Arthritis Pain-Elbow

THE CLINICAL SYNDROME

Elbow pain secondary to degenerative arthritis is a common problem encountered in clinical practice. Osteoarthritis of the joint is the most common form of arthritis that results in elbow joint pain. Frequently, tendonitis and bursitis will coexist with arthritis pain of the elbow, making correct diagnosis more difficult. The olecranon bursa lies in the posterior aspect of the elbow joint and may become inflamed as a result of direct trauma or overuse of he joint. Bursae susceptible to the development of bursitis also exist between the insertion of the biceps and the head of the radius as well as in the antecubital and cubital area. In addition to the aforementioned pain, patients suffering from arthritis of the elbow joint will often experience a gradual decrease in functional ability with decreasing elbow range of motion, making simple everyday tasks such as using a computer keyboard, holding a coffee cup, or turning a door knob overhead quite difficult. With continued disuse, muscle wasting may occur and an adhesive capsulitis with subsequent ankylosis may develop.

Arthritis of the elbow can cause pain and functional disability during common everyday tasks.

SIGNS AND SYMPTOMS

The majority of patients presenting with elbow pain secondary to osteoarthritis and post-traumatic arthritis pain will present with the complaint of pain that is localized around the elbow and forearm. Activity makes the pain worse, with rest and heat providing some relief. The pain is constant and characterized as aching in nature. The pain may interfere with sleep. Some patients will complain of a grating or popping sensation with use of the joint and crepitus may be present on physical examination.

TREATMENT

Initial treatment of the pain and functional disability associated with arthritis pain of the elbow should include a combination of the nonsteroidal anti-inflammatory drugs or cyclooxygenase-2 inhibitors and physical therapy. The local application of heat and cold may also be beneficial. For patients who do not respond to these treatment modalities, an intra-articular injection of local anesthetic and steroid may be a reasonable next step. Intra-articular injection of the elbow is carried out with the patient in a supine position with the arm fully with the dorsum of the hand resting on a folded towel. A total of 5 mL of local anesthetic and 40 mg methylprednisolone is drawn up in a 12-mL sterile syringe.

Proper needle placement for intra-articular injection of the elbow.

Pain and functional disability of the elbow are often the result of degenerative arthritis of the joint. Coexistent bursitis and tendonitis may also contribute to elbow pain and may confuse the diagnosis. The aforementioned injection technique is a safe procedure if careful attention is paid to the clinically relevant anatomy in the areas to be injected.

Low intensity laser therapy as well as a coordinated wellness program is also effective in treating this disorder.

Low Intensity Laser Therapy (LILT)

The low intensity Laser (LILT) sends photons (light) into the injured tissues and can penetrate two to three inches to treat affected areas. It uses a natural enhancement of the cellular machinery that can and has been dynamically measured in published studies to promote healing without burning affected tissue .Once the photons find the injured tissues, they stimulate and energize the cells to repair and strengthen at a remarkable rate. The treatment does not hurt, takes about 30 minutes and is very cost advantageous.

Wellness Program

A wellness program whichindividualizes treatment for age, performance and function has been shown in pilot studies to improve the overall health and well being of the individuals evaluated. A well conceived dietary and supplementary regimen based on scientific age–related decline in certain necessary compounds can improve quality of life, correct the ravages of hormone imbalance, balance critical neurotransmitter function without resorting to powerful drugs for depression that often have unfavorable side-effect profiles and restore vitality and youth in daily exercise routines. Furthermore, when wellness products are utilized with success, individuals often seek less costly interventions including unnecessary surgeries and narcotic options to treat pain. For more information go to www.drpwellness.com.