| Elbow Injuries
		
			| Topic OverviewEveryone has had a minor elbow
		injury. You may have bumped your "funny bone" at
		the back of your elbow, causing shooting numbness and pain. The funny-bone
		sensation can be intense, but it is not serious and will go away on its own.
		Maybe your elbow has become sore after activity. Elbow injuries can be minor or
		serious and may include symptoms such as pain, swelling, numbness, tingling,
		weakness, or decreased range of motion. Home treatment often can help relieve
		minor aches and pains. Injuries are the most common cause of elbow
		pain. Some people may not recall having had a specific injury, especially if
		symptoms began gradually or during everyday activities.To better understand elbow injuries, you may want to review the structure and function of the elbow. See a picture of the elbow.
 Elbow injuries occur most commonly
		during: Sports or recreational
		  activities.Work-related tasks.Work or projects around
		  the home.Falls.
 Most elbow injuries in children occur during activities, such
		as sports or play, or are the result of accidental falls. The risk for injury
		is higher in contact sports such as wrestling, football, or soccer, or
		high-speed sports such as biking, in-line skating, skiing, hockey, snowboarding, or
		skateboarding. Elbows, forearms, wrists, hands, and fingers are the most
		affected body areas. Any injury in a child or teen that occurs near a
		joint may injure the growing end (growth plate) of long bones and needs to be
		evaluated. Older adults have a higher risk for injuries and
		fractures because they lose muscle mass and bone strength (osteoporosis) as they age. They also have more
		problems with vision and balance, which increase their risk for accidental
		injury.  Sudden (acute) injuryAn acute injury may be caused
		  by a direct blow, penetrating injury, or fall or by twisting, jerking,
		  jamming, or bending an elbow abnormally. Pain may be sudden and severe.
		  Bruising and swelling may develop soon after the injury. Acute injuries
		  include: Bruises from a tear or rupture of small
			 blood vessels under the skin.Injuries to
			 ligaments, the ropy fibers that connect bones to
			 bones around joints.Injuries to
			 tendons that connect muscles to
			 bones.Injuries to joints (sprains) that
			 stretch or tear the ligaments.Pulled muscles (strains) caused by overstretching
			 muscles.Muscle tears or ruptures, such as your biceps or triceps
			 in your upper arm.Broken bones (fractures) of the
			 upper arm bone (humerus) or the forearm bones (ulna or radius) at the elbow
			 joint.Dislocations of the elbow joint (out of its normal
			 position).
 Overuse injuriesOveruse injuries occur when too much
		  stress is placed on a joint or other tissue, often by overdoing an
		  activity or through repetition of an activity. Overuse
		  injuries include: Bursitis.
			 Swelling behind the elbow may be
			 olecranon bursitis (Popeye elbow).Tendinosis, which is a series of microtears in the
			 connective tissue in or around the tendon. 
			 Soreness or pain felt on the outside
				  (lateral) part of the elbow may be
				  tennis elbow (lateral epicondylitis). This is the most
				  common type of
				  tendinopathy that affects the elbow and most often is
				  caused by overuse of the forearm muscles. This overuse may occur during sports,
				  such as tennis, swimming, golf, and sports involving throwing; jobs, such as
				  carpentry or plumbing; or daily activities, such as lifting objects or
				  gardening.Soreness or pain in the inner (medial) part of the elbow
				  may be
				  golfer's elbow. In children who participate in sports
				  that involve throwing, the same elbow pain may be described as
				  Little Leaguer's elbow.
Pinched nerves, such as ulnar nerve compression, which is the
			 pinching of the ulnar nerve near the elbow joint. This usually occurs with
			 repeated motions.
 An
		infection of the elbow may cause pain, redness,
		swelling, warmth, fever, chills, pus, or swollen
		lymph nodes in the armpit on that side of your body.
		"Shooter's abscess" is an infection commonly seen in people who inject illegal
		drugs into the veins of their arms. Elbow injuries such as bruises, burns, fractures, cuts, or punctures may be caused by abuse. Suspect possible abuse when an injury cannot be explained or does not match the explanation, repeated injuries occur, or the explanations for the cause of the injury change. TreatmentTreatment for an elbow injury may include
		  first aid measures; application of a brace, splint, or cast;
		  physical therapy; medicines; and in some cases,
		  surgery. Treatment depends on: The location, type, and severity of the
			 injury.How long ago the injury occurred.Your age,
			 health condition, and activities, such as work, sports, or hobbies.
 Check your symptoms to decide if and when
		you should see a doctor.Check Your SymptomsDo you have an elbow injury?How old are you? Less than 5 years Less than 5 years5 years or older 5 years or olderHas it been more than a month since the elbow injury? Yes Elbow injury over a month agoNo Elbow injury over a month agoHave you had elbow surgery in the past month? If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it. Yes Elbow surgery in the past monthNo Elbow surgery in the past monthHave you had a major trauma  in the past 2 to 3 hours?Yes Major trauma in past 2 to 3 hoursNo Major trauma in past 2 to 3 hoursDo you have symptoms of shock?Are you having trouble moving your arm? Pain or swelling can limit movement.Can you move the elbow at all? Yes Able to move the elbowNo Unable to move the elbowHave you had trouble moving your arm for more than 2 days? Yes Difficulty moving arm for more than 2 daysNo Difficulty moving arm for more than 2 daysIs there any pain in the elbow?How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 5 to 10: Moderate to severe pain Moderate to severe pain1 to 4: Mild pain Mild painHas the pain: Gotten worse? Pain is increasingStayed about the same (not better or worse)? Pain is unchangedGotten better? Pain is improvingDo you have any pain in your elbow?How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain5 to 7: Moderate pain Moderate pain1 to 4: Mild pain Mild painHas the pain: Gotten worse? Pain is getting worseStayed about the same (not better or worse)? Pain is unchangedGotten better? Pain is getting betterHas the pain lasted for more than 2 days? Yes Pain for more than 2 daysNo Pain for more than 2 daysIs the arm blue, very pale, or cold  and different from the other arm?If the arm is in a cast, splint, or brace, follow the instructions you got about how to loosen it. Yes Arm blue, very pale, or cold and different from other armNo Arm blue, very pale, or cold and different from other armWas the elbow twisted or bent out of its normal position, even if it is back in place now? Yes Elbow is or was out of its normal positionNo Elbow is or was out of its normal positionDo you have weakness, numbness, or tingling in your arm or hand that has lasted more than an hour? Weakness is being unable to use the arm or hand normally no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness. Yes Numbness, weakness, or tingling for more than 1 hourNo Numbness, weakness, or tingling for more than 1 hourDo you think that the injury may have been caused by abuse? Yes Injury may have been caused by abuseNo Injury may have been caused by abuseDo you think the problem may be causing a fever?  Some bone and joint problems can cause a fever.Are there red streaks leading away from the area or pus draining from it?Do you have diabetes, a weakened immune system , peripheral arterial disease, or any surgical hardware in the area?"Hardware" includes things like artificial joints, plates or screws, catheters, and medicine pumps. Yes Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected areaNo Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected areaIs there any swelling or bruising?Did you have swelling or bruising within 30 minutes of the injury? Yes Swelling or bruising within 30 minutes of injuryNo Swelling or bruising within 30 minutes of injuryHas swelling lasted for more than 2 days? Yes Swelling for more than 2 daysNo Swelling for more than 2 daysHave you had symptoms for more than a week? Yes Symptoms for more than a weekNo Symptoms for more than a weekMany things can affect how your body responds to a symptom and what kind
	 of care you may need. These include: Your age. Babies and older
		adults tend to get sicker quicker.Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
		disease, you may need to pay closer attention to certain symptoms and seek care
		sooner.Medicines you take. Certain
		medicines, herbal remedies, and supplements can cause symptoms or make them
		worse.Recent health events, such as surgery
		or injury. These kinds of events can cause symptoms afterwards or make them
		more serious.Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
		use, sexual history, and travel. 
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
		able to take care of this problem at home. Try home treatment to relieve the
		  symptoms. Call your doctor if symptoms get worse or you have any
		  concerns (for example, if symptoms are not getting better as you would expect).
		  You may need care sooner.
Major trauma is any event that can
	 cause very serious injury, such as: A fall from more than
		10 ft (3.1 m)  [more than
		5 ft (1.5 m) for children under
		2 years and adults over 65].A car crash in which any vehicle
		involved was going more than
		20 miles (32 km) per
		hour.Any event that causes severe bleeding that you cannot
		control.Any event forceful enough to badly break a large bone (like an arm bone or leg bone).
With severe bleeding, any of these may
	 be true: Blood is pumping from the wound.The
		bleeding does not stop or slow down with pressure.Blood is quickly soaking through bandage after bandage.
 With moderate bleeding, any of these may
	 be true: The bleeding slows or stops with pressure but
		starts again if you remove the pressure.The blood may soak through
		a few bandages, but it is not fast or out of control.
 With mild bleeding, any of these may be
	 true: The bleeding stops on its own or with
		pressure.The bleeding stops or slows to an ooze or trickle after
		15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Symptoms of infection may
	 include: Increased pain, swelling, warmth, or redness in or
		around the area.Red streaks leading from the area.
		Pus draining from the area. A fever.
When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood
	 supply to the area. This can be serious.  There are other reasons
	 for color and temperature changes. Bruises often look blue. A limb may turn
	 blue or pale if you leave it in one position for too long, but its normal color
	 returns after you move it. What you are looking for is a change in how the area
	 looks (it turns blue or pale) and feels (it becomes cold to the touch), and
	 this change does not go away.Pain in adults and older children Severe pain (8 to 10): The pain
		is so bad that you can't stand it for more than a few hours, can't sleep, and
		can't do anything else except focus on the pain. Moderate pain (5 to 7): The pain is bad enough to disrupt your
		normal activities and your sleep, but you can tolerate it for hours or days.
		Moderate can also mean pain that comes and goes even if it's severe when it's
		there.Mild pain (1 to 4): You notice the pain,
		but it is not bad enough to disrupt your sleep or activities. 
Pain in children under 3 years It can be hard to tell how much pain a baby or toddler is in. Severe pain (8 to 10): The
		pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
		constantly no matter what you do. The baby may kick, make fists, or
		grimace.Moderate pain (5 to 7): The baby is
		very fussy, clings to you a lot, and may have trouble sleeping but responds
		when you try to comfort him or her.Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
		when you try to comfort him or her. 
Pain in children 3 years and older Severe pain (8 to 10): The pain
		is so bad that the child can't stand it for more than a few hours, can't sleep,
		and can't do anything else except focus on the pain. No one can tolerate severe
		pain for more than a few hours. Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
		sleep, but the child can tolerate it for hours or days. Mild pain (1 to 4): The child notices and may complain of the pain,
		but it is not bad enough to disrupt his or her sleep or activities.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
	 illness. Some examples in adults are: Diseases such as diabetes, cancer, heart disease,
		and HIV/AIDS.Long-term alcohol and drug
		problems.Steroid medicines, which may be used to treat a variety
		of conditions.Chemotherapy and radiation therapy for
		cancer.Other medicines used to treat autoimmune
		disease.Medicines taken after organ transplant.Not
		having a spleen.
Shock is a life-threatening condition that may quickly occur
	 after a sudden illness or injury.  Symptoms of shock (most of which will be present) include: Passing out (losing consciousness).Feeling very dizzy or
		lightheaded, like you may pass out.Feeling very weak or having
		trouble standing.Not feeling alert or able to think clearly. You
		may be confused, restless, fearful, or unable to respond to questions.
Shock is a life-threatening condition that may occur quickly
	 after a sudden illness or injury.  Symptoms of shock in a child may include: Passing out (losing consciousness).Being very sleepy or hard
		to wake up. Not responding when being touched or talked to.
		Breathing much faster than usual. Acting confused.
		The child may not know where he or she is. 
Call  911  NowBased on your answers, you need
		emergency care. Call911or other emergency services now.Put direct, steady pressure on the
		wound until help arrives. Keep the area raised if you can.Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care.Call your doctor now to discuss the symptoms and
		  arrange for care.If you cannot reach your doctor or you don't have
		  one, seek care in the next hour.You do not need to call an
		  ambulance unless: 
		  You cannot travel safely either by driving
				yourself or by having someone else drive you.You are in an area
				where heavy traffic or other problems may slow you down.
Call  911  NowBased on your answers, you need
		emergency care.Call911or other emergency services now.Seek Care TodayBased on your answers, you may need care soon. The
		problem probably will not get better without medical care.Call your doctor today to discuss the symptoms
		  and arrange for care.If you cannot reach your doctor or you don't
		  have one, seek care today.If it is evening, watch the symptoms and
		  seek care in the morning.If the symptoms get worse, seek care
		  sooner.
Make an Appointment Based on your answers, the problem may not improve without medical
		care.Make an appointment to see your doctor in the
		  next 1 to 2 weeks.  If appropriate, try home treatment while you
		  are waiting for the appointment.If symptoms get worse or you have
		  any concerns, call your doctor. You may need care sooner.
Postoperative Problems Elbow Problems, NoninjuryHome TreatmentMost minor injuries will heal on
		their own, and home treatment is usually all that is needed to relieve your
		symptoms and promote healing. But if you suspect that you have a more severe
		injury, use first aid measures while you arrange for an evaluation by your
		doctor. First aid for a suspected broken boneIf a bone is sticking out of your skin, do not
			 try to push it back into your skin. It is better to leave the bone alone and
			 cover the area with a clean bandage.Control bleeding
			 from your injury.Remove all rings, bracelets, watches,
			 or any other jewelry from the injured arm immediately. It may be hard to
			 remove the jewelry if swelling occurs, which in turn can cause other serious
			 problems, such as nerve compression or restricted blood flow.
			 Splint your injured arm without trying to straighten
			 it. Loosen the wrap around the splint if you develop signs that indicate the
			 wrap is too tight, such as numbness, tingling, increased pain, swelling, or
			 cool skin below the wrap. A problem called
			 compartment syndrome can develop.
 If a cast or splint is applied, it is important to keep it
		  dry and to try to move the uninjured part of your arm as normally as possible
		  to help maintain muscle strength and tone. Your doctor will give you
		  instructions on how to
		  care for your cast or splint. Home treatment for a minor injuryHome treatment may
		  help relieve pain, swelling, and stiffness. Remove all rings, bracelets, watches,
			 or any other jewelry that goes around your wrist or fingers of the injured arm.
			 It will be more difficult to remove the jewelry later if swelling increases.Use
			 rest, ice, compression, and elevation (RICE) to treat pain and swelling.
			  Wear a
			 sling for the first 48 hours after the injury if it
			 makes you more comfortable and supports the injured area. If you feel you need
			 to use a sling for more than 48 hours, discuss your symptoms with your
			 doctor.An elbow support, such as an elbow sleeve, forearm wrap, or
			 arm sling, may help rest your elbow joint, relieve
			 stress on your forearm muscles, and protect your joint during activity. A
			 counterforce brace may be helpful for tennis elbow
			 symptoms. Follow the manufacturer's directions for using the
			 brace.Gently massage or rub the area to relieve pain and encourage
			 blood flow. Do not massage the injured area if it causes pain.For
			 the first 48 hours after an injury, avoid things that might increase swelling,
			 such as hot showers, hot tubs, hot packs, or alcoholic
			 beverages.After 48 to 72 hours, if swelling is gone, apply
			 heat and begin
			 gentle exercise with the aid of moist heat to help
			 restore and maintain flexibility. Some experts recommend alternating between
			 hot and cold treatments.If applying ice to your elbow does not
			 reduce the swelling, talk with your doctor about hydrocortisone gel treatments
			 (phonophoresis) with a physical therapist. Start exercises using
			 the MSA process (gentle exercise). MSA stands for movement, strength, and
			 alternate activities. 
			 Movement. Resume a
				  full range of motion as soon as possible after an injury. After 24 to 48 hours
				  of rest, begin moving the injured area. Stop any activity if it causes pain, and
				  give the injured area more rest. Gentle stretching will prevent the formation
				  of scar tissue that may decrease movement. Strength. Once the swelling is gone and range of motion is
				  restored, begin gradual efforts to strengthen the injured area. Hand grip
				  exercises can help you regain elbow strength. Using a small ball, such as an
				  old tennis ball, squeeze the ball 20 to 25 times holding each squeeze for about
				  5 seconds. After 2 to 3 weeks of hand grip exercises, you may begin forearm
				  exercises of extending or bending the elbow. Alternate activities. After the first few days but while the
				  injury is still healing, slowly add in regular exercise, such as activities or
				  sports that do not place a strain on the injured area. If certain activities
				  cause pain, stop doing those activities but continue doing your other
				  exercises.
Do not smoke or use other tobacco products.
			 Smoking slows healing because it decreases blood supply and delays tissue
			 repair. For more information, see the topic Quitting Smoking.
 Medicine you can buy without a prescription| Try a nonprescription
			 medicine to help treat your fever or pain: | 
|---|
 | Talk to your child's doctor before switching back and
				forth between doses of acetaminophen and ibuprofen. When you switch between two
				medicines, there is a chance your child will get too much medicine. |  Safety tips| Be sure to follow these
				safety tips when you use a nonprescription medicine: | 
|---|
 | Carefully read and follow all directions
					 on the medicine bottle and box.Do not take more than the
					 recommended dose.Do not take a medicine if you have had an
					 allergic reaction to it in the past.If
					 you have been told to avoid a medicine, call your doctor before you take
					 it.If you are or could be pregnant, do not take any medicine other
					 than acetaminophen unless your doctor has told you to.Do not give aspirin to anyone younger than age 20 unless your doctor tells you to. 
					 
 |  Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
		  treatment: Pain or swelling does not improve or it gets worse.Signs of infection develop.Numbness; tingling; or cool, pale skin
			 develops.Symptoms become more severe or more frequent.
PreventionThe following tips may prevent elbow
		problems or injuries. General prevention tipsWear your seat belt when you travel in a motor
			 vehicle.Do not use alcohol or other drugs before participating in
			 sports or when operating a motor vehicle or other equipment.Don't
			 carry objects that are too heavy.Use a step stool. Do not stand on
			 chairs or other unsteady objects.Wear protective gear during
			 sports or recreational activities, such as roller-skating or soccer. Supportive
			 splints may reduce your risk for injury. Make sure your child also wears protective clothing to prevent sports injuries.Stretch before and after
			 physical exercise, sports, or recreational activities to warm up your
			 muscles.Do
			 stretching and range-of-motion (ROM) exercises with
			 your fingers and wrist to prevent stiffening of the tendons that affect your
			 elbows. Gently bend, straighten, and rotate your wrist. If you have any pain,
			 stop the exercises.Use the correct techniques (movements) or
			 positions during activities so that you do not strain your
			 muscles. Avoid overusing your arm doing repeated movements that
			 can injure your
			 bursa or tendons. In daily routines or hobbies,
			 examine activities in which you make repeated arm movements.Take
			 lessons to learn the proper technique for sports. Have a trainer or person who
			 is familiar with sports equipment check your equipment to see if it is well
			 suited for your level of ability, body size, and body strength.If
			 you feel that activities at your workplace are causing pain or soreness from
			 overuse, call your human resources department for information on alternative
			 ways of doing your job or to discuss equipment modifications or other job
			 assignments.
 Reduce fallsPreventing falls will help you to avoid
		  elbow injuries. To prevent falls: Keep bones strongEat a nutritious diet that includes enough
			 calcium and
			 vitamin D, which helps your body absorb calcium.
			 Calcium is found in dairy products, such as milk, cheese, and yogurt; dark
			 green, leafy vegetables, such as broccoli; and other
			 foods.Exercise and stay active. Talk to your doctor about an
			 exercise program that is right for you. Begin slowly, especially if you have
			 been inactive. For more information, see the topic Fitness: Getting and Staying Active.Don't
			 drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink
			 a day if you are a woman. People who drink more than this have a higher risk
			 for weakening bones (osteopenia). Alcohol use also increases
			 your risk of injuries related to falls. Do not smoke or use other
			 tobacco products. Smoking puts you at a much higher risk for developing
			 osteoporosis. It also interferes with blood supply and healing. For more
			 information, see the topic Quitting Smoking.Cut down on
			 caffeine. Caffeine in coffee and soda pop may increase calcium loss from your
			 body and increase your risk for osteoporosis. 
 Possible abuseInjuries such as bruises, burns,
			 fractures, cuts, or punctures may be a sign of
			 abuse. Suspect possible abuse when an injury cannot be
			 explained or does not match the explanation, repeated injuries occur, or the
			 explanations for the cause of the injury change. You may be able to prevent
			 further abuse by reporting it and seeking help.Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
		doctor diagnose and treat your condition by being prepared to answer the
		following questions: What are your main symptoms?How long
		  have you had your symptoms?How and when did the injury occur? How
		  was it treated?Have you ever had any injuries to the same area? Do
		  you have any ongoing problems because of the previous injury?What
		  activities related to sports, work, or your lifestyle make your symptoms better
		  or worse?What home treatment measures have you tried? Did home
		  treatment help?What prescription and nonprescription medicines
		  have you tried? Did they help?  Do you have any
		  health risks?
CreditsByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
 Kathleen Romito, MD - Family Medicine
 Specialist Medical ReviewerAdam Husney, MD - Family Medicine
Current as ofApril 7, 2017Current as of:
                April 7, 2017 Last modified on: 8 September 2017  |  |