Give problems with your arms the elbow; HEALTHMATTERS YOUR MEDICAL QUERIES ANSWERED.

Byline: Elena Douse 

Q For the last two weeks I have been getting a constant pain in one spot on the side of my right elbow. The pain shoots down my arm to my wrist and is unbearable if I try to lift anything heavy or if I try to unscrew bottle tops. Someone said I might have tennis elbow, but I don't play tennis!

A Despite its name, you don't have to be a tennis player to get tennis elbow. Anyone can get it, and from your description, it does sound like you have developed this common condition.

Tennis elbow was originally described by tennis players, who, following strenuous tennis matches, complained of pain over the bony lump on the outer aspect of the elbow.

This bony lump is known as the lateral epicondyle and is the point of insertion of a large number of forearm muscle tendons.

Overuse of the muscles and tendons of the forearm, which occur during activities such as gardening, golf, racquet sports, weight lifting and typing, can result in inflammation of the epicondyle and subsequent pain in the elbow and forearm. This pain is typically worse on lifting the arm and on twisting actions of the wrist and arm, such as when opening door handles and bottles.

Sometimes pain will also occur on the bony lump on the inner side of the elbow (the medial epicondyle) and this is known as golfers' elbow. Your doctor will advise you to rest the arm and avoid actions which could cause further inflammation and pain. I usually prescribe a four to sixweek course of oral or topical anti-inflammatory medication such as ibuprofen or diclofenac. Applying ice packs to the painful site can also be helpful.

If your symptoms are not settling with anti-inflammatories and rest, or if you are unable to take anti-inflammatory medication, I would usually recommend a cortisone (steroid) injection.

A combination of steroid and local anaesthetic is injected directly onto the point of maximal tenderness. Symptoms start to improve within a few days and the condition often settles over the next few weeks. Sometimes, a course of two to three injections, over a few months, may be needed before improvement is seen.

Persistent, problematic tennis elbow is often helped with physiotherapy by strengthening the forearm muscles to help support the inflamed elbow.

QI seem to be developing a swelling over my elbow. It feels like a collection of fluid and has been there for three days now. It doesn't cause me any problems and it isn't painful. Any ideas what this could be and should I see my GP? A This sounds like olecranon bursitis.

The olecranon is the main bony prominence in our elbow, more commonly known as the funny bone.

Overlying the olecranon is a fluid-filled sac called a bursa. Normally you can't see or feel this bursa, but occasionally the bursa can become inflamed and excess fluid builds up within the sac. A swelling develops over the elbow, just like you have described above, and this can range from the size of a golf ball to the size of a tennis ball or larger.

These inflamed pockets of fluid can develop in response to an injury to the elbow or more commonly, as a result of repeated pressure on the elbow, such as occurs when leaning on the elbow on a hard surface for a prolonged period of time.

Generally, an olecranon bursitis will resolve by itself, and the fluid will be reabsorbed by the body over a few weeks. If the swelling is particularly large or persistent, your GP may attempt to aspirate some fluid from the bursa, using a wide-bore needle.

You should rest the elbow and avoid leaning on it.

Ice packs can help reduce the amount of swelling around the joint and a course of anti-inflammatory tablets will speed up recovery.

A red, hot, painful elbow can indicate infection within the bursa, and you should visit your GP for a course of antibiotics should this develop.

Send your questions to Dr Elena Douse c/o South Wales Echo, Six Park St, Cardiff CF10 1XR