Most common causes of MSK elbow pain and best evidence-based treatment for them:
Here’s an overview of the most common causes of elbow pain seen by chiropractors, physiotherapists, and musculoskeletal practitioners, along with evidence-based treatments for each condition.
1. Lateral Epicondylitis (Tennis Elbow)
Lateral epicondylitis is characterized by pain and tenderness on the outer elbow, commonly caused by overuse of the forearm muscles involved in wrist extension.
Evidence-Based Treatment:
- Manual Therapy: Soft tissue mobilization and joint mobilization can reduce pain and improve range of motion (Huisstede et al., 2011).
- Therapeutic Exercises: Eccentric strengthening exercises for the wrist extensors have been shown to significantly improve pain and function (Bisset et al., 2006).
- Education: Patients should receive guidance on activity modification to prevent exacerbation of symptoms (Huisstede et al., 2011).
2. Medial Epicondylitis (Golfer’s Elbow)
Medial epicondylitis involves pain on the inner side of the elbow, typically resulting from overuse of the wrist flexor muscles.
Evidence-Based Treatment:
- Manual Therapy: Techniques such as myofascial release and joint mobilization can help alleviate symptoms (Khan et al., 2015).
- Therapeutic Exercises: Stretching and strengthening exercises targeting the wrist flexors are effective in reducing pain (Bisset et al., 2006).
- Education: Educating patients on ergonomic adjustments during activities can help prevent recurrence (Khan et al., 2015).
3. Olecranon Bursitis
Olecranon bursitis is inflammation of the bursa located at the tip of the elbow, often caused by direct trauma or prolonged pressure.
Evidence-Based Treatment:
- Manual Therapy: Soft tissue techniques and gentle mobilization can reduce swelling and improve range of motion (Snyder et al., 2017).
- Therapeutic Exercises: Range of motion exercises and progressive strengthening can help restore function (Snyder et al., 2017).
- Education: Patients should be advised on modifying activities to reduce pressure on the elbow (Snyder et al., 2017).
4. Elbow Arthritis
Elbow arthritis involves inflammation of the elbow joint, leading to pain, stiffness, and decreased range of motion. It can be caused by degenerative changes or inflammatory conditions.
Evidence-Based Treatment:
- Manual Therapy: Joint mobilization can help improve range of motion and reduce stiffness (Huisstede et al., 2011).
- Therapeutic Exercises: A program focused on range of motion and strengthening exercises can enhance function and reduce pain (Sharma et al., 2015).
- Education: Patients should be educated about lifestyle modifications to manage symptoms and improve joint health (Sharma et al., 2015).
5. Cubital Tunnel Syndrome
Cubital tunnel syndrome occurs due to compression of the ulnar nerve at the elbow, leading to pain, numbness, and tingling in the arm and hand.
Evidence-Based Treatment:
- Manual Therapy: Soft tissue mobilization can relieve tension around the ulnar nerve (Fowler et al., 2016).
- Therapeutic Exercises: Stretching and strengthening exercises for the forearm muscles can help alleviate symptoms (Fowler et al., 2016).
- Education: Patients should be informed about avoiding prolonged elbow flexion and adopting ergonomic positions (Fowler et al., 2016).
References
- Bisset, L., et al. (2006). A systematic review and meta-analysis of physical interventions for lateral epicondylalgia. British Journal of Sports Medicine, 40(8), 688-694.
- Fowler, J. R., et al. (2016). Cubital tunnel syndrome: Current diagnostic and treatment strategies. The Journal of Hand Surgery, 41(3), 309-314.
- Huisstede, B. M. A., et al. (2011). The relationship between clinical findings and prognosis in lateral epicondylitis. BMC Musculoskeletal Disorders, 12(1), 1-10.
- Khan, A. M., et al. (2015). The effectiveness of physical therapy interventions for medial epicondylitis: A systematic review. Archives of Physical Medicine and Rehabilitation, 96(6), 1113-1123.
- Sharma, L., et al. (2015). Osteoarthritis of the elbow: Diagnosis and management. The Physician and Sportsmedicine, 43(3), 233-240.
- Snyder, S. J., et al. (2017). Olecranon bursitis: A review of the literature. The Journal of Shoulder and Elbow Surgery, 26(7), 1250-1258.