At MedStar Harbor Hospital, we understand how vital it is for you to have healthy elbows—they serve a wide variety of functions and are necessary for achieving our most basic needs and performing our most complex movements. Any elbow injury has the potential to significantly affect your quality of life.
From repairing traumatic injuries to treating repetitive motion injuries, arthritis, and congenital conditions, MedStar Health orthopaedic specialists have the training and the experience necessary to restore your elbow function and minimize your pain. Our goal is to help you return to your regular activities healthy and pain-free.
We treat a variety of elbow conditions, including:
- Cubital Tunnel Syndrome
- Ulnar Nerve Compression
- Reflex Sympathetic Dystrophy
- Tendinitis and Tennis Elbow
Cubital Tunnel Syndrome
The cubital tunnel is a narrow tube of tissue at your elbow that contains the ulnar nerve. The ulnar nerve runs from your shoulder down to your wrist and controls movement in your ring and pinky fingers. Cubital Tunnel Syndrome is a type of nerve entrapment that forms when this tunnel swells, putting pressure on the ulnar nerve, causing pain and numbness in the hand and fingers.
Cubital tunnel syndrome can cause the following symptoms:
- Tingling in the ring and pinky fingers, making it more difficult to use them
- Numbness in the ring and pinky fingers
- Weakness in the hands
The cubital tunnel is more likely to swell if
- You sleep or lean on your elbow for too long
- You bend the elbow back and forth repeatedly
- Fluid builds up in the elbow
- You hit or fall on the elbow with force
Other conditions that can contribute to the development of cubital tunnel syndrome include elbow arthritis, fractures, cysts, and bone spurs.
Treatment for cubital tunnel syndrome depends on how severely your nerve is compressed and whether you are beginning to develop muscle weakness. Nonsurgical treatment options may include
- Injections of steroids or anti-inflammatory medications
- Physical therapy
If nonsurgical treatment does not relieve your symptoms, or your muscles are weakening too much, you may need surgery. Surgical options can relieve symptoms by:
- Widening the cubital tunnel to release the pressure on your nerve
- Moving the nerve so it is more protected from injury
Ulnar Nerve Compression
The ulnar nerve is what people commonly call the funny bone. It fits in a groove in the bottom of the elbow and is very vulnerable to stress, trauma, or overuse. Ulnar nerve compression can cause a lack of sensation, muscular weakness, and shooting pain from the elbow down to the pinkie and ring finger. Numbness and tingling in ring and pinkie fingers are the most common symptoms.
Nonsurgical treatments such as splints, oral anti-inflammatory medications, and adjustments in daily activities are typically pursued as the initial course of action. If the swelling around the nerve does not respond to nonsurgical treatments, surgery may be recommended.
Arthritis is an inflammation of the tissues that line your joints. This inflammation can cause pain, swelling, and joint damage. Types of arthritis that most often affect your elbow include:
- Osteoarthritis: The natural aging process can wear away at the protective cartilage that allows the many bones in your elbow to move smoothly, causing inflammation, swelling, and pain.
- Rheumatoid arthritis: This immune system dysfunction attacks and wears away at the cartilage lining between the bones in your elbow. Rheumatoid arthritis generally affects the joints on both hands and is less likely to affect your elbow.
Elbow arthritis symptoms generally include:
- Limited ability to move elbow
- Numbness or tingling in ring and pinky fingers
Along with the symptoms above, rheumatoid arthritis can also cause:
- A weak grip
- Difficulty using the hand
- Pain in the knuckles
- Weight loss
An elbow dislocation occurs when any of the elbow bones are moved out of place. Falling with force onto your hand can push elbow bones out of place; this is the most common cause of cause an elbow dislocation. In some cases, elbow bones may fall back into place on their own, but still cause some pain or bruising.
Dislocating any of the bones of the elbow can cause the following symptoms:
- Pain and swelling
- Inability to bend or move the elbow
- Lack of feeling in the fingers
- Arm looks obviously bent out of shape
To treat an elbow dislocation, our specialists will immediately perform a reduction maneuver, in which two doctors will hold your arm and twist it around to move your bones back into alignment
In some cases, elbow dislocations require surgery. If your injury caused your bones to shift out of place or break through the skin, you may need surgery to restore the proper alignment and avoid infection. If your injury crushed portions of your bone, your surgeon may need to replace the lost bone with bone filler, which is human or artificial bone replacement material.
Reflex Sympathetic Dystrophy
Reflex sympathetic dystrophy (RSD) is a condition of chronic, burning pain; stiffness; swelling; sweating; and discoloration of the hand or arm that may become disabling. It occurs from over-activity in the sympathetic (unconscious) nervous system that controls the blood flow, sweat glands, and other involuntary bodily functions. Additionally, a patient with RSD who sustains an injury usually feels a greater amount of pain than a person without RSD who has sustained the same injury.
RSD has three stages:
- Acute: May last up to three months. Symptoms include pain and swelling, increased warmth and redness in the affected part/limb, and excessive sweating.
- Dystrophic: Can last three to 12 months. Swelling is more constant, skin wrinkles disappear, skin temperature becomes cooler, and fingernails become brittle. Pain is more widespread, stiffness increases, and the affected area becomes sensitive to touch.
- Atrophic: Lasts one year or more. The skin of the affected area is now pale, dry, tightly stretched and shiny. The area is stiff, pain may decrease, and the chance of getting motion back is decreased.
In some cases, the cause of RSD is unknown. RSD may follow a sprain, fracture, injury to nerves or blood vessels, or the symptoms may appear after a surgery. Other causes include pressure on a nerve, infection, cancer, neck disorders, stroke, or heart attack.
The pain of RSD may be severe, resulting in physical and psychological alterations. A coordinated multidisciplinary approach to treatment is best, which may include medication (oral and injections), physical or occupational therapy, and/or surgery.
Tendinitis and Tennis Elbow
The tissues that attach your bones to your muscles are called tendons. When your muscles flex, tendons spring into action, helping to move your bones. It is easy to injure the tendons in the arms and hands, since we use them so often. Tendinitis is an inflammation of a tendon that causes pain near a joint. It generally develops when an accident or injury cuts or damages the tendon.
Tennis elbow is the common term for one of the most common types of tendinitis. It is an overuse injury that causes an inflammation of the tendon fibers that attach the forearm muscles to the outside of the elbow. As the name suggests, tennis players, as well as golf players and other athletes, often suffer from this type of tendinitis. But it can also affect you if you twist your wrist repeatedly on a regular basis, or if you type on a computer keyboard without proper support.
Although tendinitis can be painful, the good news is that it rarely becomes chronic if caught early and treated properly with the following
- Cortisone injections
- Ceasing or changing your activity
- Wrist splints
If surgery becomes necessary, arthroscopic procedures are minimally invasive, provide a relatively short recovery period, and can produce long-lasting results.