Chiropractic Care is an Excellent Treatment Choice for Elbow Pain
Chiropractic has been proven to be a safe and effective therapy for elbow pain that promotes healing and restores strength without surgery or medication. In terms of elbow pain, chiropractic aims not only to relieve the pain itself but to address the structural components (muscles, skeleton, etc.) that contribute to the condition being there in the first place.
A Brief Introduction to the Elbow & Elbow Pain
The elbow is a joint, which is the conjunction (or meeting point) of two or more bones. What’s more, it is considered a ball-and-socket joint, which means that the bones form a cup shape around a slippery, gelatinous sac (forming the “ball”), allowing movement of the joint in more than one direction.
In the case of the elbow there are three bones involved – the humerus (or upper arm bone), and the radius and ulna (which make up the forearm or lower arm). Together, they allow us to move the joint in two different ways – flexing and extending (like doing bicep curls), and pronation/supination (which is when you turn arm from palm facing down to palm facing up, or vice-versa).
The complexity of bones, muscles, and ligaments meeting at this joint coupled with its range of motion, not to mention its range of everyday movements, can sometimes cause parts of this joint to become irritated or inflamed – the two most common sources of elbow pain. The causes for that irritation and inflammation are most often some combination of overexertion and overuse, though infection, genetics, and degenerative diseases can always play a role as well.
Common Elbow Pain Related Conditions We See In Our Office
Elbow pain is a common issue we address in our office. It is most common in a person’s dominant arm. Some of the most common causes of that elbow pain follow below:
Tennis Elbow (Lateral Epicondylitis):
“Manipulation of the wrist appeared to be more effective than ultrasound, friction massage, and muscle stretching and strengthening exercises for the management of lateral epicondylitis when there was a short-term follow-up.” (Australas. Chiropr. Osteopathy. 1998 July; 7(2): 53–67)
Tennis elbow is a pain or soreness that is felt on the outside of the elbow. A form of tendonitis, it is caused by damage to the muscles and tendons connecting the forearm muscles (the ulna and radius) to the elbow joint. Specifically, tennis elbow involves the muscles and tendons that connect to the bony spur on the outside of the elbow (called the lateral epicondyle). This damage is most frequently caused by overuse of the joint, particularly when that overuse is repetitive.
Tennis elbow pain usually starts small and slowly increases, although occasionally (if rarely) the pain comes suddenly and as though out of nowhere. With tennis elbow, it can hurt to shake hands or squeeze an object. Any activity involving the elbow joint then exacerbates the pain (lifting, brushing teeth etc.).
Tennis elbow occurs more with men than women, and it occurs more with people in the 30-50 year-old age range than in other age groups.
Tennis elbow should not be ignored, and it is unlikely to go away on its own. While pain from tennis elbow starts on the outside of the elbow, if the condition is left untreated, the pain can spread down the arm all the way to the wrist. When this happens, simple tasks liking turning a key in a lock or open a door become painful and difficult, if not impossible.
Treatments that may be indicated for pain relief from tennis elbow include:
- graded exercise programs
- myofascial release
- cross friction massage
- joint manipulation
- mobilization (in the subacute phase)
Before moving on to the next condition, there is another common treatment people use for tennis elbow, but one that is of questionable value and safety – and this is steroids. The following quote gives an eye-opening accounting of the contrast between steroidal treatment and more conservative treatments like those named in the previous paragraph. It’s a tad long, but if you’re taking steroids to treat tennis elbow, or you’re considering it, it’s worth a read.
“While administration of steroid compounds has traditionally been the mainstay of conservative treatment of tennis elbow, the high recurrence rate of side effects and structural tissue changes associated with steroid therapy, leaves this modality as the most controversial approach in the treatment of tennis elbow. In contrast, in some studies evidence in favour of a role for classical acupuncture, ultrasound and low level laser as effective therapeutic means in the treatment of tennis elbow has been provided. As these modalities have not been associated with any side effects, in view of the ease of application, low cost and good curative effects, their increased application has been suggested by some authors.” (A Critical Review of the Current Conservative Therapies for Tennis Elbow. Chiropractic & Osteopathic College of Australasia)
Posterior Tennis Elbow (Triceps Tendonitis):
Also known as posterior elbow tendonitis, the difference between posterior tennis elbow and tennis elbow is in the part of the joint that’s affected. In “regular” tennis elbow, it’s the outside of the elbow. In posterior tennis elbow, it’s the back or underside of the elbow that’s involved.
At risk are people who frequently do any activities/motions that rapidly extend the arm, such as:
- certain weightlifting exercises (specifically those involving the triceps and the ulna)
- punching (lending to the condition’s sometimes nickname “Boxer’s Elbow”)
Indicated treatment for posterior tennis elbow includes:
- myofacial release
- cross friction
Golfer’s Elbow or Medial Epicondylitis:
Golfer’s elbow is also quite similar to tennis elbow, the only real differences being, as with posterior tennis elbow, the location of the pain and the activities/motions that cause it. With golfer’s elbow, instead of the outside or back or the elbow being affected, it’s the inside of the elbow that is.
With golfer’s elbow, a person may feel a shooting pain down the inside of their forearm as they’re trying to grip an object. Golfer’s elbow can be caused by a single violent jolt, but more often it is a form of repetitive stress injury, in which pain develops gradually over time as the repetitive actions continue being taken and the condition, untreated, worsens. Obviously golfers are particularly susceptible to this condition but so are other types of people, some not even athletes – such as a “weekend carpenter” who uses hand tools.
As far as treatment is concerned, golfer’s elbow is so similar to tennis elbow that their recommended treatments are virtually identical. It is important to note, however, that golfer’s elbow is not to be taken lightly, as the longer the condition lasts, the longer it will take to treat it. As it stands, it still could take up to 8 weeks or more for a patient suffering from golfer’s elbow to experience a full recovery.
Posterior Impingement Syndrome:
Also known as Posterior Elbow Impingement, as distinct from Posterior Ankle Impingement, Posterior Impingement Syndrome, is caused by repeated overextension of the arm, especially when the motion is forced, such as when throwing. The injury starts with this repeated forced extension of the arm causing the tip of one bone to jam into the hollow of another. This leads initially to an inflammation of the joint lining, but if left untreated can lead to pain in the cartilage and bone as well.
Symptoms of elbow impingement are generally felt as tenderness or pain in the back of the elbow, particularly while attempting to straighten the elbow or throw an object. The elbow may swell up, and become stiff, with an increasing difficulty in fully straighten the arm out. Pain generally starts out gradually and develops over time with continued aggravation and no treatment.
People especially prone to posterior impingement syndrome include:
- racket sport players
Posterior Impingement Syndrome responds well to conservative treatment, notably:
Occasionally, however, a surgical referral may be made.
Little League Elbow:
An overuse injury occurring in young little league baseball players (and especially pitchers) around the age of puberty (ages 9-16), little league elbow is caused by repeated forced throwing. What happens is the ligament that attaches to the inside of the elbow starts to tug at one of the growth plates, pulling it away from the bone. The growth plate is extremely important at this stage in a child’s life because it is the site where the muscle groups attach that are responsible for flexing the rest and rotating the arm with palm facing down. Because a pubescent child is still growing – and obviously that includes his bones – it causes the dislocated growth plate to become weak and injury prone. Then, when tissue starts breaking down from the overuse of the arm and elbow, it breaks down too fast for the body to be able to repair it.
Little league elbow can be caused or worsened by:
- throwing the ball too hard
- throwing the ball too often
- upping the number of weekly pitches too fast and too soon
- throwing too many sliders or curve balls at too young an age
- switching into a league that has the pitcher’s mound located farther away than the child is used to from home plate, or the mound is raised, and the child has never thrown from an elevated mound before
Symptoms of little league elbow include:
- pain when throwing overhead
- pain located around the bony knob situated on the inside of the elbow
- swelling and inflammation
- (occasionally, but less frequently) pain when lifting heavy objects or gripping something
Little league elbow occurs in boys more than girls, simply because there are more boys playing in little league than girls.
- changing activities
- learning how to do the same activities in a healthier and safer manner
- practicing warm-up stretching before activity
Occasionally, however, an orthopedic consult may be needed.
Bursae are the joint’s shock absorbers. They are the gelatinous sacs referred to at the beginning of this article which cushion the bones that meet at a joint. Olecranon bursitis (also known as elbow bursitis) is when the bursa in the elbow joint is injured, irritated, or inflamed. There are several things that cause elbow bursitis:
- traumatic injury
- extreme pressure for prolonged periods of time (like leaning on a desk for a long time)
- certain medical conditions including gout and rheumatoid arthritis
The bursa of the elbow joint is located at the tip of the elbow, between the bones of the elbow and the loose skin surrounding it. Its purpose is to enable the skin free movement over the bone beneath. Usually this bursa is flat, but when it becomes injured or irritated it can become inflamed.
The main sign of olecranon bursitis is inflammation, though since the skin around it is so loose, it is sometimes hard to notice right away. But over time, untreated, further inflammation develops, causing pain and eventual difficulty moving the elbow. If an infection is involved, then redness and swelling might also be present.
- ice and ultrasound