Bring a large pot of salted water to a boil over medium-high heat. Add the elbows, and cook al dente according to the package directions.
Reserve about a cup of the pasta water, then drain and set aside.
Brown the ground beef in a large skillet or Dutch oven over medium heat.
Remove the meat. Reserve about 1 tablespoon of leftover fat, and drain the rest.
Add the onions and peppers to the skillet and sauté in the reserved fat until slightly softened, about 3 minutes.
Add the garlic and continue sautéing until fragrant, about 1 minute.
Add the cooked ground beef to the skillet and sauté until mixed well.
Add the tomato sauce, crushed tomatoes, oregano, basil, parsley, Worcestershire Sauce, salt, and pepper. Continue to stir while heating until bubbly.
Add the cooked elbows, and mix to combine. Add some of the reserved pasta water if you like it more soupy.
Taste and adjust seasoning if needed, and then let it simmer until heated through. Serve warm.