Elbow pain

1, Lateral elbow pain--- tennis elbow/lateral epicondylalgia
It is painful condition with repetitive wrist movements, such as brick layer or carpenter, only very few people have this condition resulted from tennis, but unfortunately, its nickname is still “tennis elbow”. This is a degenerative tendon condition, same as shoulder, groin, patellar and achillis tendon.

Signs and symptoms:

• Most of time gradually onset lateral forearm pain, but it can occur after single injury, such as pulling, pushing or lifting
• Sharp pain with wrist extension, more pain with resistance.
• Tender on palpation over lateral epicondyle region

Treatments:

• Acute phase, deep tissue massage, acupuncture, TENS, ice and taping can ease the pain.
• Tendon strengthen exercise is crucial for this condition.
• Occasionally, steroids inject or even operation needed.

2, medial elbow pain--- Golfer elbow/ medial epicondylalgia
This is a same kind of condition as “Tennis elbow” but less common, signs and symptoms are similar to “Tennis elbow”, just in medial side of elbow, treatments are similar to “Tennis elbow”

3, referred pain from neck --- neck OA or facet dysfunction
Neck pain is commonly referred down to shoulder blades and upper limbs. The referred pain is normally diffused ache. It has no relationship with local movements, but it may relate with neck movement.

Signs and symptoms:

• Diffused ache, gradually onset, occasionally sharp pain with wrong neck movement
• Morning stiffness,
• Stiff neck and shoulder muscles,
• Decrease ROM, typical more decreased extension than flexion.

Treatments:

• Degenerative change, it is no cure, but it is fully manageable
• Acute phase, hot pack, TENs, acupuncture, joint mobilisation, traction and AROM exercise will help with pain
• Long-term management: AROM exercise, traction, neck core-control exercise, stretch and self traction.

4, radiating pain down to arm---- radiculopathy/radicular pain
This is a nerve compression which leads to pins, needles and numbness radiating down to up limb, may or may not with sharp shooting pain.

Common causes for radiculopathy include local trauma, OA, bulge disc, infection etc.

Signs and symptoms:

• PNN radiating down to arm, the further the worse, sometimes down to tips of digits.
• Sharp shooting pain down to upper limb, typical with neck movements
• Less pain with lying down, more pain with sitting or standing.

Treatments:

• Acute phase: soft collar (only for few days to two weeks), gentle mobilisation and traction.
• Ice, compression and lying down
• TENs, acupuncture and gentle massage
• Long-term management: AROM exercise, stretch, traction and core-stability exercise.