Elbow and Wrist Pain
There are two bones in your forearm, the ulnar and the radius. Between them they make and link your elbow and wrist.
I’ve written about the elbow and wrist in one article as they are often linked. But firstly let’s examine the elbow.
Elbow Pain
As with all joints in the body there are a multitude of damage and dysfunctional problems that can occur in the elbow. As ever my objective is to use various tests to discover or rule out damage or pathology (disease process). Both your case history (what you tell me about when your pain developed) and my examination will help me with this. In the cases where I’m able to rule out pathology or damage I will tend to consider your pain the product of dysfunctional operation in the joint, or the muscles that attach to it or cross it, or of the nerves that supply those muscles. As I’ve already mentioned the elbow can be considered intimately linked with the wrist so I will examine here too.
Underlying Causes
As you can imagine it’s very important to consider if other aspects of your anatomy are causing your elbow pain but also if any aspect of your lifestyle is affecting it. This includes hobbies, sports, sleeping positions, general health and your occupation. How long you’ve been doing these things, any accidents and equipment and techniques involved in hobbies sports work etc..
Assessment
It’s always nice to have a diagnosis such as “tennis elbow”. But a diagnosis is often generally a name for a pathology or “condition” and if the problem is one of dysfunction leading to pain there can be multiple factors involved. This isn’t always easy to put a name to. Factors often found involved in elbow pain include neck dysfunction, nerve pressure through the neck shoulder and chest area, upper arm muscle dysfunction, forearm muscle dysfunction and joint restriction in the elbow, wrist or both.
Treatment
How I treat your elbow pain will obviously depend on what I find, what you tell me about lifestyle factors, but will more often than not involve massage techniques to the muscles in your forearm or upper arm sometimes mobilisation techniques to the joints in the wrist or elbow. I may need to free the nerve pressure in the neck chest or shoulder using similar techniques. I will only rarely give stretching or strengthening exercises. But I’ll often prescribe self treatment techniques, normally in the form of self massage. The use of supports can be both helpful and detrimental so we will discuss the merits of this.
Pathology or Damage
If it appears you have some form of damage or disease process going on and you haven’t already spoken to your doctor then this will be the next step. There are a number of investigative procedures available to your doctors including Xrays, MRI’s, blood tests etc. As well as certain treatments that can sometimes be helpful.
I believe that your body has the capacity to heal any damage or disease as long as you are alive. The reason that this often doesn’t happen is that the conditions for repair aren’t appropriate. The factors that caused the problem are still in place or the materials required for repair aren’t available. This is where natural or non medical therapy excels. Physical therapy can re-establish optimal conditions for repair, lifestyle factors can be altered or removed, nutritional factors can be considered.
Medicine
The above being considered, there are times when modern medicine can be extremely helpful. Anti-inflammatory medication can be useful in the form of oral drugs or cortisone injection but as a last, rather than first, resort. This is because of the potential side effects of these drugs, as well as the lack of consideration for causative factors.
Resolution
In the majority of cases treatment factors in all the above will be successful within 3 to 6 weeks with treatment on a weekly basis.
Wrist and Hand Pain
Because wrist and hand pain are often nerve related it is worth looking at my article on so called RSI or repetitive strain syndrome.
Wrist Pain
Wrist or hand pain that does not have the characteristics of RSI can be related to the way the elbow is functioning, sometimes with no hint that there is an elbow problem at all.
See this (case history) link to case history about badminton player.
Of course the wrist itself consists of 8 tiny bones articulating with the 2 forearm bones. Misalignment or damage hare can case sharp pain on movement or a constant ache. Sometimes just trying to undo a jar lid or hold a pen can cause agony.
Underlying Causes
It is important to figure out why you have wrist pain. If you’ve injured it in an accident that’s pretty obvious, but as is often the case, there appears to be no clear causative factor then we need to consider underlying causes. This can be nerve related, muscle or joint related, it could be use related so factors such as work, sports, hobbies and play should be considered. Often techniques or tools and equipment have a rate to play here as well.
Assessment
Once underlying causative factors have been considered we need to determine exactly what is going on in your wrist. Often the problems are in the forearm muscles, sometimes joints become restricted in their movement due to misalignment or more commonly adhesions in soft tissues that simply prevent normal movement of the joint as mentioned.
It is very important to consider the role of the elbow in any wrist pain, problems with the head of the radius in the elbow create strong issues with the way the wrist functions.
Treatment
If we can rule out disease and damage then treatment will almost certainly involve a variety of massage techniques to the forearm. This is often extremely powerful in restoring normal function to the wrist if done in the correct way. We may need to mobilise joints in the wrist or elbow or both. There are 19 muscles in the forearm and it is also important to consider the substance that keeps them all in place this is known as connective tissue, which can also be worked on to help resolve wrist problems.
Pathology or Damage
If it appears you have some form of damage or disease process going on and you haven’t already spoken to your doctor then this will be the next step. There are a number of investigative procedures available to your doctors including Xrays, MRI’s, blood tests etc. As well as certain treatments that can sometimes be helpful.
I believe that your body has the capacity to heal any damage or disease as long as you are alive. The reason that this often doesn’t happen is that the conditions for repair aren’t appropriate. The factors that caused the problem are still in place or the materials required for repair aren’t available. This is where natural or non medical therapy excels. Physical therapy can re-establish optimal conditions for repair, lifestyle factors can be altered or removed, nutritional factors can be considered.
Medicine
The above being considered, there are times when modern medicine can be extremely helpful. Anti-inflammatory medication can be useful in the form of oral drugs or cortisone injection but as a last, rather than first, resort. This is because of the potential side effects of these drugs, as well as the lack of consideration for causative factors.
Resolution
In the majority of cases treatment factors in all the above will be successful within 3 to 6 weeks with treatment on a weekly basis.