Michael S. Vrana, M.D.
Orthopedic Surgeon
The elbow is really two joints in one: a hinge that bends, and a pivot that turns your palm up and down.
Your elbow is where three bones meet: the upper arm bone and the two forearm bones. It works as both a hinge, bending and straightening, and a pivot that turns your palm up and down. The tendons that power your grip anchor to two bony bumps on either side of the elbow, and the nerve that runs to your ring and little fingers passes right behind the inner one. That is why so much elbow trouble is either a worn tendon at one of those bumps or a pinched nerve.
Worn, painful tendon on the outer side of the elbow. You do not have to play tennis: gripping and lifting are the usual triggers.
The same kind of tendon problem on the inner side of the elbow.
The funny-bone nerve gets pinched at the elbow. Numbness and tingling in the ring and little fingers, worse with a bent elbow.
A fluid-filled lump over the tip of the elbow, from leaning on it or a knock. Usually painless and not dangerous.
The ligament on the inner elbow takes the strain of throwing. Pain in throwers that builds over a season.
Most elbow soreness settles in a week or two with rest and over-the-counter pain relievers. Come in sooner if the pain followed a fall and the elbow will not straighten, the joint looks deformed, the arm is numb or weak, a lump over the elbow turns red and hot, or you have a fever along with the pain.
Your visit starts with a conversation and a hands-on exam. What you do for work and sport, where the pain sits, and what movements set it off usually point to the answer before any pictures are taken. We take X-rays in the office the same day if we need them. Most elbow pain gets better without surgery: activity changes, a brace or strap, physical therapy, and sometimes an injection.
Most elbow pain gets better without an operation. The usual path is activity changes, a brace or strap that takes load off the sore tendon, physical therapy built around progressive loading, and occasionally an injection. Tendon problems here are slow healers, so the honest message is that improvement is measured in weeks to months, not days.
Surgery enters the conversation when a tendon or ligament has fully torn, a nerve is being damaged, or a long course of non-operative care has not worked. When that is the right step, your OSI surgeon performs it. See the elbow operations we perform or browse non-operative care.