The elbow region is comprised of the joints between the bones of the upper arm (humerus) and the lower arm (radius and ulna). The elbow joint allows us to bend and straighten our arms. The bending action at the elbow joint brings the forearm closer to the upper arm. This type of movement is referred to as flexion. The straightening of the arms at the elbow joint moves the forearm away from the upper arm. This type of movement is referred to as extension.
The forearm can also be rotated inward and outward to some extent at the elbow joint. These movements are referred to as pronation and supination. All these movements at the elbow joint are made possible due to the articulations of the humerus, radius and ulna. Apart from articulating with the humerus, the bones of the forearm (radius and ulna) also articulate with each other.
Elbow Joint Structure
The elbow joint is classified as a type of hinge joint. Apart from the ends of the bones, the elbow joint also has other important constituents. These include the tendons, ligaments, muscles, and bursae. The inner surface of the elbow joint is lined by a synovial membrane. The synovial membrane is covered by a capsule. Between the capsule and the synovial membrane lie three groups of fatty tissue. A problem within the elbow joint may arise from any of its constituent tissues.
Some parts of the bones that constitute the elbow joint are more important than others when it comes to problems within the elbow joint. The olecranon, medial epicondyle and lateral epicondyle are the most frequent contributors to elbow problems. The olecranon is the terminal curved part of the ulna in the forearm.
It articulates with a depression (known as the olecranon fossa) at the terminal part of humerus. The lateral and medial epicondyles are protruding surfaces at the ends of the humerus. The medial epicondyle protrudes on the inner side of the elbow joint, whereas the lateral epicondyle protrudes on the outer side of the elbow joint.
Swelling of the Elbow
Swelling of any joint in the body is typically caused by an inflammation in the joint. A swelling in the elbow joint is no different. A swelling in the elbow usually involves inflammation of the soft tissues of the elbow joint. The bones of the elbow joint can also contribute to the swelling in some cases.
However, these bones are usually resistant to the effects of inflammation in the surrounding soft tissues. The swelling of the elbow joint is mainly caused by an accumulation of excess fluid in the cavities and tissue spaces of the elbow region.
Swelling at the elbow joint may involve different tissues. For example, a swelling that occurs at the back of the elbow joint may involve the bones that form the elbow joint or the bursa. In contrast, a swelling that appears on the front part of the elbow joint (in the brachial fossa) may involve the ligaments, muscles, tendons, subcutaneous tissue, blood vessels and skin.
Apart from visible swelling in the elbow region, other signs and symptoms may also be present in case of a swollen elbow. Pain is a common occurrence in such cases. The range of motion of the forearm at the elbow joint may also be compromised.
In case of inflammation, the skin on the elbow joint may also display redness. Skin rashes may also be present in the region of the swollen elbow. These accompanying signs and symptoms are important considerations when reaching a diagnosis about the possible cause of a swollen elbow.
Causes of a Swollen Elbow
Bursae are thin fluid-filled sacs that are sandwiched between tissues all over the body in order to reduce friction during movements. The elbow region contains a bursa (known as the olecranon bursa) between the olecranon process of the ulna and the overlying skin. Elbow bursitis refers to an inflammation of this olecranon bursa.
For this reason, elbow bursitis is also referred to as olecranon bursitis. Elbow bursitis can be caused by multiple factors, such as infections, injuries, prolonged pressure on the elbow and diseases. One may pick up injuries to the elbow region during sports activities, falls and assaults. Bacterial infection of the olecranon bursa can lead to septic bursitis.
Elbow bursitis can also occur in diseases such as tuberculosis, renal disease, gout, arthritis and AIDS.
A fracture refers to a break or crack in a bone. Although a fracture can occur in all the bones of the body, some bones are more prone to getting fractured than others. In the elbow joint, the olecranon of the ulna is the most susceptible to getting fractured in case of an injury. The olecranon has very little protection against impacts.
It is covered only by a thin layer of subcutaneous tissue and the skin. Elbow fracture can occur due to a direct injury to the bones of the elbow joint. Such injuries may be a result of accidental falls, intentional assaults and vehicle accidents. The olecranon can also get fractured if the triceps muscle contracts very forcefully. Such a fracture is referred to as an indirect fracture.
Swelling of the elbow joint can also be caused by inflammation due to arthritis. The elbow joint can get affected by both osteoarthritis as well as rheumatoid arthritis. The cartilaginous part of the bony joints degenerate in osteoarthritis, whereas the lining of the joint becomes inflamed in rheumatoid arthritis.
However, these two types of arthritis are less common in the elbow joint when compared to septic arthritis. Bacterial invasion and infection of the elbow joint causes septic arthritis. Cellulitis and septic elbow bursitis may also be associated with septic arthritis.
Also known as medial epicondylitis, golfer’s elbow refers to an inflammation of the tendons of the muscles that are attached to the medial epicondyle of the humerus. Overuse of the pronator and flexor muscles is the main cause of golfer’s elbow. Damage due to overuse of these muscles can occur in certain sports (such as golf, baseball and tennis) or due to repeated screwdriver or hammer use in certain occupations.
Tennis elbow is caused by repeated overuse of the muscles and tendons that attach to the lateral epicondyle of the humerus. Also referred to as lateral epicondylitis, tennis elbow is mainly caused by strain on the extensor muscles of the forearm.
Read more on tennis elbow.
Treatment for Swollen Elbow
The exact treatment for swollen elbow depends on the nature of the underlying cause. Some of the general treatment measures that may be helpful include immobilization of the forearm, elevating the forearm position, use of elbow brace or compression bandage, application of ice packs to counter inflammation and use of anti-inflammatory medications. To avoid aggravating the condition further, one must consult a doctor before beginning any kind of treatment.