There are many different causes of elbow pain. Common injuries that we see at our Burlington sports injury clinic include tennis elbow, golfers elbow, and tendinopathies or overuse injuries in the bicep or tricep muscles. Often the history associated with the condition is what helps us diagnose. Are you a throwing athlete? Does your job require a repetitive strain of the area on a daily basis? Was there trauma? One major variable in the history can be the age of the patient. Nursemaid’s elbow is an injury that really only affects young children. So when a young child presents with unexplained pain in the elbow, this diagnosis needs to be considered.
The name “nursemaid’s elbow” is a little odd, but perhaps the mechanism of injury gives the name some meaning. A typical patient with nursemaid’s elbow would be a young child with pain on the outside of the elbow. Usually, this area is sore to the touch yet the child won’t recall any obvious fall or impact of the area. What may be part of the story is that someone (probably an adult caregiver) pulled the child’s arm as you would if you were playing and swinging them around.
We have two bones in our forearm. The smaller one on the thumb side (outside) of the elbow is the radius. It spins within a circular ligament close to the elbow called the annular ligament. Children are susceptible to nursemaids elbow because this area hasn’t fully developed yet. Essentially, the radius and the annular ligament get separated. For ease of understanding, it’s much like a dislocation of the smaller bone in the forearm and it comes out in the area of the elbow.
Treating a Child’s Elbow Pain
The treatment is to “relocate” the bone by flexing the elbow and rotating the radius. Following treatment x-rays should be considered to ensure proper relocation. The child may still be in some minor pain which can be treated with modalities like laser or interferential current. Ice can also be helpful to reduce associated inflammation. Proper instruction with respect to rehabilitative exercises is important to ensure proper range of motion and strength in the area. Generally speaking, under most circumstances this injury is fairly easily resolved once properly identified.