Flareups of pain in elbow with tight joint. Treatment?

Resolved Question:

I'm a healthy 33 year old male. Always been healthy, not very high muscle mass, 6'0" 180 lbs

I've had a "bad elbow" since the age of 13. The pain started probably when I was whipping baseballs / soccer balls etc. No broken bones. Shoveling in the winter made it worse. Ever since my elbow has been inflamed in one part or another and I can't seem to get a straight answer as to why, and more importantly, I cannot cure it. Most of the time the loss of mobilty is minor, but I can always feel it being "tight" and cannot fully extend or contract. When I get a "flare up" it becomes much worse and more painful.

For a brief period in my life, age 24-25, when I lived across the country, shoveling and digging for 2 years, my elbow was completely healed and free of pain. I wonder if that job played a factor, in strengthening my arms the right way, or if the change of environment, diet, etc made a difference as well.

When I moved back home, I changed jobs again, and for a couple of days I had to do alot of "scraping" with chisels and could feel the pushing motion causing pain. I also hit my elbow really hard a few times in the funny bone and tendons so believe this was why the flareups came back.

I usually get a flare up once every couple of years old patientand it lasts for a few months. I lose full motion of my elbow. I cannot fully contract it (I cannot touch my shoulder). I cannot fully extend it (ie about 10 degrees lost mobility).

I had a flare up about 7 days ago. I was trying to remove a tree stump with a pry bar, and while standing, pulled the bar back and it let go. My arm contracted really quickly, so it compressed towards my shoulder and because it's alway swollen and doesn't want to fully "close", something inside compressed and within an hour I was in "flare up" mode. I take 400mg of alieve twice a day and it helps, but doesn't cure it.

I have had MRIs, X-rays, Ultrasounds, and my doctors don't really have an answer or cure. One said that it was a bone spur, but that doesn't make sense as I was fully cured for 2 years, and the swelling and flare ups came back in a matter of days. Another said my bones didn't grow equally and the joints aren't perfectly aligned like they should be. Another said it's mild arthritis according to x-rays, which wouldn't have made sense at age 13 (he did say I probably have a bit of arthritis in the other elbow so it may not be the cause). And the symptoms and pain level have been the same at all times.

I had a gym membership for 4 months when I was 32, and I didn't notice any improvements after all my strength training. I tried physiotherapy at age 15-16 without any improvements. I tried physiotherapy again age 27 for a few months without any improvement. I've tried accupuncture and that didn't do anything. Someone told me to try a chiropractor.

My own theory is that my nerve is somehow pinched/misaligned and when I compress my arm too hard the nerve swells up and pushes on my tendons, which causes them to bulge out. I believe this is why I cannot fully extend my elbow in a flare up. I can clearly see the tendon bulging out more than my other arm even though it doesn't hurt.

I'm really at a loss and hoping someone can take my "case" on or refer me to a specialist. I am located in Canada. It's frustrating because it's not something that will kill me, so doctors don't seem to pay any attention. However I work physically (hardwood floors) and if I have to stop working I cannot earn a living anymore. One doctor has reluctantly agreed to give me a shot of cortisone to see if that may work. I will try it in a few months when work slows down because I need a week off after that.

Does anyone out there have any idea what else could be the cause or how to cure this?


Category: Orthopedic Surgeon

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Category: Spine Surgeon
Dr. Karun Jain is online now

Expert:  Dr. Karun Jain replied 4 Days.

Hello,
Greetings from DoctorSpring.com
Thanks for writing to us.
I have read you history. Elbow pain last for many years old patient(almost since childhood) with waxing & weaning phenomenon, restricted elbow movements, along with near normal MRI & USG usually goes in the direction of:
1. Chronic lateral epichondylitis
2. Mono articular arthritis
3. Myositis ossificans
4. Or any Developmental disorders
5. Unknown pathologies
Usually MRI picks up all the above mentioned pathologies.
I advise you to please send us latest MRI and USG elbow reports along with arthritis blood investigations. Please send clinical pictures also for better understanding.
Please revert us back with the said investigations. I hope my opinion will help you.
Stay happy & healthy,
Thanks


Dr. Karun Jain
Category: Spine Surgeon
Experience: 
MBBS, 2002 - Kasturba Medical College, Mangalore
D.Orth, 2009- J.S.S Medical College, Mysore
MS - Orthopaedics, 2011 - University of Seychelles - American Institute of Medicine
Currently pursuing ChM (Trauma & Orthopedics) from The Royal college of Surgeons, Edinburgh & University of Edinburgh, U.K
Dr. Karun Jain and 4 other Medical Specialists are ready to help you

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