What is the elbow?
The elbow is the joint that attaches the arm to the forearm, connecting the humerus to the proximal ends of the ulna and radius. The joint is also composed of bone, cartilage, ligaments and fluids. Muscles and tendons help keep it from moving when we move it. If any of these structures suffer any trauma, elbow problems arise.
The elbow is the joint of the arm that allows the movements of extension and flexion of the arm.
extension and flexion movements of the arm
Function of the elbow
The elbow allows a series of movements to extend and flex the arm. Thus, the movements are as follows:
- Extension, thanks to the triceps brachii muscle.
- Flexion, with the biceps brachii, anterior brachialis and brachioradialis muscles.
- Supination, with the supinator brevis muscle and biceps brachii muscle.
- Pronation, thanks to the pronator teres muscle and pronator quadratus muscle.
Pathologies that can affect the elbow
There are many factors that can cause pain in the elbow, whether or not they lead to injury. Thus, the most common are:
- Arthrosis: degenerative process that rarely affects the elbow. When it occurs it is due, mainly, to very intense and continuous exercises, or repetitive traumatisms.
- Arthritis: is an inflammatory process that affects a joint, causing pain and increased temperature. The origins are very varied. In the elbow, the most frequent causes are: rheumatoid arthritis, psoriatic arthritis, arthritis of infectious cause, gout and chondrocalcinosis.
- Epicondylitis or tennis elbow, which causes pain on the outside of the elbow.
- Epitrocleitis or golf elbow, which causes pain on the inside of the elbow.
- Olecranian bursitis or student elbow. It is a rheumatic disease that affects the soft parts (not bones) of the joint.
- Elbow dislocation, although it is less common than shoulder dislocation, for example, because the surfaces of the bones fit together perfectly. The main cause is a fall with the hand outstretched, and a fracture is usually related.
- Painful pronation (nursemaid’s elbow or radial head subluxation). The radial head moves from its normal position, without being completely displaced, so it can be considered subluxation. It is common in children under 5 years of age due to abrupt tractions made on the forearm (e.g. when taking a child by the hand and pulling him/her to help him/her climb steps, in physical contact sports such as judo…).
- Fractures. The main ones are those of the lower extremity or distal humerus, the head of the radius and the olecranon in the ulna.
- Monteggia fracture. It is a complex and uncommon injury where dislocation of the head of the radius at the elbow is associated with fracture of the ulna in its proximal third.
- Terrible triad of the elbow. It is a serious injury that is usually produced by falls in which the hand rests on the ground in extension position. In this type of injury there is usually also a dislocation with the fracture of the radius dome and the coronoid process of the ulna. To cure it it is necessary to operate.
Treatments for elbow pathologies
The treatment of the pathologies of the elbow will depend on the cause that provokes it. To diagnose any elbow injury, several tests will be performed: direct arthrography, radiography or nuclear magnetic resonance, among others. Once the diagnosis has been established, the specialist will indicate how best to approach the elbow pathology in each case.
Normally the main measure to treat the injured structure is to reduce inflammation, restrict mobility, alleviate pain, weakness and functional disability. Hence it is important, in the first instance, to administer NSAIDs (anti-inflammatory drugs), place a sling or similar to limit mobility and physiotherapy. Physiotherapy treatment will commonly consist of cryotherapy (cold), electrostimulation (TENS), passive stretching program of the pronator-supinator muscles (those involved in rotating the forearm), wrist extensors and flexors, and postural recommendations. Once the pain has passed, exercises to strengthen the musculature of the affected arm can be established.
If the injury is more serious, the specialist may recommend other procedures. Thus, some may be elbow arthroplasty, surgery for tennis elbow or, if it should not be operated, injections in the joints and soft tissues.
Specialist who treats the pathologies of the elbow
The expert who treats elbow pathologies is the specialist in traumatology and orthopedic surgery. Usually there are also traumatologists who specialize in elbow complaints and their therapeutic approach.