The elbow is a movable bony joint that allows motion between the upper arm and the forearm and is one of the most important joints for everyday activities. The joint itself contains fluid that acts as a lubricant on top of the articular cartilage. There are multiple tendons attached around the elbow joint.

Elbow pain can originate from overuse of the elbow during daily activity or sports. The source of pain can arise from the joint itself or from the surrounding tendons and muscles. Elbow pain can persist throughput the day and night, and usually gets worse with elbow overuse. This could hinder the patient’s ability to move his or her forearm during normal daily activities or sports.

The pain can be in the form of tenderness on the inner or the outer side of the elbow and could extend along the inner side of the forearm. There could also be a sense of stiffness, weakness in the hands and wrists and sometimes a numbness or tingling sensation that radiates into one or more fingers. Elbow pain most commonly affects individuals of middle age or older whether males or females.

Elbow pain occurs due to several reasons; these include:

1.Medial Epicondylitis/Golfer’s Elbow:

This is an inflammation of the medial “epicondyle” (the larger and more prominent bony protrusion that can be felt on the inside of the elbow).

-This condition is commonly known as “Golfer’s Elbow” as the pain associated with it often arises from the excessive flexing of the muscles of the forearm, such as from a golf swing.

-Some of the causes include carrying heavy weights, jobs that include bending and straightening the elbow frequently such as painting, cooking, chopping wood or using a computer and some racket and throwing sports.

2.Lateral Epicondylitis/Tennis Elbow:

It’s caused by the inflammation of the lateral “epicondyle” (the smaller, less protruding bony protrusion found on the inside of the elbow).

-Lateral Epicondylitis is commonly called “Tennis Elbow” as it often occurs due to overstressing the extensor muscles of the elbow such as a backhand in tennis. Extensor muscles are skeletal muscles whose contraction extend or stretch a part of the body.

-Other causes include daily activities such as typing, using scissors, jobs like gardening, plumbing, or certain sports such as swimming, throwing and racket sports.

3.Elbow Joint Arthritis:

Elbow joint arthritis is usually found in individuals with rheumatoid arthritis (a chronic disorder that mainly affects the flexible joints causing loss of function and mobility of the affected areas and pain). It is commonly found in elderly and affects women two to three times as much as men but can also be seen at any age.

-Osteoarthritis/Degenerative Arthritis (a degeneration of the joint cartilage and the underlying bone) and other elbow injuries can also cause elbow joint arthritis.

-At the earlier stages of arthritis, the patient usually feels the pain when bending his/her elbow and sometimes even when straightening it.

4.Olecranon Bursitis:

Bursae are small, fluid-filled sacs that are located in joints throughout the body, including the elbow. They act as cushions to reduce friction between bones and the overlying soft tissues.

-When leaning on the tip of the elbow for example while using laptops or for people who have jobs where they lean on a table for long hours, this may cause the bursa to swell and accordingly cause pain.

5.Nerve Entrapment/Cubital Tunnel Syndrome:

The main nerve in the arm is called the “Radial Nerve” and is responsible for the flexible movement of the arm. If this nerve is compressed by the elbow joint causing the nerve to be constricted, it causes pain and numbness, a condition often called “Cubital Tunnel Syndrome”.

6.Bone Fractures:

Sometimes the bones of the elbow can fracture (break) due to trauma or a strong blow to the elbow causing severe pain. This condition is generally diagnosed with an x-ray and requires placing a cast on the elbow.

7.Ligament Sprains:

This is a stretch or tear that happens to one ligament or more in the elbow which usually happens due to an injury/trauma. The ligament/s tear could be either partial or complete and the amount of pain associated with it worsens with the number of ligaments torn and whether they’re partially or completely torn.

This technique uses FDA approved medication, which is injected, directly into the pain area under ultrasound guidance. This technique has the following benefits:

-Helps the radiologist to accurately identify the inflamed tendon or bursa, which is important to confirm the clinical examination.

-Allows the radiologist to accurately localize and effectively administer the medicine to one or more compartments of the painful area “if necessary” resulting in better and faster pain relief.

-The patient benefits the most by having the medication in the right spot without pain or complications.

-The patient is injected a numbing local anesthetic. A mild burning sensation can be felt due to the numbing anesthetic.

-The radiologist then uses an ultrasound probe to guide the needle to the painful area.

-The medication is then injected in the exact location.

-The injection needle is then removed.

-The patient can leave immediately after the injection. Some patients may be asked to wait for re assessment.

-After the procedure the patient may experience complete relief of pain.

-The maximum effect of the medications may take up to 2 weeks to show the maximum effect.

-The patient is instructed to use painkillers during the first few days if needed.

Different patients respond differently to the same. So one may have a total relief and others may have residual pain and would benefit from another injection.

Most patients report the following after the procedure:

-A great reduction or total elimination of the pain for a period of several weeks after which they may need to have another injection to maintain the results.

-A great reduction or elimination of the pain for several months.

-A great reduction or elimination of pain for years after the procedure especially if complimented with physiotherapy.