Your elbow joint is made up of bone, cartilage, ligaments and fluid. Muscles and tendons help the elbow joint move. When any of these structures is hurt or diseased, you have elbow problems.

Many things can make your elbow hurt. A common cause is tendinitis, an inflammation or injury to the tendons that attach muscle to bone. Tendinitis of the elbow is a sports injury, often from playing tennis or golf. You may also get tendinitis from overuse of the elbow.

Other causes of elbow pain include sprains, strains, fractures, dislocations, bursitis and arthritis. Treatment depends on the cause.

Elbow Joint

The elbow joint is a uniaxial hinge joint formed by the humeroulnar joint, the articulation between the trochlea of the humerus and the trochlear notch of the ulna. Also associated with the elbow are the humeroradial joint and the proximal radioulnar joint. All three of these joints are enclosed within a single articular capsule (image).

The articular capsule of the elbow is thin on its anterior and posterior aspects, but is thickened along its outside margins by strong intrinsic ligaments. These ligaments prevent side-to-side movements and hyperextension. On the medial side is the triangular ulnar collateral ligament. This arises from the medial epicondyle of the humerus and attaches to the medial side of the proximal ulna. The strongest part of this ligament is the anterior portion, which resists hyperextension of the elbow. The ulnar collateral ligament may be injured by frequent, forceful extensions of the forearm, as is seen in baseball pitchers. Reconstructive surgical repair of this ligament is referred to as Tommy John surgery, named for the former major league pitcher who was the first person to have this treatment.

The lateral side of the elbow is supported by the radial collateral ligament. This arises from the lateral epicondyle of the humerus and then blends into the lateral side of the annular ligament. The annular ligament encircles the head of the radius. This ligament supports the head of the radius as it articulates with the radial notch of the ulna at the proximal radioulnar joint. This is a pivot joint that allows for rotation of the radius during supination and pronation of the forearm.

Tennis elbow is the common term for a painful elbow disorder.

The technical name for tennis elbow is "lateral epicondylitis". This term refers to an inflammation that is occurring near a small point or projection of the upper arm bone (humerus) just above the elbow joint on the outer side of the arm. However, pain can also occur in the forearm and wrist.

The pain from tennis elbow comes mainly from injured or damaged tendons near the elbow. Tendons are strong bands of tissue that connect muscles to bones. When repeatedly stressed or overused, tendons can become inflamed and degenerate. This results in a painful condition called tendinopathy, the medical term for disorder of a tendon. Tennis elbow is simply a specific type of tendinopathy that occurs in a particular part of the elbow.

Damaged tendons can occur on either side of the elbow. When it happens on the outside of the elbow, which is most common, it is called tennis elbow. When it happens on the inside, it is called "medial epicondylitis" or "golfer's elbow."

Tennis elbow is an injury to the tendon in the outer elbow. Golfer's elbow affects the inner tendon of the elbow. Any activity that involves a lot of wrist turning or hand gripping, such as using tools, shaking hands, or twisting, can bring on these conditions. Pain occurs near the elbow. It can also travel into the upper arm or forearm.

What Are Bursitis and Tendinitis?

Bursitis and tendinitis are both common conditions that cause swelling around muscles and bones. They occur most often in the shoulder, elbow, wrist, hip, knee, or ankle.

A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving body parts such as muscles, tendons, or skin. Bursae are found throughout the body. Bursitis occurs when a bursa becomes swollen.

A tendon is a flexible band of tissue that connects muscles to bones. Tendons can be small, like those found in the hand or ankle, or large, like the Achilles tendon in the heel. Tendons help create movement by making the muscles push or pull the bones in different ways. Tendinitis is the severe swelling of a tendon.

What Causes These Conditions?

People get bursitis by overusing a joint. It can also be caused by direct trauma. It usually occurs at the knee or elbow. Kneeling or leaning your elbows on a hard surface for a long time can make bursitis start. Tendinitis usually occurs after repeated injury to a certain area such as the wrist or ankle. Tendons become less flexible with age and become more prone to damage.

Doing the same kinds of movements every day or putting stress on joints increases the risk for both conditions. People like carpenters, gardeners, musicians, and athletes often get bursitis or tendinitis.

Infection, arthritis, gout, thyroid disease, and diabetes can also cause swelling of a bursa or tendon. Both bursitis and tendinitis are more frequent the older you get.

What Parts of the Body Are Affected?

Tendinitis causes pain and soreness around a joint. Some common forms of tendinitis are named after the sports that increase their risk. They include tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder, and jumper's knee.

You’ve probably heard of such sports injuries as tennis elbow or jumper’s knee. These are just 2 examples of tendinitis, a painful condition caused by overusing and straining the joints in your body.

Tendons are the tough but flexible bands of tissue that connect muscle to bones. You have about 4,000 tendons throughout your body. Tendons make it possible for you to bend your knee, rotate your shoulder, and grasp with your hand.

Tendinitis is inflammation of a tendon. (When you see “itis” at the end of a medical word, it means inflammation.) In tendinitis, the tendon gets inflamed and can rub against bone, making movement painful.

Tendinitis is usually caused by repeated motion, stress, or injury to certain muscles or joints. A sports or job-related injury is a common way to get tendinitis, but the condition can happen to anyone. Your risk for tendinitis also increases with age. “Tendons lose health as we get older and become less able to handle the load,” says Dr. Evan Flatow, an orthopedist at Mount Sinai Roosevelt Hospital in New York.

Any activity that requires repetitive wrist turning or hand gripping, jumping or bending, pulling, pushing, or lifting can irritate the tendons. Some of the most common places to get the condition are in the shoulders, elbows, hands, wrists, knees, and ankles. Gardeners, carpenters, musicians, and other people whose work regularly places stress around the same tendons are at increased risk for developing tendinitis.

If treated early, tendinitis is usually a short-term condition. But it can come back if the tendon is aggravated over and over again. If tendinitis keeps affecting the same area over time, the tendon can weaken and tear or break.

If you have pain or swelling—and especially if you can’t move a joint at all—contact a primary care doctor or an orthopedist. They can perform tests to pinpoint the exact areas of inflammation. You may also get an MRI scan or X-ray to check for a tear in the tendon or rule out other conditions, such as arthritis.

The first step in treating tendinitis is to reduce pain and swelling. Be sure to rest the swollen tendon so it can heal. “We have to break the cycle of inflammation to allow therapy to work,” Flatow says. A doctor may prescribe medicines that relieve inflammation (such as aspirin or ibuprofen), give steroid injections, or give you a splint or brace. Then gentle exercises can help strengthen the tendon.

If a tendon becomes torn, surgery might be needed to repair the damage. NIH-funded researchers such as Flatow are working to develop new ways to repair and regenerate tendons without surgery.

Regular physical activity helps keep muscles, bones, and tendons strong, and can lower your risk of injury and tendinitis. But be careful not to overdo it so you don’t injure yourself.

“Keep joints limber,” Flatow advises. “Warm up and stretch before physical activity to prevent sudden injury.” Take care of your tendons so they can keep you painlessly bending and flexing your muscles long into old age.

Preventing Tendinitis

• Exercise regularly to strengthen muscles around the joints.
• Begin new activities or exercise routines slowly and gradually increase the intensity.
• Position your body properly when doing daily tasks.
• Take frequent breaks from repetitive exercises and motions.
• Stop activities that cause pain.
• Use padding, gloves, or grip tape to cushion joints while using tools and sports equipment.

Replacement of the ELBOW JOINT.