The elbow is a joint that connects the upper arm to the forearm and consists of three bones: the arm bone (humerus), a forearm bone on the thumb side of the arm (radius), and another forearm bone on the pinky side (ulna). The three bones join together to form the elbow joint, and when an injury occurs or a condition develops, requires an orthopedic elbow specialist doctor for proper diagnosis and treatment.
What is an Orthopedic Elbow Doctor?
An elbow doctor, or elbow specialist, is typically a sports medicine doctor and/or orthopedic doctor. Orthopedics is an area of medicine that focuses on the musculoskeletal system, which encompasses all the muscles, bones, and supportive structures and tissues in the body. The specialized knowledge of the elbow means that the doctor is equipped to provide elbow treatments for various injuries and conditions, sometimes surgery as well.
Orthopedic Elbow Conditions: Causes of Elbow Pain
There are a range of orthopedic elbow injuries and elbow conditions a patient can develop, including:
- Elbow Fractures: These involve a break in one or more of the bones. Common fractures include:
- Radial head fractures
- Olecranon fractures
- Distal humerus fractures
- Elbow Dislocation: This is when the bones of the forearm (the radius and ulna) move out of place compared with the bone of the upper arm (the humerus).
- Tennis Elbow (Lateral Epicondylitis): This is a painful condition caused by overuse, where tendons in the elbow are overloaded, usually by repetitive motions of the wrist and arm.
- Golfer's Elbow (Medial Epicondylitis): Similar to tennis elbow, but the pain is on the inside of the elbow. It's also caused by overuse.
- Bursitis: Specifically, olecranon bursitis, which is inflammation of the small sac of fluid (bursa) located at the tip of the elbow. It can be due to trauma, infection, or repetitive movements.
- Ulnar Nerve Entrapment (Cubital Tunnel Syndrome): This occurs when the ulnar nerve becomes compressed or irritated. Symptoms can include numbness or tingling in the ring and small fingers, pain in the forearm, and/or weakness in the hand.
- Osteoarthritis: A degenerative joint condition that can affect the elbow, causing pain, stiffness, and a limited range of motion.
- Rheumatoid Arthritis: An autoimmune disease that can affect the elbow, causing pain, swelling, and deformity.
- Elbow Ligament Injuries: Ligaments are soft tissue structures that connect bones to bones. The most well-known ligament injury in the elbow is an injury to the ulnar collateral ligament (UCL), which is often seen in athletes who throw repetitively (like baseball pitchers).
- Tendonitis: Inflammation or irritation of a tendon. This can affect various tendons around the elbow.
- Elbow Sprains and Strains: These involve injury to the ligaments (sprains) or muscles and tendons (strains) around the elbow.
- Osteochondritis Dissecans: A condition where a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. It can lead to pain and decreased joint movement.
- Elbow Contracture: This is a stiffening of the elbow joint, which can result from various causes, including trauma, burns, or being immobilized for a prolonged period.
- Thrower’s Elbow: This encompasses a range of injuries associated with the repetitive motion of throwing, leading to damage to the ligaments, tendons, and bones of the elbow.
- Infections: In rare cases, the elbow joint can become infected, which requires immediate medical treatment.
Elbow Care and Treatment Options
Orthopedic elbow doctors can provide both non-surgical and surgical elbow treatments, though unless an injury or condition requires it, most will use a conservative approach. Below is a list of common non-surgical elbow treatments:
- Rest: Allowing the elbow to heal by avoiding activities that worsen the condition or cause pain.
- Physical Therapy: A trained physical therapist can guide patients through exercises that can help improve mobility, strengthen the muscles around the elbow, and promote healing.
- Bracing or Splinting: These can provide support to the injured area, reduce strain on the joint, and prevent further injury. For instance, counterforce braces are often used for lateral epicondylitis (tennis elbow).
- Ice and Heat Therapy:
- Ice: Reduces inflammation and numbs the area to dull pain.
- Heat: Can relax and loosen tissues and stimulate blood flow to the area.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen, naproxen, or aspirin can help reduce pain and inflammation.
- Corticosteroid Injections: These can help reduce inflammation and pain in the joint, but they are typically used for short-term relief and have some potential side effects when used frequently.
- Platelet-Rich Plasma (PRP) Injections: This involves taking a sample of the patient's blood, processing it to increase the concentration of platelets, and then injecting it into the injured area to promote healing.
- Occupational Therapy: Especially beneficial for conditions that impact daily activities, occupational therapists can offer strategies and adaptations to reduce strain on the elbow during everyday tasks.
- Activity Modification: Altering or changing the way you perform activities can reduce strain on the injured area, allowing it to heal and preventing further injury.
- Pain Management: This might include over-the-counter pain relievers, prescribed medications, or other techniques like transcutaneous electrical nerve stimulation (TENS).
- Ultrasound Therapy: Uses sound waves to produce heat that penetrates deep into the soft tissues and muscles, promoting healing and reducing pain.
- Shockwave Therapy: A non-invasive treatment that uses intense, short-energy waves to promote healing and reduce pain.
- Compression: Using elastic bandages to provide support and reduce swelling.
- Extracorporeal Shock Wave Therapy (ESWT): This is sometimes used for chronic tendinitis that hasn’t responded to more conventional treatments.
- Topical Pain Relievers: Gels, creams, or patches that can be applied to the skin over the painful area.
Elbow Surgery
When conservative methods don’t alleviate symptoms or solve the condition, an orthopedic elbow doctor may recommend surgery. If the doctor is qualified as an orthopedic surgeon, they may perform it themself or recommend a patient to another surgeon. Depending on the condition and severity of injury, these are the most common types of elbow surgery recommended:
Used for fractures of the elbow, where the bones are repositioned (reduced) and secured with hardware like screws, plates, or wires.
Commonly known as “Tommy John surgery,” this procedure involves replacing a torn ulnar collateral ligament with a tendon from elsewhere in the patient’s body or from a donor.
A minimally invasive procedure where a small camera (arthroscope) is inserted into the elbow joint to diagnose and treat various conditions. This can be used for:
- Removing loose bodies (small pieces of bone or cartilage)
- Treating osteoarthritis
- Treating specific types of elbow injuries
This involves replacing the damaged parts of the elbow with artificial components, usually due to severe arthritis or certain complex fractures.
Used for stiff elbows that don’t respond to physical therapy. The procedure involves releasing tight tissue to improve the range of motion.
For ulnar nerve entrapment, this surgery involves releasing the structure compressing the nerve, often by making more space for the nerve or by moving the nerve to a position where it is less likely to be compressed.
In cases where the radial head (a part of the radius bone near the elbow) is fractured and can’t be repaired, it might be replaced with a metal or plastic implant.
For cases of tennis elbow that don’t respond to conservative treatments, this surgery involves removing damaged tissue and reattaching healthy muscle back to the bone.
Similar to the procedure for tennis elbow, but addresses golfer’s elbow by treating the inner part of the elbow.
In chronic or infected cases of olecranon bursitis, the inflamed bursa may be surgically removed.