Elbow pain is any type of pain that comes from structures in the elbow joint and/or in structures adjacent to the elbow joint .The causes of elbow pain are numerous. Most elbow pain is due to overuse or strain on the elbow joint components, but some causes are due to trauma, infection, and/or autoimmune processes [1].

Risk factors for elbow pain are numerous and range from engaging in repetitive activities and participation in sports to those associated with infection, trauma, and rheumatoid arthritis[1,2].

Treatment of elbow pain involves rest of the joint by reducing its motion and stress. Other treatments depend on the cause of the joint pain. Orthopedic consultation is often advised to design appropriate treatment protocols that may require casting and surgical intervention [3].

Rest, ice packs, and compression of the elbow joint are commonly used home remedies. There are others, but before their use, discuss them with a physician [4].

For most patients with elbow joint pain, if treated quickly and appropriately, the prognosis is very good. The prognosis decreases if the joint pain is allowed to become chronic or is due to an underlying process that may be progressive if not treated [5].

A number of studies conducted in different parts of India reveal widespread ignorance about the elbow pain among people. As this disease largely relies on prevention and the right information at the right time is essential to bring about a behavioral change when the population is most receptive. Hence, this study was undertaken with the objective to assess the knowledge about preventive factors and practices during elbow pain among Ortho  OPD patients in civil hospital Rohru.

Objectives of the Study

• To evaluate the knowledge of patients attending Ortho OPD towards prevention of elbow pain in civil hospital Rohru

• To evaluate the practices  of patients attending Ortho OPD in  civil hospital  Rohru on having  elbow pain

• Research approach -descriptive

• Research design-descriptive survey design

• Setting of the study- Ortho OPD of  civil hospital  Rohru

• Study duration- between Aug- December 2020

• Study population- Ortho OPD patients in civil hospital   Rohru.

• Sample size-400 Ortho  OPD patients

• Sampling technique- convenience  sampling technique

• Sampling criteria- first five patients attending the Ortho OPD of civil hospital Rohru everyday were selected till the completion of sample size after explaining the purpose of the study. Informed consent/assent was taken from  them and confidentiality  of the selected  participants was also maintained 

• Inclusive criteria- patients selected during the day of data collection in study setting and who were willing to participate in the study.

• Exclusion criteria: patients who were not willing to participate in the study 

• Development of tool-knowledge related questionnaires

• Description of tool

Section A

Socio-demographic characteristics of the patients (age, gender etc.).

Sections B

Questions regarding knowledge of preventive factors for elbow pain and practices of patients in case of elbow pain.

• Validity of tool - by the experts in this field

• Permission- obtained from the concerned head of the civil hospital

• Data collection by myself and patients  was given 5 minutes time to complete that questionnaire and collected at the end of the prescribed time

• Data analysis with appropriate statistical test in terms of frequencies, percentage, mean, standard deviation. P value of less than 0.05 was considered to be statistically significant

The present study was non-experimental descriptive study carried out to evaluate knowledge of preventive factors for elbow pain and practices of patients in case of elbow pain in   civil hospital   Rohru. 

In the present study 35% (140) of the patients fall were below 40 years   of age while 65% (260) were above 40 years.  54% (216) of patients were male and 46% (184) were female.

Among the total patients maximum 312(78%) replied that taking frequent breaks  from repetitive tasks helps in prevention of elbow injury or pain followed by interchanging hands during activities, such as when sweeping, or gardening 311 (77.75%), avoid  overuse of arm  by doing repeated movements302(75.5%),avoid  lifting a heavy weight 301(75.25%),avoid making the same hand and arm movements over and over 299 (74.75%), avoid falls on ground280 (70%),use the correct techniques or positions during activities 278(69.5%),avoid sleeping on one's side with the elbow bearing chest weight  263(65.75%),avoid leaning of elbow on the hard surfaces255(63.75%), avoid leaning on elbow for prolonged periods 234 (58.5%),warming up before playing sports or exercise 190(47.5%),stick to the middle of your range of motion /avoid bending or straightening arm 189(47.25%),avoid injury/fracture of elbow joint  188(47%),stretching exercise of elbow regularly 153 (38.25%),stick with smooth movements instead of sharp, jerky ones 134 (33.5%),using a proper-sized grip on sports equipment 124(31%), avoid working with a bent wrist 101(25.25%),calcium and vitamin D supplements101(25.25%) and eat healthily and  balanced diet 89(22.25%). 

Among the total patients, 87(21.75%) didn’t know anything about prevention of elbow injury or pain. (Table 1)

Table 1: knowledge of patients towards prevention of elbow pain

Among the total patients maximum 335(83.75%) replied that they applied of pain relief gels upon elbow during pain followed by  avoid lifting heavy weight 314(78.5%), rest the elbow joint 313(78.25%), immobilize  the elbow 304(76%), avoid any stress on elbow 301(75.25%), pain relief medications301(75.25%),Cold applications189(47.25%), Stretching exercises for elbow 156(39%), calcium and vitamin D supplements 124(31%), compression & wrapping with elastic bandage 111(27.75%), heat applications 108 (27%), specific and correct type of elbow  band102(25.5%), use elbow sling 87(21.75%) during elbow pain. (Table 2)

Table-2: Practices of patients in case elbow pain

Elbow pain is a sharp, dull, burning, or pressure discomfort or pain that can be intermittent, constant, or shooting due to a strain, sprain, fracture, dislocation, infection, autoimmune condition, cancer, or trauma to the structures in and adjacent to the elbow joint [6].

Primary care management of elbow pain aims at decreasing stress and increasing the strength of elbow joint. Rest should be relative and the patient should avoid activities that aggravate symptoms. Counterforce bracing (band over muscle body) reduces stress, while rehabilitative exercises and physiotherapy improve muscle strength. Exercises to stretch and strengthen your wrist and forearm muscles can be a big help in preventing elbow pain [7,8].

In the present study ,among the total patients maximum 335(83.75%) replied that they applied of pain relief gels upon elbow during pain followed by Avoid lifting heavy weight 314(78.5%), Rest the elbow joint 313(78.25%), Immobilize the elbow  304(76%), Avoid any stress on elbow  301(75.25%), Pain relief medications301(75.25%),Coldapplications189(47.25%), Stretching exercises for elbow 156(39%), Calcium and Vitamin D supplements 124(31%), Compression & Wrapping with elastic bandage 111(27.75%), heat applications 108 (27%), specific and correct type of elbow  band 102(25.5%), use elbow sling 87(21.75%) during elbow pain.

Other type of treatments that help to heal elbow pain is RICE therapy. This therapy translates to rest, ice, compress, and elevate. This means to rest the affected elbow, ice it to reduce any swelling or pain, then compress it by wrapping the elbow with an elastic medical bandage, and then keep it elevated by using some pillows whenever you can. Use an elbow strap to reduce strain. Physiotherapy exercises will be recommended by your doctor if your muscles in the affected area are weak. These exercises will ensure that any type of stiffness in the elbow joint is reduced while also increasing flexibility as part of the treatment, if the injury to the area is not much, your doctor may also prescribe pain killers or steroid injections to reduce pain and swelling temporarily [9,10].

Work-related problems causing elbow pain are more resistant to non-operative management. In this situation consider advising patients to take a short period of time off work to help restore function by promoting rest. Follow-up should be tailored to the individual patient, and review after 2–4 weeks depending on severity of symptoms is a reasonable option [4,5].

Elbow pain can be best treated with rest, stretching, ice and physical therapy. Exercising and stretching may reduce pain, and can aid in recovery. Still, surgery may be necessary in extreme cases

1. EmedicineHealth. “Elbow Pain.” EmedicineHealth, June 2021, https://www.emedicinehealth.com/elbow_pain/article_em.htm.

2. Verywell Health. “Pain in Both Elbows.” Verywell Health, June 2021, https://www.verywellhealth.com/pain-in-both-elbows-5114457.

3. MedicineNet. “Elbow Pain.” MedicineNet, June 2021, https://www.medicinenet.com/elbow_pain/article.htm.

4. Versus Arthritis. “Elbow Pain.” Versus Arthritis, June 2021, https://www.versusarthritis.org/about-arthritis/conditions/elbow-pain/.

5. Medical News Today. “Elbow Pain: Causes and Treatments.” Medical News Today, June 2021, https://www.medicalnewstoday.com/articles/175848.

6. WebMD. “Elbow Pain.” WebMD, June 2021, https://www.webmd.com/pain-management/guide/elbow-pain.

7. Physio-Pedia. “Lateral Epicondylitis.” Physio-Pedia, June 2021, https://www.physio-pedia.com/Lateral_Epicondylitis.

8. Physio-Pedia. “Medial Epicondyle Tendinopathy.” Physio-Pedia, June 2021, https://www.physio-pedia.com/Medial_Epicondyle_Tendinopathy.

9. WebMD. “RICE Method for Injuries.” WebMD, June 2021, https://www.webmd.com/first-aid/rice-method-injuries.

10. HCAH. “Elbow Pain Treatment.” HCAH, June 2021, https://hcah.in/health-advantage/elbow-pain-treatment/.