Elbow and Hand Pain
Elbow and Hand Pain
1. Tendon injuries
2. Nerve compression
Examples of tendon overuse injuries at the elbow include lateral epicondylitis (tennis elbow) and medial epicondylitis (golfers elbow). Treatment includes activity modification, anti-inflammatory medications, therapy, bracing and occasionally a steroid injection. These conditions most commonly resolve after one year without surgical treatment. When non-surgical treatment is not effective some patients may benefit from surgical treatment.
The distal biceps tendon is responsible for bending your elbow and twisting the forearm to turn the palm upwards such as tightening a screw with a screwdriver. Some patients may experience weakening of the distal biceps tendon (tendonitis) resulting in pain and decreased function. Rarely some patients may experience a complete rupture of the tendon resulting in a pop followed by bruising and swelling. Treatment options often include surgical intervention to reattach the tendon to the bone to avoid fatigue with repetitive motions.
Tendinitis at the wrist most commonly includes de Quervain’s tendinitis (pain at the thumb side of the wrist) and trigger finger or trigger thumb. Often treatment includes ice or heat, splints, anti-inflammatory medications, and steroid injections. If symptoms persist despite appropriate treatment, surgical treatment may be indicated in select patients.
The ulnar nerve (cubital tunnel syndrome), radial nerve (radial tunnel syndrome), and median nerve (carpal tunnel syndrome) may be compressed at the elbow, forearm, or wrist and cause pain and numbness and weakness in the hand. In addition to patient examination in the clinic, electromyography (EMG) and nerve conduction velocity (NCV) tests may be ordered to aid in the diagnosis. Treatment options include activity modification, anti-inflammatory medications, bracing, therapy, and steroid injection in the appropriate patient. Surgical release and decompression may be an option when non operative treatment has failed.