Elbow Pain
Lateral (meaning away from the midline of the body) epicondylalgia (meaning pain of the epicondyle) is a painful condition on the outer aspect of the elbow. The common name for lateral epicondylalgia is tennis elbow but only 5% of the people afflicted with this condition play tennis.
Pain at the elbow may have one or more causes: it could be from the forearm tendons that attach at the outer aspect of the elbow, it could be referred pain from the next, it could be from one or more of the joints at the elbow, or it may originate from the radial nerve that is in close proximity to the elbow joint.
It often occurs with repetitive use of the arm especially with a clenched fist. Most cases are not due to tennis.
Local tenderness and pain with resisted and passive extension of the wrists is common.
Activity modification, anti-inflammatory medications, ice, and progressive stretching and strengthening will relieve most cases. Surgery is only an option in recalcitrant cases.
Wrist Pain
Carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel. There is pain, tingling, and in severe cases, numbness in the thumb, index middle and ½ of the ring finger. It is typically caused by repetitive tasks involving the hand and wrist. Typing with the wrists resting on hard surfaces can result in this problem.
It is often worse at night or with driving and can lead to loss of grip strength and coordination. As the problem progresses, atrophy (muscle wasting) of the thumb muscles may occur.
Treatment typically consists of splinting the wrist in a neutral position (no bend in the wrist in either direction), anti-inflammatory medication, and most importantly, activity modification such as wearing a padded glove during cycling. Surgical release of the transverse carpal ligament is often performed before muscle wasting occurs. Physical therapy follows to help restore range of motion, strength, and to educate the patient of factors that can lead to a reoccurrence of the problem.
