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Could Elbow Pain be Cause by a Bone Spur?

Spring is a time for baseball, homeruns and pitching that perfect game. However, hard throwers including pitchers and position players, not only impose great force on their UCL, but they also put great force on the bone at the back of the elbow, called the olecranon. This additional stress can create bone spurs, also called osteophytes. Bone spurs can crack and become loose, which is often referred to as “chips in the elbow.” When the bone spurs break, they can cause significant pain in the back of the elbow.

What is osteochondritis dissecans of the elbow?

Osteochondritis dissecans of the elbow is a disorder in which fragments of bone or cartilage come loose and float around in the elbow joint. Cartilage is a tough, smooth tissue that lines and cushions the surface of the joints. These chips usually come from the upper arm bone (humerus). Some players can get through the season with anti-inflammatory medication, and even a cortisone injection. Other players will experience pain to a debilitating degree and require surgery. Fortunately, bone chips can be removed arthroscopically,


How does it occur?

The chips usually result from a forceful injury to the elbow joint. It is also seen in the elbows of throwing athletes and gymnasts.


What are the symptoms?

It hurts when you move your elbow. Your elbow may click or lock or you may feel a bone chip inside the joint. Your elbow may be swollen, and you may not be able to completely straighten your arm.


How is it diagnosed?

Your doctor will review your symptoms and examine your elbow. Your doctor may do an x-ray, which may show a bone chip or an abnormal joint surface.


How is it treated?

The treatment for osteochondritis dissecans is to rest your elbow until the symptoms are gone. This may take up to a few weeks. You should apply ice to the elbow for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain and swelling go away. Your doctor may prescribe an anti-inflammatory medication. Small bone chips that do not affect elbow motion and do not cause further pain do not need to be removed. Surgery may be needed to remove a large bone chip.


When can you return to your sport or activity?

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your elbow recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may return to your sport or activity when you are able to forcefully grip your tennis racquet, bat, or golf club, or do activities such as working at a keyboard without pain at your elbows. In sports such as gymnastics, you should be able to bear weight on your elbow painlessly. There should be no swelling around your injured elbow, and it should have regained its normal strength compared to your uninjured elbow. You must have full range of motion of your elbow.


How can I prevent osteochondritis dissecans of the elbow?

Osteochondritis dissecans is usually caused by trauma to the elbow and is not preventable.


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