Pain on Inside of Elbow When Straightening Arm

Pain on Inside of Elbow When Straightening Arm: Causes and Solutions 

Introduction

Elbow pain, particularly at the inside, can be quite debilitating; it can affect not only sports-related activities but also simple daily routines like lifting, typing and doing things around the house. The inside of the elbow or medial aspect is rather prone to the strain that results from repetitive moves and overuse, hence pain here is very common with athletes, office workers and manual workers. What can be helpful in alleviating the pain and the ways of preventing further deterioration to the elbow joint would be knowing what causes it and what the solution is.

Understanding the Anatomy of Elbow 

Bones and Joints

The elbow joint is made up of three bones, i.e. the humerus, radius and ulna. These bones are joined together with other ligaments and muscles that help allow movement of the arm.

Humerus: A rather large bone constituting the upper arm making up the upper portion of the elbow joint.

Radius and Ulna: These are two very important bones constituting the forearm and thus working together for the purpose of enabling in rotating the hand and its extension and flexion with respect to the elbow.

Elbow Joint: It is a hinge joint, thus allowing it to bend and straighten. It can even allow a limited movements in rotation, making the forearm able to rotate inwards and outwards. 

The elbow can also move in other ways such as flexion (bending) and extension (straightening). The possibility of causing pain during arm extension might therefore suggest problems with other structures around the elbow, such as tendons, ligaments or nerves.

image credit: FREEPIK

Details of the Causes of Pain in the Inside of Elbow

1. Golfer's Elbow (Medial Epicondylitis) 

Golfer's elbow is one of the most common diagnoses that fall under pain on the inside of the elbow, especially while extending the arm. 

Causes in Detail: micro-tears and inflammation of the tendons attaching to the medial epicondyle of humerus. The condition is usually initiated through repetitive or forceful wrist flexion, where stress is applied on the elbow's flexor muscles and tendons. Although common among golfers, it can happen to anyone who often work with hands and wrists, be it tennis players, weightlifters and even people typing or using computers for extended hours. 

Symptoms in Advanced Stages: Pain may not be confined to the elbow. It may diffuse down the forearm, affecting normal activities such as gripping and lifting. Extension of symptoms can lead to loss in range of motion and grip strength over time, leading to functional impairment. 

Management for Golfer's Elbow: Usually advised rest, anti-inflammatory medicines and physical therapy. Stretching and strengthening exercises are expected to restore tendon flexibility and strength. For some cases not amenable by the conservative approach, invasive interventions like corticosteroid injections or surgery may be considered to address severe tendon injury or tear.

2. Compression of the Ulnar Nerve (Cubital Tunnel Syndrome)

The ulnar nerve travels on the inner side of the elbow; with its compression, he suffers from cubital tunnel syndrome with pain and discomfort on straightening the arm.

Detailed Etiology: The entrapment of the ulnar nerve is when the ulnar nerve gets compressed or irritated in its course through the cubital tunnel, i.e. a small passage on the inside of the elbow. Repeated bending of the elbow or direct pressure over the elbow may cause inflammation of the nerve. Some of these activities include resting one's elbows or sleeping with bent arms. 

Signs and Symptoms: The main symptom is pain on the inside of the elbow. Additional signs may include tingling, numbness or weakness in the ring and little fingers. These symptoms may become aggravated by activities requiring repetitive elbow flexion such as typing or carrying a phone. 

Treatment for Ulnar Nerve Entrapment: Non-surgical treatment measures help alleviate cubital tunnel syndrome by modifying activities that trigger the symptoms, elbow braces allow for maximum straightening of the elbow and nerve gliding exercises help decrease the compression on the ulnar nerve. In severe cases, surgery may be required to relieve the ulnar nerve from compression. 

3. Flexor Tendinitis

Flexor tendinitis is inflammation of the tendons controlling the flexion of the wrist and fingers attached to the inner side of the elbow.

Detailed Cause: This occurs due to repetitive movement of the flexor tendons or overuse leading to micro-tears in the tendon. It mostly occurs in sports persons who cause repetitive throwing or swinging motions (baseball pitchers or tennis players) but also occurs in those who perform repetitive hand movement-type activities such as typing or painting. 

Symptoms of Flexor Tendinitis: Pain on the inner elbow that worsens when extending the arm or doing activities that involve gripping. Swelling and tenderness, as well as weakness of the forearm muscles, may also be present.

Treatment of Tendinitis: Ice, anti-inflammatory medication and stretching exercise are indicated for treatment. Physical therapy or cortisone injection may be used in some cases. Chronic tendinitis can degenerate into degeneration of the tendon and possible rupture if untreated.

4. Bursitis of the Elbow

Bursitis elbow refers to the inflammation of the olecranon bursa, which is actually a very tiny, fluid-filled sac located at the back of the elbow, but may also induce discomfort on the inner elbow.

Causes in Detail: Bursitis in the elbow may occur directly by any number of trauma to the elbow or through the routine joint pressure of long periods or repetitive motions. Any activity that requires someone to lean on the elbow, like some types of work or even resting elbows on hard surfaces, may bring about this condition. Very, but rather rarely, cases of bursitis are infectious.

Symptoms of elbow bursitis: A swelling and often painful lump will be found at the back of the elbow in bursitis. It also produces pain inside the elbow when straightened because of irritation of the adjacent structures. The elbow joint is usually stiff and movement or pressure causes painful sensations.

Medication for Bursitis: Rest, ice and anti-inflammatory medication are usually employed for the reduction of swelling and pain. Drainage (aspiration) of the bursa or corticosteroid injection into it may be necessary in severe cases. Surgery for bursa removal is considered only in chronic cases.

5. Injury to Medial Collateral Ligament (MCL)

The MCL is the inner stabilizing ligament of the elbow. Although it is relatively uncommon, injury to this ligament presents as pain in extending the arm.

Detailed Causes: MCL injury typically occurs with high-impact activity or as participation in sports with overhead motions, like baseball pitching or javelin throwing. These acts cause a high demand placed on the ligament, which could cause partial or complete tears. Traumatic falls or accidents may contribute to MCL injuries.

Symptoms Of MCL Injury: Pain on the inner side of the elbow, especially when straightening the arm, swelling, bruising and decreased elbow stability. The pain may be sharp and there is a sense of instability in the joint.

Treatment for MCL Injury: Treatment options may include some combination of rest, physical therapy and surgery, depending on the severity of injury to the ligament. Minor sprains may only necessitate conservative treatment, while complete ruptures may have to undergo surgical reconstruction.

6. Osteoarthitis of the elbow.

Osteoarthritis of the elbow refers to a degenerative ailment under which the cartilage in the elbow joint is damaged, causing the person to experience pain, stiffness and limits in movement.

Causes in detail: Osteoarthritis is acquired with time by the wear of a protective cartilage in the elbow joint. The causes are many, generally resulting from old age, past injuries (broken bones), or the repetitive wear and tear on the elbow joint owing to repetitive strenuous activities.

Symptoms of osteoarthritis: Pain and stiffness in the elbow joint, especially when extending the arm. Also, the elbow feels somewhat swollen, with an observed significant decline in range of motion.

Treatment of Osteoarthritis: Non-surgical therapies include physical therapy, joint injection therapies like hyaluronic acid or corticosteroids and anti-inflammatories. Severe cases may require elbow replacement surgery to regain joint function.

image credit: FREEPIK

Thorough Diagnosis of Inside Elbow Pain

Diagnosis holds the key to the correct treatment of elbow pain. This is the full diagnostic process:

Physical Examination

The healthcare provider will examine the elbow for swollen, red or deformed appearances. Then gentle palpation or pressure on the elbow will determine the specific point of pain and the range of movement assessment will bring out any limitation.

Medical History

A long list concerning the story of symptoms, like onset and intensification of pain from a certain activity and past injuries, will help the health provider assess differential diagnosis.

Diagnostic Imaging

X-ray: Commonly used to check for an area that could be fractured, arthritic or deformed in some way.

MRI: An MRI creates detailed images of soft tissue such as muscles, tendons, ligaments and even nerves; it is especially useful for the diagnosis of tendinitis, ligament injury, compression of nerve.

Ultrasound: sometimes used to examine soft-tissue injury or fluid collection about the elbow.

Nerve Conduction Studies: These may be performed if a nerve entrapment, e.g. ulnar nerve entrapment, is suspected.

Pain Management Approaches for Elbows

1. Rest and Change of Activities

Resting from activities that aggravate recover elbow function. Competitions of repetition, with various techniques in sports and at work, can greatly help with reducing stress put upon the elbow.

2. Ice and Heat Therapy

The elbow is treated for inflammation and pain relief by icing 15 to 20 minutes several times daily. Heat provides muscle relaxation along with improved blood flow.

3. Medications 

NSAIDs: Non-steroidal anti-inflammatory medicines such as ibuprofen or naproxen relieve pain and inflammation.

Acetaminophen: An alternative medication to NSAIDs, acetaminophen has an analgesic but not anti-inflammatory effect. 

4. Physical Therapy 

Physical therapy is where you would focus on exercises to strengthen the muscles around the elbow and enhance flexibility. Stretches and strength exercises can help reduce the stress placed on tendons and ligaments. 

5. Bracing 

It may be used for golfer's elbow or cubital tunnel syndrome where elbow joints are stabilized in case splinting is limited. 

6. Injections

Examples of these injections are as follows:

Corticosteroid Injections: Such injections can provide temporary pain and inflammatory relief in pathologies such as tendinitis and bursitis.

Injections of Hyaluronic Acid: are used for joints' lubrication and pain relief in osteoarthritis. 

7. Surgery 

Surgical options are tendon repair, ligament reconstruction or elbow replacement. 

Preventing Pain on the Inside of the Elbow 

To better prevent elbow pain in the future, the following will help:

Warm Up and Stretch: Always warm up before beginning any exercise and include stretching exercises that will help increase the flexibility of the forearm muscles.

Strength Training: Strengthening exercises for the forearm, wrist and shoulder muscles may help prevent too much strain acting on the elbow joint.

Ergonomical Modification: Proper ergonomics in an office or manual labor setting can significantly reduce the stress imposed on the elbow ergonomically.

Avoid Overuse: Rest periods between repetitive work should be adequate enough for recovery of the tendons and muscles surrounding the elbow joint. 

Conclusion: Pain on Inside of Elbow When Straightening Arm

Pain inside one's elbow while stretching the arm straight can arise from various conditions: range tendinitis to nerve entrapment and even arthritis. The underlying causes can be understood and targeted treatment options will bring about pain relief while restoring function and preventing further long-term damage. Early intervention along with lifestyle changes and physical therapy can help most people completely recover from any elbow injuries while allowing a full range of motion without pain.