肘部疼痛

Most elbow pain has a very simple cause and clears up within a few days. The pain usually comes from strained or inflamed soft tissues such as tendons. You can normally treat this pain yourself with over-the-counter疼痛killersand a few days' rest, and you may not need to see your doctor.

It’s important not to rest for too long as lack of movement causes your joint to stiffen and the muscles around your elbow to weaken, which increases the chance that you'll have further symptoms. Simple exercises can help to reduce the risk of future problems. Long-term elbow pain can be caused by arthritis.

肘关节是顶部的长骨of your arm, known as the humerus, meets the two bones in your forearm – called the radius and the ulna. It’s a hinge joint, and it allows you to bend your arm. The upper part of the radius can rotate so you can twist your forearm.

The end of the humerus has two bony parts that you can feel at either side of your elbow. These are:

• the lateral epicondyle on the outside of your arm
• the medial epicondyle on the inside of your arm.

附着在肱骨外部的肌肉可以帮助您拉直手腕和手指。这些通过径向神经连接到大脑和神经系统，径向神经在肘部的外部传播。

连接到肱骨内部的肌肉可以帮助您弯曲手腕和手指，让您掌握物体。这些肌肉通过中位神经连接到大脑和神经系统，该神经在肘部前面延伸。

The ulnar nerve, which is on the inside of the elbow is mainly responsible for the movements of the small muscles of the hand. These are useful for precise and delicate hand movements. The feeling of hitting your funny bone is caused by the ulnar nerve being pinched.

There are also strong cords in the elbow that help to hold the joint in place. Tendons attach muscles to bones and ligaments link bones together.

Most cases of elbow pain are due to strained or inflamed soft tissues such as tendons or ligaments.

几天后，您可以在家中做一些简单的自我保健后，这些往往会变得更好。

有时，肘部疼痛可能是由疾病引起的。

A number of things can cause stiffness in your elbow, including arthritis (arth-rye-tus). Arthritis simply means a joint that is painful and swollen, and there are a number of types of arthritis.

Stiffness can happen due to problems with the elbow joint itself or with the muscles, covering of the joint, or ligaments.

In some situations, such as after an injury or operation, soft tissue can form into scar tissue. This can cause elbow stiffness.

Occasionally, the elbow may lock in a fixed position. This is often short-lived but may be due to a loose bit of bone or cartilage in the joint. The loose fragments may need to be washed out in surgery.

Arthritis of the elbow

The elbow can be affected by various types of arthritis.

Osteoarthritis是关节炎的最常见形式。它始于软骨的损失，这是一个薄薄的保护层，可覆盖关节中的骨骼。作为响应，人体可以在关节内生长骨刺，并且关节空间中可能会增加液体。这可能会在没有任何症状的情况下发生。但这会导致关节的疼痛，肿胀和僵硬。

Osteoarthritis is not very common in the elbow unless you’ve injured it in the past, for example if you’ve previously broken a bone.

The following types of arthritis can also affect the elbow:

• rheumatoid(roo-ma-toyed) arthritis – an autoimmune condition that can cause pain and swelling in joints. Joints can be red, hot, stiff and tender to touch. Autoimmune conditions are caused when your immune system, which normally protects you from illness and infection, gets confused and mistakenly attacks the body’s healthy tissue.
• psoriatic(sorry-atik) arthritis – an autoimmune condition associated with the skin condition psoriasis (so-rye-a-sis), that causes patches of red, raised skin with white or silvery flakes. It can cause pain and swelling in and around joints.
• gout– a type of arthritis that causes pain and swelling in joints. It’s caused by a build-up of crystals of the waste product urate in the joints. Affected joints can be very painful, and the skin can sometimes be red and shiny.

Most cases of elbow pain will get better on their own or with simple self-help treatments. You should see a doctor if:

• your pain doesn’t improve after two weeks of taking painkillers and resting your elbow, and you haven’t had an injury or infection
• you have tingling, numbness or weakness in your arm or hand.

您应该直接访问医院的事故和急诊科。

• 您会注意到诸如严重疼痛之类的症状会阻止您移动手臂，肿胀，发烧，热和发红。这些有时可能是感染的迹象。
• you think you’ve fractured your elbow – this will probably follow an obvious injury such as a direct impact or fall onto an outstretched hand. A fracture will cause pain and usually bruising and swelling.

There are several ways you can help yourself if you have elbow pain. These include taking疼痛killers, applying heat or ice packs, changing your movements and exercising.

Changing how you move

首先要做的如果你有肘部疼痛change, or possibly stop, any movements that might be causing your symptoms or making them worse. Flare-ups of some conditions, where the symptoms become suddenly worse, can be eased by avoiding bending the elbow into certain positions.

如果您执行任何涉及重复运动（例如使用螺丝刀或绘画）的工作任务，那么值得与occupational therapist。这些是医疗保健专业人员，他们可以建议如何改变您的运动和肘部愈合时支撑肘部的方式。

AGPcan refer you to an occupational therapist, or you can see oneprivately。

If your workplace has an occupational health department, they should be able to help.

Drugs to reduce pain

Painkillers, such as paracetamol may help to ease pain. You should use them as and when you need them, but it’s best to take them before the pain becomes very bad.

Non-steroidal anti-inflammatory drugs (NSAIDs)are a group of drugs that can help ease pain, swelling and stiffness. A common NSAID is ibuprofen, which you can buy at chemists and supermarkets.

If you have stomach problems after using pain relief or NSAIDs, you should stop taking the tablets and see your doctor. There are also anti-inflammatory creams or gels you can rub onto your elbow, which don’t cause stomach problems.

Splints

For some conditions, such as tennis elbow, using a splint to support your elbow may ease the strain when you’re doing certain activities that cause it to flare up. They’re available from chemists, sports shops andphysiotherapists。They’re also known as epicondylitis clasps. Ask a healthcare professional or a pharmacist if a splint would help you, and when and how you should wear it.

Heat or ice packs

Placing a heat or ice pack to your elbow for 10 to 15 minutes every few hours can ease pain and stiffness. You can use a reusable pad, a microwavable wheat bag or a hot water bottle. A bag of frozen peas can also be helpful if you don’t have an ice pack.

Make sure you don’t put either a heat or an ice pack directly onto your skin, as this could burn or irritate it. You should wrap them in something like a tea towel first.

Heat encourages blood to flow to a part of the body, and this can ease stiffness, encourage recovery of damaged tissue, and relieve pain. Don’t apply heat to your elbow if it’s swollen or if you’ve just injured it, as this can make it worse.

Ice reduces blood flow to part of the body, and this can reduce swelling.

人们有时会发现全天在热量和冰之间交替会有所帮助。实验，看看什么最适合您。如果您有任何疑问或疑虑，请与GP或药剂师交谈。

练习

为了防止肘关节变硬，手臂肌肉减弱，最好不要休息几天。疼痛开始缓解后立即开始一些轻柔的运动。简单的练习可以帮助恢复您的运动范围，保持力量并轻松僵硬。

我们有一些examples of simple stretching and strengthening exercises。

Start by exercising very gently and gradually build up the amount you do. It’s normal to feel muscle ache after exercise but stop if you get any joint pain that doesn't go away quickly.

GP或物理治疗师可以为您提供有关运动的建议。

Most elbow problems can be diagnosed and treated after a simple examination, and it’s unlikely you’ll need to have any special tests.

Your doctor may suggest you have an X-ray, which can show any new bone growth, any small pieces of loose bone, or arthritis.

Very rarely an ultrasound scan or a magnetic resonance imaging (MRI) scan may be needed to rule out or confirm a diagnosis.

In an ultrasound scan a small device is placed on the skin. Sound waves create an image of part of the inside of the body.

Someone having an MRI scan will need to lie in a large tube, and magnetic fields and radio waves produce detailed images of the inside of the body.

You may need a nerve conduction test if you’ve been having problems with your nerves. Small electrodes are placed on your skin to stimulate nerves. This will measure how fast messages are sent through the nerve, and the length of delay will give an idea of how badly the nerve is being squeezed.

Self-help treatments and a few days’ rest are often enough to clear up a spell of elbow pain.

If you have a soft-tissue condition such as tennis elbow or golfer’s elbow, stopping the activity that caused it in the first place is important. This should dramatically improve your symptoms.

If you have a more complex or persistent problem, your doctor will be able to recommend other treatments and therapies.

物理疗法

Physiotherapymay be useful to help build up the strength in your elbow and prevent the condition returning.

物理治疗师是训练有素的专家，可以帮助患有伤害或长期健康状况的人保持活跃和独立。

Your physiotherapist will help you keep up or regain flexibility in your elbow through exercise. You should stretch out your elbow at least once a day and do general range-of-movement exercises. Your physiotherapist might also recommend biceps and triceps strengthening exercises with light weights or resistance bands.

Anoccupational therapist可以识别运动可能导致discomfort. They can look at activities you find difficult and see if there’s another way you can do them so you can maintain daily living and working skills.

Steroid injections

If you’re in severe pain your doctor may suggest asteroid injection。几个小时后，疼痛可能会变得更糟，但通常会消失。

For some conditions steroid injections can have an effect on symptoms for a short term. Depending on what type of steroid injection you’ve had they may start to wear off after about six weeks.

If you have a type of inflammatory arthritis that’s affecting the elbow, such asrheumatoid arthritisor银屑病关节炎, your specialist may inject the joint as part of your treatment.

不建议在网球或高尔夫球手肘部注射类固醇。从长远来看，它们可能会导致这些条件恶化。

Platelet-rich plasma injections

A technique called platelet-rich plasma (PRP) injections is becoming increasingly popular for tennis and golfer’s elbow. Platelets are cells in the blood that perform a number of roles, including helping the blood to clot if you cut yourself.

This treatment is usually performed in hospitals by orthopaedic specialists. It involves taking a blood sample from you, which is then treated to increase the number of platelets. This is then injected into the painful area.

Recent studies have shown that PRP may reduce pain and increase movement more effectively than steroid injections. This is not yet available in all hospitals in the UK.

Surgery

Most cases of elbow pain will heal using the treatments above, but a small number of people will need surgery to ease their symptoms. There are different types ofelbow surgery取决于您的状况。下面详细介绍的特定肘部疾病的手术类型的例子。

Most operations are carried out as day-case procedures and you’ll be able to go home the same day.

You’ll need to talk with your doctor and hospital team about the benefits and disadvantages of surgery for you.

If your stiffness is caused by the growth of new bone or soft tissues shortening, you may need an operation to remove the bone or release the tension in the shortened tissues. After the operation, you’ll need physiotherapy.

If loose pieces of bone are causing pain, they can be removed with keyhole surgery. This means the operation can be done through a small cut or incision, so the joint doesn’t have to be opened up. This type of operation is also known as arthroscopy.

If necessary, bits of bone can be removed from the joint in an open surgical procedure, through a bigger incision.

如果肘部的关节炎使您难以继续日常生活或造成很多痛苦并限制运动，则可以选择肘部替换。

Some of the specific conditions that affect the elbow include the following:

Tennis elbow and golfer’s elbow

Tennis elbow and golfer’s elbow are two separate but similar conditions in which tendons become painful. Anybody can develop them, but they’re most common between the ages of 40 and 50. Tennis elbow is the more common of the two conditions.

尽管有名字，但打网球或高尔夫并不是最常见的原因。他们过度使用与涉及手腕和手的重复动作的活动有关。

People who are continually gripping and twisting – for example carpenters and plasterers, or people who use a computer mouse – may be at risk. Repetitive actions combined with weight, for example lifting heavy boxes, can also cause these problems.

Tennis elbow affects tendons on the outside of the elbow. Golfer’s elbow affects tendons on the inside of the elbow.

症状

The main symptoms are pain and tenderness – on the outside of the elbow for tennis elbow, and on the inside for golfer’s elbow. People may also have pain when gripping.

The level of pain can vary from person to person, ranging from a mild discomfort to a severe ache that prevents you from sleeping.

通常，所需要做的就是停止或更改引起问题或使问题变得更糟的任何活动，以及您可以在家中可以做的一些自我保健步骤。

Both conditions can last between six months and two years. Most people get better within a year. Unfortunately, they can both return.

网球和高尔夫球手肘部手术

只有少数患有这些疾病的人需要手术。这些操作可以使用钥匙孔手术或约4至5厘米长的切割。这些操作后，您应该能够直接使用肘部直接使用，但是要完全恢复需要几周的时间，并且通常需要短暂的理疗路线。

橄榄球囊炎

橄榄球囊炎occurs when the bursa at the back of the elbow becomes swollen and inflamed. Bursae, which is the plural for bursa, are sacs of fluid found where parts of the body move over one another, for example where tendons or ligaments pass over bones. They help cushion the area and reduce friction.

The olecranon is the bony tip you can feel on your elbow. It has a bursa between the bone and the skin.

当肘部背面有压力或摩擦时，最常见的是橄榄球囊炎，例如，如果您经常将肘部靠在椅子或桌子上。因此，这种情况有时被称为学生的肘部。

症状

橄榄球囊炎的主要症状是：

• swelling, pain and warmth over the bony part at the back of the elbow
• restricted movement of the elbow.

Occasionally, bacteria can cause the bursa to become infected. Olecranon bursitis often clears up on its own, but if the condition is caused by an infection, your doctor will prescribe a course of antibiotics.

Resting your elbow and applying ice packs can help. If this doesn’t work, talk to your doctor about other treatment options. This may include a healthcare professional draining fluid with a syringe. This treatment is called aspiration.

Surgery for olecranon bursitis

A small number of cases may need surgery if this condition keeps coming back or affects everyday activities. The operation involves removing the bursa through a cut at the back of the elbow. Some surgeons have recently started to use keyhole surgery for this procedure.

Compression or entrapment syndromes

如果将肘部穿过前臂的神经被挤压或按下，则可能在您的前臂，手腕或手中​​引起症状，包括：

• 疼痛
• tingling in the fingers and hands
• 肌肉的减弱。

These are called compression or entrapment syndromes.

肘隧道综合征

肘隧道综合征is caused by the ulnar nerve being squeezed where it passes the inside of the elbow. This can be due to the space it passes through becoming tighter than usual.

In rare cases, it can be due to arthritis. Other causes can include a fracture around the nerve which has healed into a different position or new bone growing when the fracture heals.

症状

The main symptoms of cubital tunnel syndrome are:

• tingling and numbness of your ring and little finger after your elbow has been bent for long periods or after you’ve been resting on the inner edge of your elbows
• weakness of the small muscles of your hand, causing your ring and little fingers to become claw-like – this only happens if it’s left untreated.

径向隧道综合征

径向隧道综合征is similar to cubital tunnel syndrome but is caused by the radial nerve being pressed on below the elbow. It’s a rare condition.

径向隧道综合征normally gets better on its own.

症状

The main symptom of radial tunnel syndrome is pain starting from the outside of the elbow that runs down to the forearm. Because this type of pain also occurs in tennis elbow the two can be confused, but with radial tunnel syndrome there’s no tenderness on the outside of the elbow – the problem is further down the arm.

治疗for cubital and radial tunnel syndromes

A physiotherapist will be able to tell you about the best exercises for you.

大多数情况可以通过以下方式在家中进行治疗：

• stopping or changing movements that are aggravating your symptoms
• applying ice – such as a bag of frozen peas wrapped in a tea towel
• taking painkillers
• wearing a splint to support it – a GP, pharmacist or physiotherapist will be able to give you advice on the best ones to wear.

如果几周后您的症状不会变得更好，或者您的疼痛不好，请去看医生。

A small number of people will need surgery for these conditions. The operation involves making a cut to find the affected nerve, which is then freed from the tissues that are pressing on it. You can use your elbow for activities that don’t involve heavy lifting straightaway and continue with other tasks as your pain allows.

Distal biceps rupture

二是大muscle at the front of the upper arm. Its upper (proximal) end is attached at the shoulder and its lower (distal) end is attached to the upper part of the radius by a tendon close to the elbow joint. A distal biceps rupture is caused if this tendon close to the elbow tears, which can happen if you’ve lifted a heavy weight. You may hear the tendon snapping.

症状

The symptoms of a distal biceps rupture are:

• a sudden and severe pain in the elbow, which gradually eases
• 受伤第一次发生后的几个小时或几天内，肘部和前臂周围瘀伤
• the bicep changing shape and shifting up towards the shoulder – this is commonly called the Popeye sign
• difficulty in twisting the forearm to turn the palm upwards, for example when turning a door handle or using a screwdriver – your arm will feel weak compared to the unaffected arm when doing this.

A similar condition can occur in the triceps, the muscle at the back of the arm. This is called a distal triceps rupture and it can cause pain and swelling at the back of the elbow, and reduce movement. It’s very rare, but it can be caused by falling onto an outstretched hand.

Treatment for distal biceps rupture or triceps rupture

If you think you have a distal biceps rupture or a triceps rupture you should seek medical attention as soon as possible. These conditions may require urgent surgery to prevent permanent damage to your arm. You should either go to an accident and emergency department or book an urgent appointment with your GP.

Surgery may be recommended depending on your level of activity and whether your activities need you to twist your forearm. This operation involves making a cut over the front of the elbow and fixing the torn tendon back onto the radius.

Research is helping to increase our understanding of how elbow pain develops and identify the best ways to treat it.

我们的研究发现，通常给予治疗肌腱疼痛的类固醇可可通过过早衰老的肌腱细胞造成肌腱损伤。这些发现将有望导致肌腱疼痛的新疗法，例如高尔夫球手肘部。

Our research has also found that although rest is commonly recommended for people with lower arm pain, remaining active while waiting for physiotherapy is better for reducing symptoms.

We are currently funding research projects looking at how tendons, such as those in the elbow, become damaged and how cells in the tendon help with repair following this. This will allow our researchers to better understand how tendon pain develops in conditions such as tennis elbow and golfer’s elbow and find new and effective ways to treat it.