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Arm and Elbow Pain - Dr. John Atwater

Arm and elbow pain is not usually a sign of a serious condition, but it can be a major discomfort that interrupts life activities.

More than 3 million Americans visited the emergency room because of an arm or elbow injury in 2009. Sports injuries are on the rise, with more than 45% of teens aged 13-14 experiencing arm and elbow pain after just one season of baseball.

At OSA, our surgeons and physical therapists are experts in their field and can help improve mobility and reduce pain. We recognize that arm and elbow injuries can get in the way of the activities you love most. Our experienced arm and elbow orthopedic specialists work with patients to develop tailored treatment plans, focusing on giving you control over your recovery.

The Anatomy of the Arm and Elbow

The upper arm:

  • The upper arm bone (humerus) extends from the shoulder to the elbow.
  • There are four main muscles in the upper arm (biceps brachii, brachialis, and coracobrachialis on the top and triceps brachii below). The musculocutaneus nerve supplies them.
  • The upper arm muscles help you move your lower arm, flex and extend the elbow, and lift the arm above the head.

The lower arm:

  • The lower arm (forearm) extends from the wrist up to the elbow by two major bones: the radius (on the thumb-side of the wrist), and the ulna (on the “pinkie” side of the wrist).
  • There are flexor and extensor muscles in the lower arm, which allow you to flex your wrist and fingers, and turn the hand to face up or down. They’re supplied by the radial nerve and are divided into two layers: deep and superficial.
  • The lower arm is divided into two compartments: anterior (front), which houses the flexing muscles, and posterior (back), which contain the extensors of the hands.

The elbow:

  • The elbow is made up of the three joints: the hinged joint between the humerus and ulna, allowing you to bend and straighten the elbow; the joint between humerus and radius, allowing for complex hand motions; and the pivot joint formed by the ulna and radius at the elbow.
  • The arm bones (humerus, radius, and ulna) connect at the elbow.
  • The bony processes felt on either side of your elbow are called the medial and lateral epicondyles, which form into the humerus.
  • The ulna forms a cup shape at the elbow joint, allowing the humerus to move.
  • The elbow has three ligaments (medial collateral ligament, lateral collateral ligament, and annular ligament).

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Causes of Arm and Elbow Pain

  • Tennis Elbow (lateral epicondylitis)
  • Fracture
  • Joint inflammation
  • Sports injury
  • Dislocated elbow
  • Golfer’s elbow
  • Arthritis
  • Work-related tasks
  • Home improvement projects
  • Positional
  • Overactivity
  • Chronic posture stress by carrying heavy objects
  • Osteoarthritis

How Arm and Elbow Pain Conditions are Diagnosed

Your doctor will ask you questions about your history, lifestyle, and how your symptoms affect your daily life. He or she will also ask about the severity of your arm and elbow pain, and they may want you to walk or bend over in the office. These questions and exercises can help diagnose your arm and elbow pain condition and allow your orthopedic doctor to narrow down treatments that would be suitable for your unique experience.

Here are some ways you can help your arm and elbow doctor:

  • Bring all medical records, scans, and recent laboratory results to your appointment. This is very important!
  • In the appointment, point to the area(s) of pain or discomfort
  • Wear loose clothes to your appointment so the doctor can easily examine the area of pain.
  • Tell your doctor if you have any other health problems, even if they don’t seem related to your arm or elbow.

Many doctors will want to see what’s going on inside your body. They may order one or more of the following:

  • X-rays
  • MRIs
  • Blood tests
  • Nerve tests
  • Bone scans

Seek medical attention if:

  • You have pain or difficulty moving your arm or elbow
  • There is bruising or swelling in the area
  • You experience numbness and tingling
  • Your arm or elbow has changed shape after a snapping/cracking noise

Surgical and Non-Surgical Treatments

Many patients do not need surgery. In fact, pain and discomfort in the arm and elbow will often go away with position changes, rest, or gentle exercises; however, some pain will persist for several months without relief. If this is the case for you, ask your doctor if surgery will help.

Non-surgical treatments include:

  • Physical therapy
  • RICE: Rest, ice, compression, and elevation
  • Evaluate equipment and lifting/throwing techniques
  • Posture correction (head tall and strong, shoulders back, chest open, pelvis tucked and centered).
  • Frequent stretch breaks
  • Braces, straps, or support pads
  • Acupuncture
  • Anesthetic creams
  • Extracorporeal shock wave therapy
  • Pain medication
  • Dietary and lifestyle changes

The type of surgery you receive depends on your diagnosis; however, common arm and elbow surgeries include:

  1. Arthroscopy: This is a minimally invasive procedure where a small camera scope and instruments are inserted through a small incision at the elbow, with the goal of removing diseased muscle and reattaching healthy muscle to bone.
  2. Ulnar Nerve Anterior Transposition: This relieves inflammation of the ulnar nerve by moving the nerve to the front of the elbow.
  3. UCL Reconstruction: This is a surgical reconstruction of the ulnar collateral ligament using a tissue graft from your tendons.
  4. Open Elbow Surgery: This is most commonly performed in Tennis Elbow cases to remove diseased muscles and reattach healthy muscle to bone.

Talk to your doctor if you would like to try any of these treatments for your arm and elbow pain. He or she can help you develop a safe, long-term plan for better health and mobility.