Living With Chronic Pain

10 Ways To Get Relief From Elbow Pain

You don’t have to be Serena Williams or Jack Nicklaus to have “golfer’s” or “tennis” elbow.  Even if you don’t play sports, you can still have elbow pain. Pain results from any activity that requires repetitive motion of the arm or wrist and inflames tendons that attach to the elbow. This is called epicondylitis. The only difference is ” tennis elbow” is pain on the outside of the elbow, or lateral epicondylitis, and “golfers elbow” affects the inside, or medial epicondyle.

Many activities, sports, painting, weight lifting, computer work, or even lifting objects you wouldn’t suspect could cause harm- like a gallon of milk- can inflame the tendons. It can occur in any age group that is at risk for injury such as those performing repetitive activity at least two hours a day,  individuals that are obese or smoke, but it’s most common in 30-55 year olds.

If elbow pain persists, get seen sooner than later. 

Injuries are often due to damage to muscles and tendons in the forearm that help to stabilize the wrist when the elbow is straight, as in tennis elbow. The muscle is weakened from overuse and microscopic tears form in the tendon where it attaches to the epicondyle (the bony protrusions in the elbow). This leads to inflammation and pain. The muscle also rubs against these bony bumps in the elbow, causing gradual wear and tear of the muscle over time. Pain can then radiate from the elbow into the forearm and even into the wrist and hand.  Shaking hands, turning a doorknob, making a fist, or holding a cup of coffee may become too painful.

Once it starts, it can be difficult to stop since using our arms in everyday activities exacerbates the underlying issue. I remember when we first started using computers in my office. I went from paper to digital overnight. This suddenly meant using a keyboard and mouse for hours at a time. My elbow flared up in just a few weeks. Everyday I was forced to continue the very same actions that had created the problem in the first place! I couldn’t stop working, so my only choice was to figure out how to stop inviting the pain and calm it down throughout the day. Like me, the majority of people will get resolution using these ideas:

1) Rest the arm: But, don’t baby it- just stop the repetitive motion that caused the pain. Also stop lifting, and don’t pick anything up with a straight arm, which puts all the pressure on the elbow. Bending at the elbow makes the entire arm take the weight of the item being lifted

2) Ice it:  Ice your arm several times a day for 10-15 minutes. Always use a barrier between the ice and your skin so it doesn’t get burned. You can also stimulate circulation by getting into a hot bath or shower and icing the elbow for a few minutes, then moving it in all directions under hot water.

3) Use compression: Wrap or buy a sleeve to keep the area warm and compressed. This is especially helpful when you still have to be active i.e. using your computer.

4) Elevate your arm above the level of your heart when sitting or lying down:This will help keep any swelling or inflammation to a minimum. I added a pillow and kept my arm bent at a 45 degree angle. This took the pressure off the elbow and let it rest.

5) Use non-steroidal anti-inflammatories (NSAIDs) such as Motrin or Aleve: If you have no contraindication for use, these help to stop the inflammation that goes with the tiny micro tears in the tendons from overuse activities.

6) Try steroids for repeated episodes of pain: Steroids by pills or injection may be an option.

7) Physical therapy: I’m a huge advocate of physical therapy. Physical therapists can diminish the acute inflammation and help guide you through stretches and exercises to relieve the pain and prevent injury in the future.

8) Use proper technique: Make sure you’re using proper technique in any weight lifting program so you’re not stressing the joint and muscles inappropriately. Also, make sure you’re not lifting too much weight. If it’s a struggle or too heavy, STOP. Check your work station and ensure it’s ergonomically set up to prevent unnecessary strain on your arm.

9) Return gradually to activity that involves the arm: Don’t jump back into the exercises or activity that caused the problem. Go slow and build up to a full return. When it comes to weight lifting, I usually recommend starting with 50% of what you usually lift. Remember, we’re not trying to become Arnold Schwarzenegger. A little goes a long way to toning and strengthening.

10) Surgery: If pain persists, surgery may be an option.

Talk to your provider and learn which might be the best treatment for you. If it persists, get seen sooner than later. Elbow pain treated acutely has a far better chance of resolution than one that’s become chronically inflamed for weeks or months.

dsc_0323-1    –Dr. Courtney

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