Structure of the elbow joint

 

The elbow is a hinge joint formed by the meeting of three bones, humerus of the upper arm, radius and ulna of the forearm. The contacting of the humerus and the ulna formed a anterior flexible joint, and the radius meet the ulna in the elbow to allow for rotation of the forearm. The Biceps is the major muscle that flexes the elbow and the triceps is the muscle that extends the elbow. Medial and Lateral epicondyles are the bony prominence in the inner and outer portion of the elbow. Muscle tendons are attached to these epicondyles. A busa, fluid-filled sac which serves to reduce friction, overlies the tip of the elbow.   

 

Causes of elbow pain

TENDINITIS.

l        Lateral epicondylitis (Tennis Elbow)

Tennis elbow results with inflammation of the tendons which attached to the outer bony prominence of the elbow causing pain over that area. The tendon can be injured with repetitive motions of the forearm, such as hitting a backhand in tennis play, using a manual screwdriver or washing windows. As the inner joint is not affected, the elbow maintains its full range of motion. Increasing pain can be elicited by repeated twisting motions or any activities which strain the tendon.

l        Medial epicondylitis (Golf’s elbow)

Inflammation of the tendon which attached to the inner prominence of the elbow causing results Golf’s elbow. This tendon can become strained in a golf swing or by other repetitive motions. The range of motion is preserved because the inner joint of the elbow is not affected. Those activities which require twisting or straining the forearm tendon can elicit pain and worsen the condition.

 

BRUSITIS.  Olecranon bursitis is an inflammation of the bursa at the tip of the elbow. Brusitis can occur from injury or minor trauma, as a result of systemic diseases (gout or rheumatoid), or can be due to a local infection.

 

ARTHRITIS.  Inflammation of the elbow joint can occur as a result of many systemic of arthritis, including gouty, rheumatoid, psoriatic, reactive arthritis. Sign of local inflammation, e.g. heat, swelling, pain, tenderness and decreased range of motion can be seen.

 

FRACTURE. Broken of bone of the elbow usually caused by trauma.

INFECTION. Infection of the joint, called septic arthritis, is uncommon. It is most often seen in patient with suppressed immunity. Infection of the skin, called cellulitis, commonly occurs as a result of abrasion or puncture to the area.

 

ULNER NERVE ENTRAPMENT.  The ulner nerve is travels between the tip of the elbow and the inner elbow bone on the posterior portion of the elbow. This nerve can be pinched or entrapment by normal or swollen structures after injury. Pain over the forearm, especially the inner side and numbness of the little and ring finger can be experienced.

 

TUMOR. Bone tumors of the elbow are rare. It can be pain or painless.

 

Treatment of Tennis elbow

 

One of the most frequent injuries suffered by athletes likely is lateral epicondylitis, Tennis elbow. It is caused by repeated twisting of the wrist or frequent rotation of the forearm and can be lead to elbow pain, weakened grip, and damage to the bone of the upper arm, humerus.

Traditional therapy of tennis elbow consists of rest, braces, heat, physical therapy and medications. The majority of these treatments are effective in relieving pain but serves little for restoring the function of the joint and to prevent the condition from recurring.

Clinical practices and researches suggest that acupuncture not only relieves the symptoms of tennis elbow, it appears to resolve the condition completely.

 

Documentation on treatment of tennis elbow with acupuncture

 

Dorsher PT. Treatment of chronic lateral epicondylitis with acupuncture: a pilot study. Presented at the annual meeting of the American Academy of Physical Medicine and Rehabilitation, San Francisco, CA, November 4, 2000

 

Dr. Peter Dorsher, a medical doctor certified in acupuncture, reported 22 patient, performed acupuncture treatment with varying degrees of tennis elbow. Subjects in this study group suffered symptoms for 8 months in average, 6 of them had symptoms for more than 2 years. Every patient had previously attempted to cure the disease through multiple conventional therapies without success before trying acupuncture.

Of 22 patients in this study group, 14 patients had undergone extensive interventions, 17 had used an elbow brace or splint, 7 received corticosteroid injections for pain relief, and one patient had elbow surgery.   

All the patients were treated with needle insertion on the local points around the elbow joint in tight myofascial bands. Each patient was treated between 2-10 times. A maximal response was achieved with disappearance of symptoms after an average of 3.9 treatments. The response also appeared to last much longer than that usually seen in patients using other traditional methods.

Follow-up for average 8.5 months after receiving acupuncture, 77.3% (n=17) of patients experienced a resolution of symptoms and had returned to full, normal activities; another 2 patients had returned to normal activities except those that involved heavy lifting in the affected arm.

From this small group study, it is clearly showed that acupuncture helps patient in the early and latter stages of tennis elbow, with immediately loosen the tight muscles around the elbow joint. Acupuncture is an extremely powerful tool for pain and very helpful to tennis elbow. It might consider acupuncture as a primary form of treatment.