment: Mild fractures can be treated non-operatively, but more serious ones may require surgery.
A loose piece of bone and/or cartilage breaks off from the articular surfaces inside the elbow joint. Patients experience intermittent episodes of acute pain and a locking of their elbow joint. It can be caused by an old injury, or as a result of arthritis in your elbow joint – where a minor trauma causes part of the arthritic bone to break off. Symptoms include pain, clicking, locking and a sensation of instability preventing usual sports and activities.
Treatment: If symptoms are significant, keyhole surgery may be necessary to remove the loose bodies.
Simon Moyes is an internationally renowned orthopaedic surgeon and leader in the field of arthroscopic (keyhole) surgery. His Capital Orthopaedics team works from The Cromwell Hospital in London, The Basinghall Clinic in The City and the Platinum Centre near Regents Park – with state-of-the-art diagnostic and surgical equipment and top sports medicine professionals.
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