The Not-So-Funny bone
For decades and decades, elbows have been referred to as the ‘funny bone’ of the body. Anyone who has ever bumped his or her elbow against any inanimate object knows for darn certain that there is nothing funny whatsoever about the elbow. Discomfort in the elbow is real and tends to be persnickety. Elbows sustain a lot more stress during the day than most people realize. When adult elbow pain presents to our clinic, it is likely one of two pathologies: tennis elbow (lateral epicondylitis) or olecranon bursitis (inflammation of a bursa). Let’s explore!
Tennis elbow is a common pathology caused by overuse of the elbow, often in the form of repetitive motions (not necessarily swinging a tennis racket). The repetitive motion causes inflammation and swelling of the tendons that exist near the lateral epicondyle. That inflammation or tendinitis is uncomfortable and can make daily activities difficult, such as lifting a gallon of milk out of the refrigerator. The pain typically localizes to the outer aspect of the elbow and can radiate into the forearm to the muscles that attach to those tendons. Often, the symptoms are worse with activity and improve with rest.
The treatment for tennis elbow is not all that different from any other form of tendinitis: rest, ice, anti-inflammatory medications, and avoidance of aggravating activities. In particularly stubborn cases, a cortisone injection may be provided to help calm down the inflammation right at the source. An elbow support strap may be recommended by your physician in an attempt to remove the stress from the affected tendon. Often times, occupational therapy is prescribed to help stretch the area and re-train the muscles to function optimally. Tennis elbow doesn’t go away overnight because it doesn’t come on overnight. With commitment to the treatment plan and modification of activity, most people can resolve their symptoms and get back to normal pain-free functioning in due time.
Different from tennis elbow is olecranon bursitis. Bursitis is the inflammation of a bursa. Bursas are sacs of fluid that exist to prevent friction in the joints of the body. The olecranon bursa lives over the bony prominence of your elbow. This fluid-filled sac can become irritated from either friction or direct trauma, such as bumping your NOT-very-funny-bone. The trauma or stress causes an increase in the amount of fluid present in the sac which makes it red, swollen, and often uncomfortable. The pronounced fluid is visible and often requires some kind of conservative management as it can get infected under just the right circumstances. Our physicians often recommend avoidance of aggravating factors, compression, protective padding, ice, and anti-inflammatory medications. More aggressive treatments may include aspirating (or removing) the fluid to help relieve pressure. Your doctor may send the specimen to the laboratory to check for infection or gout that could be complicating the situation. If either infection or gout is discovered, different oral medications may be prescribed. If the bursitis is particularly stubborn, some physicians may inject a small amount of cortisone into the area to help calm down the inflammation long enough for symptoms to resolve. In rare cases of unrelenting bursitis often teamed with infection, surgical removal may be warranted but those cases are few and far between.
If you have been dealing with stubborn elbow pain unresolved by home remedies, give our office a call to schedule an appointment to get on the road to feeling better once again!