Elbow Problems

Elbow Problems

The most common elbow problems I see in my clinic setting are:

Tennis Elbow & Golfer’s Elbow

These conditions are very common in both sportsmen and the ordinary working population. It is related to an overuse tendinopathy of the wrist extensor tendons for tennis elbow (pain on outside of elbow) and the wrist flexors for golfer’s elbow (pain on the inside of the elbow). Usually, this is a clinical diagnosis; however, if imaging is needed to establish the diagnosis an ultrasound scan will usually suffice.

A wrist muscle stretching and eccentric strengthening programme is always the 1st line treatment option perhaps with a trial of NSAID’s. However, if this 1st line treatment is unsuccessful then 2nd line treatment s must be considered.

Dr Davies has expertise in managing chronic tendon problems like these and will advise you of the best next treatment modality. 2nd line treatments he can offer include Extracorporeal Shock Wave Therapy (ESWT), steroid injections, injections of platelet rich plasma (PRP) and acupuncture. He will outline the advantages and disadvantages of the various treatment options before proceeding in a particular direction.

Olecranon Bursitis

This common elbow problem presents as a painful swollen elbow, over the bony olecranon at the tip of the elbow. The olecranon bursa becomes swollen and painful often related to repeated friction of the elbow. Whilst many of these are self-limiting the swelling can become quite unsightly as well as painful. Investigations are rarely needed. An examination will confirm the diagnosis and exclude any associated infection. A needle can remove the fluid and at the same time a steroid is injection to reduce the risk of recurrence of this simple but often troublesome problem.

Elbow Impingement

Elbow impingement usually causes pain at the back of the elbow and is commoner in people who perform repeated forced elbow extensions eg swimming, boxing, tennis etc. The bony tip of the elbow (olecranon) is repeatedly forced into the groove at the back of the elbow. These repeated movements can cause inflammation of the sift tissues at the back of the elbow and may cause bony spurs to develop in the region. The impingement symptoms can be due to soft tissue or bony impingement or a combination of both. Plain x—rays may be useful as may diagnostic ultrasound in skilled hands. Upper limb rehabilitation may improve the symptoms. Some cases respond well to a local steroid injection. Resistant cases may require keyhole surgery to rectify the problem. Such cases may take 2-3 months to fully recover.