Dr.

Besim Demolli

Similar to arthritis involving other joints in the body, elbow arthritis can be the result of a degenerative disease, aging, general wear and tear, trauma, or a previous injury to the elbow.

Joint pain and inflammation of the elbow joints are not uncommon with age and are often due to natural wear and tear throughout the body.

Athletes in particular know how important it is for the elbow joint to function properly when frequent punching movements occur during training or competition.

We'll show you how to properly address elbow joint pain, recognize the symptoms, and how measures such as enzyme therapy can help relieve problems and pain in your arm's most important joint.

The elbow is the joint that connects the bones of the forearm and arm, a joint that enables a bending motion that is necessary for countless daily movements.

Similar to the knee, hamstring and shoulder joints, the elbow joint is one of those joints that play a special role in freedom of movement.

The connection of the ulna and radius to the humerus does not consist of a single joint, but is an interaction of several bones, cartilage, tendons and more.

Despite free mobility of the forearm and hand, the elbow joint is limited in sustained flexion.

This is ensured by a series of tendons, ligaments and capsules that hold the forearm firmly in place and allow safe movement of the arm.

Their gentle interaction is promoted by connective tissue plates, and as in all joints of the human body, the bursa can be found as a cushion/cushion in the direct joint area.

The elbow joint is almost always in motion in daily life, which is beneficial for the natural production of synovial fluid and prevents wear and tear.

In turn, the elbow joint is relatively open and therefore prone to injuries and accidents.

Compared to other joints, the percentage of joint pain due to overuse or injury is higher than due to pure wear and tear with age.

Tennis and golf – The most common causes of elbow pain

When talking about injuries and overuse in sports, two sports are often mentioned when referring to the elbow: tennis and golf.

Both are known for their powerful swings, which are usually performed on one side in tennis or using both arms in golf.

Tennis elbow and golfer's elbow should not be equated with acute injuries or age-related wear and tear.

Instead, it is the result of chronic overload, such as incorrect or overly intense training.

When the elbow joint is overloaded, the ends of the tendon become inflamed.

This should not be equated with inflammation of the bursa, but may accompany it.

Any movement of the arm with a swing or pressure becomes correspondingly painful, and even daily movements can become torture as the inflammation progresses.

Other causes of joint pain in the elbow

Tennis elbow and golfer's elbow can occur at any age and are typical sports or overuse injuries.

There are many other reasons why your elbow may be causing problems.

Other causes of inflammation and pain in the elbow:

• Inflammation of the bursa

• General inflammation of the joints

• Rheumatic diseases such as gout, rheumatoid arthritis, collagenoses, fibromyalgia, osteoarthritis, peripheral spondyloarthropathies, pronator syndrome, medial or lateral epicondylitis, osteochondral defects, tendinopathies of the biceps brachii muscle, capsulitis, posterior impingement , tendinopathies of the triceps brachii muscle, bursitis of the olecranon, etc.

• Fractures, stress fractures of the olecranon, displacement and

overuse • Ruptured tendons and ligaments

• Compressive nerve syndromes-Radial tunnel syndrome/posterior interosseous nerve syndrome

Regardless of the type of joint pain, the so-called radial head is most often affected by pain or injuries.

Problems occur less often on the ulna side.

If the doctor diagnoses pain and problems in this area, a real physical injury can be assumed, such as broken or chipped bones.

In general, the risk of associated inflammation should always be recognized and taken seriously.

Articular capsule and synovial membrane related to age – arthrosis in the elbow joint

The human body is constantly in a process of regeneration.

Over the years, this natural regeneration of bones and organs becomes more and more difficult for the body.

In the case of joints, this is particularly noticeable through wear and tear of the joint cartilage, which is subject to gradual wear and tear.

If this is clearly attributable to advancing age and not to other causes, it is referred to as osteoarthritis.

In principle, arthrosis can affect all joints in the human body.

In the case of the elbow joint, a unilateral expression is particularly common.

On which side this cannot be clearly predicted in advance.

Because the dominant arm is supplied with synovial fluid through movement, which has a positive effect on wear, on the other hand, the dominant arm can be subjected to overload more often, for example when lifting heavy loads with this arm.

An individual clarification of pain and inflammation in the elbow joint brings to light the respective causes.

Typical side effects of joint pain and elbow inflammation

Pain in the elbow joint in arthrosis is more different than with a sports injury or a ruptured tendon.

It's important to always pay attention to pain or changes in your elbow and get them checked out by a doctor if the pain persists.

Typical side effects of pain and inflammation in the elbow joint are:

• Inflammation and swelling in the elbow

• Limited mobility of the elbow

• Pain on pressure (in the elbow, forearm, head of the radius…)

• Feeling of warmth or heat in the elbow

• Rubbing or with certain movements of the arm

• Stinging pain or other pain

The nature of pain and limitations can be a rough indicator of the nature of the injury or disease.

Acute, stabbing pain internally or externally indicate athletic overuse in tennis or golf.

Joint swelling is more likely to be a sign of bursa inflammation, and itching may indicate an infection or a skin rash in the elbow area.

Very few symptoms can be clearly defined, so an accurate diagnosis by a doctor is important.

This can assess whether you can use enzyme therapy in case of an inflammation, for example, or whether other healing measures should be started.

Diagnosis - How the doctor treats joint pain in the elbow

Diagnosis by a rheumatologist or other specialist can be done relatively quickly and helps initiate appropriate treatment measures.

At first, the doctor will ask you a number of questions in order to narrow down the possible causes.

The most important questions to prepare for in advance include:

• Is your pain acute or chronic?

• Do you have an overload of your arm, for example, through sport or work, you know?

• When exactly do you feel the pain?

• Are there currently any other symptoms in the arm and/or body?

• In what ways is arm mobility limited?

After clarifying these questions, the doctor himself will want to see closely the place of pain and palpate in which areas the pain occurs.

A very accurate diagnosis is often possible on this basis.

For further validation, diagnostic imaging methods are often used in addition.

The most important are:

• Arthroultrasonography

• Radiography

• Computed tomography (CT)

• Magnetic resonance imaging (MRI)

The type of procedure used depends on the triggers and suspected causes.

For example, X-rays are a useful form of analysis in case of suspected fractures.

If tendons and ligaments are more likely to be the cause of the pain, a detailed imaging procedure such as an MRI is the best choice.

At this point, later, it is usually clear where the exact causes of joint pain are and how you can alleviate or completely eliminate them, for example, through immobilization.

What treatments are offered?

Doctors sometimes suggest many different therapies for elbow joint pain.

According to previous studies, the following treatments may help:

Pain

medications: mainly non-steroidal anti-inflammatory drugs (NSAIDs).

NSAIDs are an option for short-term treatment.

Joint injections:

• Corticosteroids

act by reducing local inflammation.

They do this by inhibiting the production of inflammatory cells that are naturally produced in response to an acute injury or chronic condition.

Intra-articular treatments are most commonly used to treat osteoarthritis, acute gouty arthritis and rheumatoid arthritis of the knee.

However, long-term use of corticosteroids is known to progressively damage the joints.

• Hyaluronic acid

is a naturally occurring substance in the synovial fluid that lubricates joints.

In arthrosis, this substance can break down quickly and lead to worsening of the condition.

Intra-articular injections can be used to increase lubrication, reduce pain, and improve range of motion in a joint.

• Local anesthetics are

sometimes delivered by intra-articular injections as a form of pain relief after arthroscopic surgery.

But it's a practice that has come under scrutiny as evidence suggests it can degrade chondrocytes (the only cells found in cartilage) in joints.

• Botox

(botulinum neurotoxin A) injections have been shown to provide significant pain relief for people with advanced knee osteoarthritis.

• Platelet-rich plasma (PRP)

is derived from whole blood and contains platelets (a type of blood cell that is essential for clotting) and the liquid part of blood known as plasma.

Inter-articular PRP injections are prescribed to reduce pain and improve physical function for people who have osteoarthritis, while supporting collagen regeneration in the joints.

Some people benefit more than others.

However, most do not improve, and experience only a slowdown in the progression of arthritis.

There is no scientific evidence that most of the above treatments, which are also offered for elbow pain, are effective on their own.

Therefore, combinations of medicinal therapies (in some cases also surgical ones) and physiotherapy are recommended.

It cannot be said in general whether regular exercise or elbow protection is the right choice.

It basically depends on the cause of the joint pain.

If there is an overuse injury, immobilization is usually the best solution.

This gives the ulna, radius or joints the opportunity to heal in peace and the inflammation goes down better.

If, on the other hand, there is a limitation due to arthrosis, the main rule is to keep the elbows in motion.

So you should know that with moderate exercise, you stimulate the formation of synovial fluid in a natural way and thus make a contribution against progressive wear and tear.

Unfortunately, there is no cure for osteoarthritis, but with the right measures you can slow its progression and maintain the functionality of the elbow joint for years and decades to come.

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