Tag Archive for: elbow pain

Nursemaid’s Elbow

Many children squeal with delight when you swing them around or back and forth by the arms. But the fun can easily turn into Nursemaid’s elbow. Nursemaid’s elbow is a common injury among toddlers and preschoolers. It happens when a ligament slips out of place and gets caught between two bones in the elbow joint. Normally, it is easy for a doctor to fix, but if it is not treated, the child may be permanently unable to fully move the elbow. It can be quite painful and scary for your little one and certainly stressful for you. At OCC – Colorado Center of Orthopedic Excellence in Colorado Springs, Colorado, their skilled and experienced orthopedic specialists are also experts at putting an injured and frightened child at ease. It’s not just that they provide the best care, but also that they are caring and sensitive.

OVERVIEW

Nursemaid’s elbow has many names: pulled elbow, radial-head subluxation, and annular ligament displacement. The condition is a dislocation of a bone in the elbow called the radius. Dislocation means the bone slips out of its normal position. Because the joints and ligaments in young children are still growing and relatively loose, it doesn’t take a lot of force to pull the radial bone out of place. Nursemaid’s elbow does not usually occur after age 5. By this time, a child’s joints and the structures around them are stronger. Also, the child is less likely to be in a situation where this injury might occur.

ABOUT THE ELBOW

The elbow is often thought of as being a single joint. Actually, it’s made up of three separate joints that together form a hinge joint called the elbow. A hinge joint is a joint between bones that permits motion in only one plane. The upper arm bone or humerus connects from the shoulder to the elbow forming the top of the hinge joint. The lower arm or forearm consists of two bones, the radius and the ulna. The ends of the bones are covered with cartilage which has a rubbery consistency that allows the joints to slide easily against one another and absorb shock. The bones are held together with ligaments that form the joint capsule. The elbow allows the hands to reach an object, stabilize the upper extremity to perform activities, and assist in throwing an object.

WHAT IS NURSEMAID’S ELBOW?

The name “Nursemaid’s elbow” comes from an era when nursemaids or nannies commonly looked after young children and either pulled on the child’s forearm or lifted or swung them by the arms. The medical term is radial head subluxation. Technically, it’s not a fully dislocated elbow. It means that the radial bone has started moving out of its socket and gotten caught between the ligaments—bands of connective tissue in the elbow—just short of popping out. Nursemaid’s elbow makes up more than 20% of upper arm injuries in children. It affects children assigned female at birth slightly more than children assigned male at birth. The left arm is more commonly affected than the right arm. Once the elbow dislocates, it is likely to do so again, especially in the 3 or 4 weeks after the injury.

Read more about Nursemaid’s Elbow on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with an elbow specialist today.

Tendinitis Elbow: When elbow strain leads to elbow pain.

 

What is tendonitis elbow?

Tendinitis elbow is one of the most common forms of tendinitis. When the tendon that connects the forearm muscles to the elbow bone becomes inflamed, lateral epicondylitis, or “tendinitis elbow” occurs. It’s also known as tennis elbow, and as the name implies, elbow tendon inflammation is frequently found in those who play racquet sports (e.g. tennis, racquetball and squash). However, it is also found in a variety of professions that require repetitive manual movements of the wrist. The flexing hand movements of a tennis backhand stroke, a painter’s brushstroke or a plumber’s pipe fastening motion all place strain on the forearm where the tendon attaches to the elbow joint (lateral epicondyle). The resulting inflammation produces pain, stiffness, and loss of motion. Although repetitive use is the most common source of tendinitis in the elbow, blunt force can also be a cause.

Risk factors

Elbow doctors find tendonitis elbow in active adults ages 30-50 that work extensively with their hands as well as less active adults that choose to dive into a new sport without the proper equipment, form or training. Professions with an elevated risk of tendonitis elbow include manual jobs with extensive wrist movement such as carpenters, painters, plumbers, as well as dentists and those involving a high use of computer keystrokes that flex the wrist repetitively.

Do you have elbow tendonitis?

If you experience pain, stiffness, or a burning sensation where the forearm tendon connects to the bony bump on the outside of the elbow, you may have tendonitis in your elbow. Other symptoms include muscle weakness, reduced range of motion, or difficulty lifting or gripping.

Treatment

If you have elbow pain, consult an elbow doctor to diagnose the source of pain and identify the most appropriate course of treatment. Early care is important in diagnosing the condition as well as reducing the possibility of chronic or persistent elbow pain. A physical exam and supporting imaging can reveal the cause of the discomfort, the severity of the condition and the best treatment option. A proper elbow examination will include assessment of the corresponding nerves, tendons, muscle and bones to identify the presence of nerve damage, arthritis, or tendonitis.

As with many overuse conditions, a pause in the activity can provide immediate relief. RICE (rest, ice, compression and elevation), stretching and muscle therapy are common conservative treatments for elbow tendonitis that produce positive results. Pain management and braces that support proper muscle movement are also effective. More intensive treatments include sonic treatment and surgical repair.

Recovery

Relief from tendonitis in the elbow can happen as quickly as a few weeks, however, some cases can take months. Severe cases that do not resolve within the first few months of conservative treatment may require corrective surgery to restore proper joint function. Elbow surgery has been shown to have a high success rate. With all treatment options, the resumption of activity should be slow and gradual to limit the risk of reoccurrence.

Prevention

Proper sports equipment, proper form, warm-up, and moderation of activity are the best safeguards against developing tendonitis elbow. Whether it’s a racket sport or manual activity, thoughtful warm-ups and limiting the duration of the training or work are also prudent.

Elbow tendonitis doesn’t need to keep you sidelined, but it does require attention and treatment. CCOE offers a complete range of treatment options for patients experiencing elbow pain. Visit one of our specialists:

David M. Weinstein, MD

Karl M. Larsen, MD

Ky M. Kobayashi, MD

Gregg G. Martyak, MD

Chance J. Henderson, MD

Visit ccoe.us or call (719) 623-1050

How Can Stress Fractures Lead to Elbow Pain?

When we think of a broken bone, we usually think of sports injuries or car accidents. However, another common way for a bone to break is via a stress fracture.

A stress fracture happens when a bone in the body breaks because of overuse. When a bone or joint is used repeatedly over long periods of time and continual stress is put on it, a stress fracture can develop.

A person may suffer a stress fracture when more pressure is put on the bone than it can handle, which leads to it breaking. Unlike in an accident, a stress fracture happens gradually.

It can take months or years for the bone to weaken and for the stress fracture to occur. A stress fracture can happen anywhere in the body, but the most common places are in the bones located in the lower legs and arms – including the elbow joint.

Link Between Stress Fractures and Elbow Pain

When a bone breaks as a result of an accident, you are likely to discover it pretty quickly because you feel sudden, focused pain. Because you are likely to see a doctor and get X-rays after an accident, even a small fracture is likely to be discovered; but discovering a stress fracture is more difficult. Stress fractures are generally smaller and cause less pain than accident fractures, so they often go undetected for quite some time. 

An olecranon fracture is a fracture that happens at the tip of the elbow. This type of fracture usually occurs due to blunt force, but it can also happen due to repeated stress and overuse of the arm, such as in tennis players or in certain manual occupations.

When an elbow fracture happens, you are likely to experience swelling at the tip of the elbow, bruising, tenderness, pain, and the inability to straighten your arm. You may also experience numbness in some fingers and instability in the elbow joint.

However, stress fractures anywhere else in the arm can also result in similar symptoms in the elbow. If you experience pain, swelling, stiffness, reduced range of motion, or discoloration near the elbow, but you didn’t experience a blunt-force blow to your arm, it’s possible you have a stress fracture somewhere in the arm.

Diagnosing Broken Bones Affecting the Elbow

To diagnose the reason behind elbow pain, your doctor will conduct a physical examination for signs of discoloration, swelling, abnormal positioning of bones, and pain on touch. The doctor will also order X-rays to confirm if and where a fracture exists. 

Depending on the location and severity of a stress fracture, the doctor will recommend treatment that may include a sling, cast, or splints. If the break is severe or complex, the physician may recommend surgery to ensure the bone heals properly.

Who Can Diagnose My Elbow Pain?

The Colorado Center of Orthopaedic Excellence provides comprehensive orthopedic care to patients with musculoskeletal conditions, including stress fractures and elbow pain. Our orthopedic physicians treat a wide range of conditions, diseases, and injuries.

If you have been experiencing elbow pain, call us at (719) 623-1050 today to make an appointment. You can also request an appointment online. We look forward to helping you live a more pain-free lifestyle once again.

Preparing for Elbow Surgery

If you are an athlete, weekend-warrior, or all around active person, then you may find yourself in the painful chokehold of agonizing elbow pain. Elbow pain usually occurs due to overuse of movements, when you grab something, or even when you just slightly move your arm when doing something that’s part of your daily routine. When it comes time to have surgery to fix a problem with the elbow, being informed and prepared will ensure a positive outcome.

Orthopedic surgeons like to use non-invasive methods of treatment first before resorting to invasive surgery. That’s because surgery isn’t always necessary, and when done prematurely could actually do more harm than good. These innovative and minimally invasive treatments range from physical therapy (exercise), steroid injections (cortisone shots), anti-inflammatory medications, and braces. These methods can typically eliminate your pain and drastically improve your range of motion without surgery. However, if your elbow pain does not improve with these treatments, then your physician will most likely recommend elbow surgery as the next step.

Surgeons perform arthroscopic (minimally invasive) or traditional (open) elbow surgery to repair fractures and repair the elbow joint. For some conditions where the cartilage and bone are badly degraded, a partial or complete elbow replacement may be the best option.

At Colorado Center of Orthopaedic Excellence, our orthopedic surgeons specializing in elbow surgery are ranked among the top specialists in the country for using the most innovative, minimally invasive techniques to decrease the pain and recovery time for patients undergoing treatment of both common and complex elbow conditions.

Our orthopedic surgeons have successfully performed countless surgeries including cubital tunnel release, arthroscopic elbow surgery, along with total and partial elbow replacement.

Preparing for Elbow Surgery 

Once you and your doctor decide that surgery will help you, you will need to learn what to expect from the surgery and create a treatment plan for the best results afterward. Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process and your role in it will help you recover more quickly and have fewer complications. 

Before surgery, your doctor will perform a complete physical examination to make sure you don’t have any conditions that could interfere with the surgery or the outcome. To decide the best procedure to perform for your elbow pain, your surgeon will also perform necessary tests such as blood tests and X-rays to get an accurate diagnosis, so that the right form of treatment can be administered. Follow these tips to prepare before your day of surgery: 

·       Have someone available to take you home after your surgery, you will not be able to drive for at least 24 hours.

·       Do not eat or drink before the surgery as directed.

·       In some cases, physical therapy or specific exercises will be prescribed prior to a scheduled procedure, to help build up muscle strength around the affected area.

·       Take your medication as directed. There are some medications your doctor may ask you to stop taking at a point prior to surgery, especially those that prevent blood clotting.

·       Arrange for someone to help out with everyday tasks like cooking, shopping, and laundry, and put the necessary items that you use most often within easy reach before surgery.

Don’t let elbow pain prevent you from enjoying your life any longer. To learn more about how to prepare for elbow surgery, call Colorado Center of Orthopaedic Excellence in Colorado Springs at (719) 623-1050 or request an appointment online.

What is Nursemaid Elbow Syndrome?

For a lot of children, one of their favorite games they used to play with your parents was having them hold onto both of their hands or arms, and as they’d count to three, they would lift and swing you up high up into the air over and over as if you were flying. We think of little kids as having pretty resilient bones, but this fun and warmhearted scenario doesn’t always end up favorably.

Did you know that for little children, this game can lead to an injury? But, it is not just this game, but any scenario when the arms are being held onto or yanked in general.

While many parents and caregivers may enjoy taking a child’s hands and wrists and swinging them as they walk in-between, doing so can result in injury. This common childhood injury is known as nursemaid’s elbow syndrome, or radial head subluxation (RHS).

Nursemaid’s elbow syndrome can be a very common injury to young children. When we are young, our bones and ligaments are not fully developed yet. As we develop into adults, our bones form and grow with us. In other words, our ligaments tighten and become thicker, bones enlarge and harden. Therefore, when we do get older the risk of getting injuries such as nursemaid’s elbow decreases.

However, kids are often rough and active, obviously making them prone to injuries such as sprains and broken bones, commonly to the arms. Children are also susceptible to having bones slip out of place.

Like the name implies, in many cases children are under the care of some sort of caregiver or a babysitter of some sort, like a nurse does in a hospital. When this scenario of the caregiver picking up the child the wrong way occurs, it results in nursemaid’s elbow, or pulled elbow, an accidental injury that occurs when the bones in the elbow partially pop out and dislocate. What happens is that one side of the elbow separates from the other side, and part of the ligament that wraps around the bone slips off and gets stuck between the bones.

Many parents and caregivers are unaware that swinging a child by the wrists or hands can really harm and injure their child.  It is important that parents and caregivers know the danger of swinging a child by the wrists or hands. Bones are fragile and can break when there is too much force. Even though it is an accident from having fun and playing around, if not careful, more severe complications can occur.

You should discourage anybody jerking or yanking a child’s arm. Pulling or grabbing a child by the hand or wrist can cause dislocation.  It doesn’t take much force for a child’s elbow to be pulled out of place, and it just takes a little miscalculation to cause a child a lot of pain.

Nursemaid’s elbow syndrome is painful but can be fixed with treatment. In most cases, an orthopedic doctor will gently move the bones back into normal position, by performing a procedure known as reduction. A joint reduction can be quite painful, albeit quick, and then the healing process can take place.

The doctor will hold the child’s wrist or forearm with the palm of the hand facing upwards. While putting pressure near the top of the radius bone, one of the bones in the forearm other than the ulna, the doctor will slowly bend the elbow in an attempt to pop or click the elbow joint back into place. Once the bones are put back into place, the pain and discomfort subside. If the injury is more severe, surgery may be required.

To learn more about nursemaid’s elbow syndrome, call Colorado Center of Orthopaedic Excellence in Colorado Springs at (719) 623-1050 to request an appointment with our orthopedic surgeons, or request an appointment online.

How to Treat Tennis Elbow

The elbow is one of the most regularly used joints in the body, especially for the active or hard-working individual. It is located in the center of the arm, providing flexibility to the arm. The elbow is also prone to injury, as a contact point for trauma and repetitive stress injuries. The elbow can be easily put under stress, as it is a major joint in one of the most active regions of the human body. It is put under extreme pressure as the point of injury or trauma. Because it has fewer planes of movement than the wrist or the shoulder, it can be painful when twisted or hyperextended.

What is Tennis Elbow?

Tennis elbow (lateral epicondylitis) happens when the tendon attached to the bony, outside part of the elbow becomes inflamed. The tendon’s tissues may not only be inflamed, but could also be partially torn. It is a condition that affects hundreds of thousands of tennis players, as well as those who manage to sustain the same injury because of movements they perform at work or in other sports.

Symptoms of Tennis Elbow:

  • Sharp pain on the outside of the elbow
  • Pain that radiates down the forearm (but not in all cases)
  •  Pain when you extend your wrist (bend it upward), shake hands or lift objects (including a comb or toothbrush in severe cases)
  • Pain to the touch
  •  Loss of grip strength

How to Prevent Tennis Elbow:

  • Minimize all activities that increase and aggravate pain in the elbow.
  • Physical therapy or occupational therapy, which may employ massage techniques, stretching exercises
  • Anti-inflammatory medications can be used. Take aspirin, acetaminophen, ibuprofen or naproxen for pain and inflammation.
  • Apply ice applications 15-20 minutes, 3-4 times a day.
  • Use an elbow brace or wrap to redirect pressure away from the inflamed elbow.

If you are experiencing elbow pain or think you may be suffering from symptoms of tennis elbow, call Colorado Center of Orthopaedic Excellence at (719) 623-1050 to request an appointment.