Health Library Elbow Problems, NoninjuryFrom Healthwise

At one time or another, everyone has had an elbow problem that may have caused pain or swelling. Most of the time our body movements do not cause problems, but it's not surprising that symptoms develop from everyday wear and tear or overuse.

Elbow problems can be minor or serious and may include symptoms such as pain, swelling, numbness, tingling, weakness, or changes in temperature or color. Home treatment often can relieve minor aches and pains. To better understand elbow problems, you may want to review the structure and function of the elbow. See an illustration of the elbow.

Conditions that may cause elbow symptoms

• Osteoarthritis may cause pain that is worse in the morning but improves during the day. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, can also affect the elbow.
• A pinched nerve can cause elbow pain with numbness and tingling.
• A problem elsewhere in the body, such as a heart attack, can cause referred pain in the elbow.

Overuse elbow problems

Most people may not remember having a specific injury when their symptoms get worse over time, but overuse problems are actual injuries. They occur when too much stress is placed on a joint or other tissue, often when you overdo an activity or repeat an activity over and over. 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.
• Ulnar nerve compression, which is the pinching of the ulnar nerve in the elbow joint. This usually occurs with repeated motions.

Treatment for an elbow problem may include first aid measures; application of a brace, splint, or cast; physical therapy; or medicine.

Review the Emergencies and Check Your Symptoms sections to determine if and when you need to see a health professional.

• Elbow or arm pain with chest pain that is crushing or squeezing, is increasing in intensity, or occurs with any other symptoms of a heart attack. After calling 911 or other emergency services:
  • If the person becomes unconscious, see the topic Dealing With Emergencies.
  • If emergency medical personnel, such as paramedics, are not going to arrive soon and the person is awake, alert, not vomiting, and not allergic to aspirin, have the person chew and swallow one 325 mg adult aspirin. Be sure to tell emergency personnel that aspirin has been taken.
• Sudden arm weakness with loss of function

If you answer yes to any of the following questions, click on the "Yes" in front of the question for information about how soon to see a health professional.

Review health risks that may increase the seriousness of your symptoms.

If you have any of the following symptoms, evaluate those symptoms first.

• Elbow injury: Go to the topic Elbow Injuries.
• Chest pain: Go to the topic Chest Pain.

	Yes	Do you have elbow pain or tenderness?
When to See a Doctor See significance of pain or tenderness if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Do you have severe pain? Call your health professional today if you answer "Yes" to any of the following questions. Yes Do you have moderate pain that is getting worse? Yes Is a young child unable or unwilling to use his or her arm? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have moderate pain that has not gotten better after 24 hours of home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Have you had mild pain that comes and goes with no other symptoms for 1 week or longer? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Is your forearm, wrist, or hand pale, white, blue, or cold?
When to See a Doctor See significance of pale, white, blue, or cold skin if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Is your arm pale, white, blue, or cold below the elbow? Call your health professional today if you answer "Yes" to any of the following questions. Yes Has your forearm turned pale, white, blue, or cold (even if the symptoms occur off and on), and these symptoms have not been evaluated by your health professional? Yes Do your symptoms come and go but have become worse since you were evaluated by your health professional? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have numbness or tingling in or below the elbow?
When to See a Doctor See significance of numbness or tingling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Have you had new numbness or tingling in or below your elbow for more than a few minutes? Call your health professional today if you answer "Yes" to any of the following questions. Yes Have you had steady numbness or tingling in your arm or hand for 1 hour or longer without other loss of function? Yes Has your numbness or tingling become worse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Are you unable to move your elbow normally?
When to See a Doctor See significance of inability to move elbow normally if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Is your elbow locked in one position and you are unable to straighten or bend it? Yes Do you have decreased elbow movement and severe pain? Call your health professional today if you answer "Yes" to the following question. Yes Is a young child unable or unwilling to use his or her arm? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to any of the following questions. Yes Are you unable to move your elbow normally after 48 hours of home treatment? Yes Do you have decreased elbow strength after 48 hours of home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Does your elbow lock up from time to time, but it is not locked up now? Yes Has your elbow felt loose or unstable off and on for a long time and your symptoms have not been evaluated by a health professional? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you have swelling in or around the elbow?
When to See a Doctor See significance of swelling if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to any of the following questions. Yes Do you have swelling and the skin below the swollen area is cold or pale? Yes Do you have increased swelling, redness, or warmth around your elbow? Yes Do you have severe pain when you move your elbow? Yes Is your elbow tender to the touch? Yes Do you know or think you have a fever? Yes Do you have diabetes? Yes Do you have peripheral arterial disease? Yes Do you have a disease that causes problems with your immune system? Call your health professional today if you answer "Yes" to the following question. Yes Has elbow swelling that is usual for you gotten worse? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Do you have moderate swelling after 48 hours of home treatment? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to any of the following questions. Yes Has mild swelling, without other symptoms, failed to improve after 1 week of home treatment? Yes Has long-term swelling gotten worse? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.
	Yes	Do you feel or hear a snap or pop in your elbow?
When to See a Doctor See significance of feeling or hearing a snap or pop in the elbow if you need information to help you answer the questions below. Review health risks that may increase the seriousness of your symptoms. Call your health professional immediately if you answer "Yes" to the following question. Yes Are you unable to move your elbow normally? You may wait to see if the symptoms improve over the next 24 hours (or specified time period) if you answer "Yes" to the following question. Yes Does your elbow snap or pop, causing pain during normal movement for longer than 24 hours? You need an appointment within the next 1 to 2 weeks if you answer "Yes" to the following question. Yes Does your elbow snap or pop during normal movement but does not cause pain? If you have answered "No" to the above questions, continue to answer the questions to evaluate your symptoms.

Other Symptoms to Watch For

If you have an arm problem, go to the topic Arm Problems, Noninjury.

If a visit to a health professional is not needed immediately, see the Home Treatment section for self-care information.

Most minor elbow problems go away on their own. Home treatment is usually all that is needed to relieve your symptoms.

Home treatment for minor problems

Home treatment may help relieve pain, swelling, and stiffness.

• If you have swelling, remove all rings, bracelets, watches, or any other jewelry that goes around your wrist or fingers of the affected 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 if it makes you more comfortable and supports your elbow. If you feel you need to use a sling for longer than 48 hours, discuss your symptoms with your health professional.
• An elbow support, such as an elbow sleeve, forearm wrap, or arm sling, may help rest your elbow joint, relieve stress on forearm muscles, and protect the joint area during an 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 elbow if it causes pain.
• 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.
• Do not smoke. Smoking slows healing because it decreases blood supply and delays tissue repair. For more information, see the topic Quitting Tobacco Use.

Symptoms to Watch For During Home Treatment

Use the Check Your Symptoms section to evaluate your symptoms if any of the following occur during home treatment.

• Signs of infection develop.
• Numbness, tingling, or cool, pale, skin develops.
• Symptoms do not improve with home treatment.
• Symptoms become more severe or more frequent.

The following tips may prevent elbow problems.

General prevention tips

• Don't carry objects that are too heavy.
• 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.

To prepare for your appointment, see the topic Making the Most of Your Appointment

You can help your health professional 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?
• What were you doing when your symptoms started?
• Have you had this problem in the past? If so, do you know what caused the problem at that time? How was it treated?
• 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 taken? Did they help?
• Do you have any health risks?

• Arm Problems, Noninjury
• Cast and Splint Care Tips
• Finger, Hand, and Wrist Problems, Noninjury
• Olecranon Bursitis (Popeye Elbow)
• Rest, Ice, Compression, and Elevation (RICE)
• Swelling

Author:	Jan Nissl, RN, BS	Last Updated: April 3, 2007
Medical Review:	William M. Green, MD - Emergency Medicine H. Michael O'Connor, MD - Emergency Medicine
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