Symptoms of elbow pain
How long does elbow pain last?
It is not always possible to provide an accurate estimation of how long elbow pain will last for. However, there are some time frames related to tissue healing that we are aware of. We know that pain does not always mean damage, therefore, once your injury or condition has improved you may still experience some pain for longer or shorter than these timeframes.
If you have experienced an elbow fracture this can take anywhere from six to twelve weeks to fully heal, requiring the joint to be immobilised in a cast for a period of time. Even after the cast has come off the individual may still experience pain due to secondary issues such as stiffness and weakness.
When it comes to ligament injuries, grade 1 ligament sprains usually heal within a few weeks. Maximal ligament strength will occur after six weeks when the collagen fibres have matured. Grade 2 ligament injuries usually take somewhere between six to eight weeks to heal, at which point activity should then be progressed gradually, with a full recovery of strength and function taking anywhere up to two to three months. Grade 3 ligament injuries usually take anywhere between three and six months to fully recover, however this obviously depends on the activities the person is looking to return to and whether or surgery is required.
With over-use injuries such as tennis elbow you may have acute pain for a few days to a few weeks depending on how much you can rest. Following on from this, it may take twelve weeks to six months to complete a loading programme to ensure you symptoms have resolved.
Can elbow pain come from the neck?
A common myth when it comes to pain is that the source of the pain is directly over the location of the pain. This is not always the case. Sometimes pain can be referred from other areas. One common area is the neck. All of our nerves that travel around the body all originate from our spinal cord that passes through the canal in our spine.
On occasion, if the nerves are being irritated around your neck (cervical spine) then you can get pain into your arm area. This irritation can come from a disc prolapse or narrowing of the joints in the neck. This pain may be specifically in the elbow or a radiating sensation down the arm. We have three nerves that travel down from our necks to our fingers; the median nerve, radial nerve and ulnar nerve. The median nerve travels down the center of the elbow and down into the hand. The ulnar nerve runs along the inside of the elbow and is closest to the surface around the elbow joint. When someone says they “hit their funny bone” this would be referring to knocking the area where the ulnar nerve is and that is why they get pain and a tingling sensation. The radial nerve runs down the opposite side on the outer part of the elbow.
If you have an irritation or compression of one of these nerves, then this could also cause other symptoms. As well as pain these could include pins and needles or numbness. Depending on the severity of the effect on the nerve it could also cause weakness in a particular area or movement.
Why do I get elbow pain and stiffness?
Stiffness in your elbow can occur for a variety of reasons. However, the most common reasons may be degenerative osteoarthritis (OA) or after your elbow has been immobilised for a long time i.e. after your elbow has been in a sling or a cast.
Osteoarthritis is a condition where there is a breakdown of the cartilage and stiffening of the soft tissue around and inside a joint. It is common and generally happens as we get older. The main symptoms of osteoarthritis are pain and stiffness. It is common for it to feel stiffer first thing in the morning or even when it hasn’t been moved for a long time.
Another less common form of arthritis is rheumatoid arthritis (RA) which is an entirely different cause (immune system medical cause). However, in the early stages of the disease RA symptoms may be confused with OA as both can cause similar pain, swelling and stiffness.
To help reduce the stiffness it is important to keep moving your elbow in all the directions it can; flexion, extension, supination and pronation. By moving regularly, it reduces the stiffness, increases the blood flow and oxygenation.
After a fracture, a person is normally immobilised whilst the fracture heals with the use of a cast or a sling. This can be anywhere from two weeks to six weeks. A consequence can be significant stiffness in the elbow and a reduction in the elbow range of movement. When our upper limb consultant has lifted movement restrictions, it is then important to see a our physiotherapists to ensure that the right exercises and treatment are given at the earliest opportunity. This ensures an increase in movement and leads to the most optimal ongoing function of the arm again. A physiotherapist may help in this regard with the use of exercises as well as manual techniques.
Why does it hurt to touch?
With certain conditions the area on and around the pain can be tender to the touch. It is not uncommon for the boney aspects of the elbow to be tender with tennis elbow and golfers elbow. People often describe pain when leaning on their elbow or resting it in a certain position. This is because there might be inflammation around the tendon or bursa that makes it sensitive to touch. As previously stated there are also a lot of nerves that are superficial around the elbow and if they become sensitised or irritated that can also cause pain with touch.
Can elbow pain radiate?
As previously discussed pain can be more complexed than initially thought and can radiate from other areas of the body. It has already been spoken about regarding radicular pain from the neck however pain can also be radiating down from the shoulder or up from the hand and wrist.
With some shoulder conditions, it is normal to feel pain in the upper arm and down to the elbow. If it is specifically the shoulder involved the pain rarely will travel further than the elbow. Conditions such as shoulder osteoarthritis or rotator cuff tendinopathies can cause this effect of the upper arm.
On occasion pain can radiate from the elbow down to the wrist and hand. With tennis and golfers elbow the tendons involved are associated with muscles that travel all the way down to the wrist and hand. Therefore, pain can also radiate down as well. As well as these structures if there is any neural involvement where the nerve is being irritated this can also cause pain to radiate down. There are three nerves that can be irritated that pass through the elbow into the wrist and hand.