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What’s causing your swollen elbow?
The elbow joint involves bone, muscles, tendons, and ligaments. The tendons attach the muscles to bones and the ligaments attach the bones to each other. The joint space also involves the bursa, which helps pad the joint. Any one of these could be the cause of your swelling. The location, timing, and circumstances involved with the swelling will help your doctor determine the cause. —Dr. Chandra Manuelpillai
A swollen elbow can get in the way of activities of daily living and things we enjoy such as sports (think golf and tennis). You may experience swelling, pain when bending or touching the elbow, redness, or warmth. A common cause is inflammation from arthritis or overuse injuries.
Most swollen elbows will get better by avoiding the activity that is causing the pain, ice, wearing an elbow brace, and taking antiinflammatory medications to reduce swelling.
1. Olecranon bursitis
- Swelling in the back of the elbow.
- Pain in your elbow.
- Fever, warmth, and/or red discoloration if it’s infected.
The olecranon bursa is a fluid-filled sac within the elbow joint. It can lead to swelling from a number of causes including:
- Irritation or inflammation from repetitive trauma, pressure, or friction.
- Infection and/or complications of chronic medical conditions such as chronic kidney disease, diabetes, rheumatoid arthritis, or gout.
Treatment usually includes avoiding activities, wearing a brace, and taking antiinflammatory pain medications.
2. Elbow breaks (fracture)
- Swelling near the injury
- Pain near the injury and with moving elbow or forearm
- Possible bruising and deformity
A broken bone is a fracture. Treatment depends on the injury, but usually involves immobilization either with sling, brace, ace wrap, or cast/splint.
3. Elbow dislocation
- Swollen elbow
- Pain in one elbow
- Difficulty moving the elbow
- Holding arm close to body because of pain
An elbow dislocation, also called radial head subluxation, is when one of the bones of the elbow slips out of place. This can occur if the arm is pulled on. It is common in children and known as a nursemaid's elbow. It can also happen from a direct blow to the point of the elbow.
This can be caused by a sports injury or an accident. If your elbow is stopped with tremendous force, swelling can happen almost immediately.
4. Nursemaid’s elbow
- Pain in the arm
- Child not moving their arm
Children under age 5 can get a partial dislocation from having their arm pulled too hard. This can happen during rough play or from swinging from their parents' hands. It’s called a “nursemaid’s elbow.”
If your child is complaining of pain and isn’t moving their arm, go to the ER. If the injury is a partial elbow dislocation, a doctor will gently “pop” it back into place in a procedure called a reduction.
5. Elbow sprain/strain
- Swelling near the injury
- Pain near the injury and with movement
- Possible bruising
An elbow sprain occurs when you pull or tear the ligaments around the elbow joint. The ligaments in your elbow help connect the bones of your upper and lower arm. A sprain can happen when you twist your arm in an unnatural position or if you injure it in an accident or fall.
An elbow strain is an injury that occurs when you overstretch the muscles or tendons.
Depending on the severity of the injury, these can take a few days to recover, but may take up to a few weeks. Also you are at an increased risk of recurrence once you have had either of these injuries.
6. Overuse injuries
- Generalized swelling in the elbow
- Generalized pain in the elbow
Overuse injuries can be caused by repetitive pressure or movement of the elbow. This can happen from daily living or work activities, as well as from repetitive movements in sports. This repetitive irritation on your elbow can cause inflammation leading to pain and swelling, particularly when you either use or put pressure on the elbow.
Two common overuse injuries from sports include lateral (outer) epicondylitis (tennis elbow) and medial (inner) epicondylitis (golf elbow). These are an inflammation of the tendon on either the inside or outside part of the elbow due to repetitive motion of tennis racquet versus golf swing.
Others may experience similar pain such as pitchers in baseball, construction workers using a jackhammer, or police officers who direct traffic for prolonged periods of time.
Overuse injuries are typically treated by avoiding the activity that causes the inflammation, and taking antiinflammatory pain medications such as ibuprofen (Advil) and naproxen (Aleve).
One misconception is swelling is only caused by injuries, but it can also occur with infection and arthritis flares. —Dr. Manuelpillai
- Pain (dull or burning), especially when using the elbow (or after using it)
- Swelling around the joint
Arthritis is an inflammation in the joints causing swelling and pain. As swelling and joint inflammation progress, using the elbow becomes increasingly difficult. Types of arthritis includes osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and gout.
- Rheumatoid arthritis: An autoimmune disorder that causes swelling of joints.
- Gout and/or pseudogout: Usually pain, swelling, and redness of the elbow joint due to formation of crystals in the joint.
- Osteoarthritis: Break down of protective cartilage from daily wear and tear or complications from prior trauma or injuries.
- Psoriatic arthritis: Sausage-like swelling of one or more fingers associated with psoriasis (chronic inflammatory skin condition), but can also affect elbows, as well as shoulders, back, hip, knees and/or feet.
- Reactive arthritis: Triggered by an infection in another part of your body, most commonly urinary, genital, or gastrointestinal infections.
- Swelling and/or pain around the elbow, particularly with movement.
- Usually red or warm to the touch.
- Sometimes has lesions or is draining pus.
Infections can involve the skin, tissue, joints, or tendons. Types of infections include:
- Septic joint: infection within joint leading to pain, swelling, and redness, and you’re unable to move your elbow.
- Cellulitis: infection of skin leading to pain, swelling, and redness.
- Bite wounds: Infection from bite wounds most commonly dogs/cats or humans.
- Infected olecranon bursitis or reactive arthritis from an infection located in another part of the body.
9. Lumps and bumps
- Elbow swelling with or without pain
Rather than swelling of the entire elbow, you may notice a smaller mass. These tend to be less common and benign, and include cysts such as a ganglion cyst (fluid-filled cyst), insect bites, and lipomas (fatty lump). Less commonly, lumps may be caused by cancer. These include basal cell carcinoma (skin cancer) and sarcoma (bone or tissue cancer).
Other possible causes
Swelling of the elbow may cause concern, but it is rarely life-threatening. However, it is difficult to use your upper extremities when this joint is swollen, so it can interfere with activities of daily living. —Dr. Manuelpillai
A number of conditions may also cause swollen elbow, though these are either rare or the swollen elbow is not usually the defining symptom. They include deep vein thrombosis (DVT), thoracic outlet syndrome, lymphedema, allergic reaction, contact dermatitis, and scleroderma.
When to call the doctor
- If little-to-no improvement after 1 week despite following at-home treatment recommendations, such as rest, ice, and anti-inflammatory medications.
- If you have any concerns of a malignancy/cancer, such as having unexplained weight loss.
Should I go to the ER for a swollen elbow?
You may need to go to the ER if you’re having the following symptoms:
- You have an elbow injury, particularly if associated with tingling, numbness, weakness, or excessive bleeding.
- Signs of infection including fever, oozing pus, or inability to move elbow at all.
- R.I.C.E. (Rest, Ice, Compress, and Elevate): Most cases of swollen elbows will respond to this treatment. Rest the affected area and ice it several times a day. If possible, compress the affected elbow with an ace bandage, and elevate it as much as possible.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve). These will relieve pain and swelling from inflammation.
- Epsom salt. Epsom salt contains magnesium, an anti-inflammatory mineral. Soak your elbow in warm water containing Epsom salt twice a day.
Other treatment options
- Aspiration. In extreme cases, removing excess fluid is the only treatment for relief. This needs to be performed by a doctor and should be monitored for signs of infection. The sample can also be tested for infection.
- Immobilization using sling, splint, ace wrap, cast, or splint.
Dr. Manuelpillai is a board-certified Emergency Medicine physician. She received her undergraduate degree in Health Science Studies from Quinnipiac University (2002). She then went on to graduated from Rosalind Franklin University of Medicine and Sciences/The Chicago Medical School (2007) where she served on the Executive Student Council, as well as was the alternate delegate to the AMA/ISMS-MSS Governing Council and the student representative to the Illinois State Medical Society (ISMS) Education and Health Workforce committee. She completed an internship year with UCLA-Harbor Medical Center's Department of Internal Medicine followed by an emergency medicine residency program at Boston Medical Center (2011) while also serving as the resident representative to the Massachusetts Medical Society (MMS) committee on Student Health & Sports Medicine. She then started working at Saints Medical Center (later Lowell General Hospital/Saints Campus and Main Campus) in Lowell Massachusetts where she served as the Continuous Quality Improvement Director for the emergency medicine group, as well as was the representative for the emergency department on the Sepsis, Stroke and PCI Quality Assurance and Compliance Committees. She joined Buoy Health in 2019. She currently works in multiple emergency departments both in the community and academics, as well as previously worked in multiple urgent care centers. She believes this mix of experiences has given her a unique perspective on the care of acute illnesses.