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Exercises for Arm Pain | Arm Pain Relief Tips

Common Causes of Arm Pain

The first step to treating an injury is understanding the cause. Exercises and treatments that work for carpal tunnel syndrome may not be effective for bursitis or tendonitis. Below are some of the most common musculoskeletal injuries that can cause arm pain. You can learn more about these and other injuries we treat here.

Carpal Tunnel Syndrome

The median nerve provides the sensation of feeling to the arms and hands and facilitates movement. To get into the hand, the median nerve passes through an opening at the base of the wrist. This opening, known as the carpal tunnel, is narrow and susceptible to compression.

Pain from carpal tunnel syndrome manifests in the forearm and first three fingers of the hand. It’s often accompanied by a numbness or tingling sensation and can make your hand feel weak.

Bicep/Tricep Tendonitis

A sudden, sharp pain in the elbow or upper arm shortly after heavy lifting is a telltale sign of a tendon injury. Bicep/tricep tendonitis are very common injuries, especially for those who lift heavy weights or use their arms in repetitive movement. Even simple tasks like lifting a heavy piece of furniture can cause tendonitis if the weight is too much to bear.

Both bicep and tricep tendonitis feature symptoms of bruising in the affected arm, weakness in the shoulder or elbow, and reduced arm mobility. You may even notice a “popeye muscle” appear in the upper arm in front of your bicep.

Thoracic Outlet Syndrome

The thoracic outlet is a narrow space that lies between the base of your neck and the front of your shoulder. Nerves, arteries, and blood vessels travel through this space to reach the arms. In the same way that the carpal tunnel can compress the median nerve in the wrist, the thoracic outlet can compress this vital passageway and cause the nerves to become entrapped at the base of the neck.

There are a variety of symptoms associated with thoracic outlet syndrome, but one of the most noticeable signs is pain that radiates down the shoulder and into the arm, often accompanied by a tingling or numbing sensation.

Referred Pain

In some cases, pain in the arm could be caused by another injury in the chest, shoulder, or other part of the body. Arm pain can even be an early warning sign of a heart or nervous system issue.

Symptoms of one condition can often mimic the symptoms of another, often leading to confusion when trying to understand your injury. It’s important to seek the help of a professional to ensure your condition is accurately diagnosed.

Exercises for Arm Pain

The best treatment for these injuries is prevention. Keeping your arms strong and flexible can help reduce the impact of daily stress and promote faster recovery when injuries do appear.

Building forearm and upper arm strength can help give your joints more support during activity. Stretching the muscles in your forearms, biceps, and triceps can help keep your arms mobile and tension-free. Watch the video below for more stretches and exercises to help reduce pain.

*Disclaimer: Always consult with your doctor before starting any exercise program. If you experience any numbness, tingling or reproduction of your symptoms, please contact your doctor.

Fast Arm Pain Relief with Airrosti

Because of its utility in everyday life, our arms are constantly in motion. When arm pain strikes, it can inhibit our mobility and alter the way we navigate the world.

If chronic arm pain is holding you back from doing the things you love, don’t wait. Schedule an appointment with Airrosti today. Our providers will conduct a thorough evaluation to help pinpoint the cause of your pain and develop a custom treatment plan to resolve pain fast. We also share resources and tools you can use to help speed up recovery, strengthen your muscles, and help avoid future injuries.

We offer both in-office and telehealth appointments to best suit your needs. Give us a call at (800) 404-6050 to schedule your appointment today.


Read our medical disclaimer here.

Reduce Arm Pain After COVID-19 Vaccination: 5 Easy Exercises

Posted on: March 31, 2021

By: Meridith Dunford PT, MSPT, OCS, Cert. DN.

While COVID-19 vaccination is a vital step for the public right now, the arm soreness after this vaccination is a side effect that is not so pleasant.  It usually only lasts for a day or two. The pain in your arm is the immune system’s response to the vaccine, and that reaction includes inflammation.

Inflammation involves redness, soreness and swelling.  This occurs at the site of the injection which is done into the middle deltoid muscle of your arm.  One way to reduce this reaction is to move your arm around to keep the vaccine and its reaction from being concentrated in one location. 

Studies looking at muscle activation with EMG have shown that the best way to get your deltoid muscle moving to reduce soreness includes these 5 simple exercises listed below. So easy, you can do them in the privacy of your own home!

  1. Lateral deltoid raises 
  2. Standing shoulder external rotation in 90 degrees abduction
  3. Standing shoulder external rotation with the arm at side
  4. Overhead press
  5. Horizontal abduction with external rotation

Lateral Deltoid Raises

Stand or sit with your palms facing down and raise your arms up with elbows straight working out to shoulder level.

Standing Shoulder External Rotation in 90 Degrees Abduction

Standing with your arms out at shoulder level and elbows bent, rotate your hands up toward your head while keeping your elbows out at shoulder level.

Standing Shoulder External Rotation with Arm at Side

Keep your elbow at your side with your thumb up and elbow bent so your forearm is parallel to the floor, rotate the hand away from the stomach maintaining the forearm position and elbow in.

Overhead Press

Start with your hands in front of your chest and elbows bent.  Press your arms up overhead straightening the elbows.

Horizontal Abduction with External Rotation

Hold your arms up at shoulder height with thumbs pointing outward (palms up) and reach your arms out beside your body then return to the middle.

Repetition throughout the day is important so try to pick a few of the motions that work for you and perform up to 20 reps as often as every hour for the first day to help disperse the vaccine and reduce local muscle soreness. Doing them into the next day is also suggested if soreness extends into the next day. You can stop when the soreness has ceased.

If you or a loved one have contracted COVID-19 and are experiencing symptoms that won’t go away, visit our outpatient COVID-19 Therapy Treatment page to learn how Sheltering Arms can help you fully recover from COVID-19. For more serious cases, please visit our inpatient COVID-19 Rehabilitation hospital website.

Arm pain: causes, symptoms and treatment

Updated: January 2020

Pain in the arms is very common — the term “arm pain” can refer to many things, including pain in the shoulders, elbows, or wrists. However, most of the time, when we talk about arm pain, we mean the part of the arm between the elbow and the shoulder. Arm pain can have various causes (it can come from muscles, joints or tendons, for example), which will determine how the pain should be treated. This is why it’s important to talk to a doctor if you have persistent arm pain.

Causes of arm pain

Arm pain most commonly occurs after an injury or fall, but it can also have various other causes. The pain could come from the arm itself or could just as likely indicate a problem somewhere other than the arm.

If the pain does come from the arm itself, it may be caused by simple muscle or tendon fatigue, overexertion, or repeated and prolonged use of the arms (for example, at work or when exercising). It could also be due to tendinitis, bruising from an impact injury, a sprain or a fracture. Bone tumours can also cause arm pain, as can conditions such as arthritis that affect the joints.

The cause of the pain may also be somewhere other than the arm itself. For example, a painful arm could also be a sign of a slipped disc, a spinal cord tumour, or osteoarthritis in the spine. Arm pain can also be radiated pain from the heart or lungs. In particular, a pain in the left arm can be a sign of a heart attack or angina. For this reason, it is important to take any sudden pain in the left arm very seriously, and consult a doctor without delay.

Symptoms of arm pain

Arm pain can manifest itself in a number of ways:

  • A short, sharp pain that occurs during a specific movement
  • A radiating or shooting pain
  • An intense pain resulting from injury
  • Pain accompanied by swelling or a change in the shape of your arm
  • Pain that worsens when you use your arm
  • A feeling like an electric shock or burning, or pins and needles that do not get worse when you move your arm
  • A pain that comes on suddenly on exertion, spreads down the left arm and does not ease off when resting (in which case it could be a heart attack — consult a medical expert immediately)

In all cases, if these symptoms are accompanied by faintness, breathlessness, and shoulder, chest or jaw pain, call emergency services and ask for an ambulance. You should also call for an ambulance if you heard a snapping sound and the pain is severe and/or your movement is very restricted.

Diagnosing arm pain

Arm pain should be treated according to its cause. However, given the many possible causes, your doctor will first have to work out whether the pain is linked to the arm itself, or whether it is a symptom of another problem elsewhere in your body.

Most of the time, the doctor will start with a clinical examination, but other information about you such as your job, activities and previous injuries, in addition to the location of the pain and the symptoms associated with it, can help the doctor to make a diagnosis. The doctor may send you for a scan in order to confirm the diagnosis, and if they think that the pain is coming from somewhere other than the arm, some more advanced tests may be needed.

Advice and solutions: treating and relieving arm pain

Once the doctor has made a diagnosis, they can start treating your arm pain. If the pain is due to a fall or strain injury, and fractures have been ruled out, your doctor will prescribe rest for your arm, and possibly pain killers. If the pain is caused by tendinitis, the doctor will prescribe rest for your arm along with anti-inflammatory drugs and physiotherapy. If any bones have been fractured or displaced, your arm will need to be immobilised and placed in a cast, probably followed by a course of physiotherapy. If your pain is due to a heart problem, you will need to be admitted to hospital as an emergency.

Drug-free, clinically validated pain reliever: TENS technology

There are also other solutions for reducing certain types of arm pain, drug-free. This is where OMRON’s range of pain relievers come in: they use Transcutaneous Electrical Nerve Stimulation (TENS) to help you to relieve your muscle and joint pain.

HV-F021-ESL

  • 15 Intensity Levels
  • 9 different massage modes
  • Drug-Free Pain Relief

See all TENS machines

Precautions to prevent and limit arm pain

There are also some precautions you can take in order to prevent or limit the pain in your everyday life. Many arm injuries and pains can be avoided by warming up and stretching before and after exertion, and if your work requires repetitive arm movements, taking frequent breaks will reduce your risk of injury. If you have severe pain from an injury, apply ice wrapped in a cloth or towel to the source of the pain for 10 to 15 minutes.


References:

PassportSanté (2015). Arm pain. Retrieved from https://www.passeportsante.net/fr/Maux/Symptomes/Fiche.aspx?doc=douleurs-bras-symptome

Right arm pain: symptoms, causes and treatment

Updated: February 2020

Arm pain is a common problem. Besides the fact that they are heavily used in everyday life, our arms are made up of muscles, joints and tendons, any of which can be a potential source of pain. However, arm pain can also come from elsewhere in the body, in which case it is a sign of a more serious underlying condition. If you experience pain in your right arm, it is likely to be caused by a problem with your bones, muscles, tendons, joints or nerves.

Symptoms of right arm pain

Right arm pain can manifest itself in a number of ways. You could have a short or stabbing pain, and the pain may be confined to a specific area or more widespread. It may come on or get worse during a specific movement, get worse at night-time or ease off with rest, or be the result of an injury, and your arm may also become swollen or misshapen. The pain may also be accompanied by a burning or electric shock sensation, or pins and needles.

Causes of right arm pain

Right arm pain can have a number of causes. It could be a musculoskeletal pain such as a sprain, pulled or strained muscle, bursitis or tendinitis (tennis elbow). This is often the case for right-handed people. The pain could also be due to an issue with your joints, such as osteoarthritis in your shoulder or elbow, or with your nerves (e.g. a pinched nerve in your neck due to neck osteoarthritis for example, or a pinched peripheral nerve). Other problems that may explain a pain in the right arm include bone tumours (which can cause stabbing pains that get worse at night-time), a slipped disc, or overuse of the arm (e. g. from playing a sport).

Treating right arm pain

If the pain in your right arm is benign, it can be alleviated with rest and painkillers. If you have tendinitis, your doctor will prescribe rest for your arm along with anti-inflammatory drugs and physiotherapy. If the pain is due to a nerve problem, treating this underlying cause will help to relieve the pain. Finally, if the cause of the pain is a fractured bone in your arm, you will need to have a plaster cast and follow this up with a course of physiotherapy.

There are also some solutions which offer drug-free relief from certain types of arm pain. This is a key feature of the OMRON HeatTens range of pain relievers — using a combination of soothing heat and Transcutaneous Electrical Nerve Stimulation(TENS), these devices can give you effective relief from joint and muscle pain.


References:

John, T. (2018). Causes of pain in the right arm. Retrieved from www.livestrong.com/article/223661-causes-of-pain-in-the-right-arm/

Quinene, P. (2018) Causes of arm pain between the wrist and elbow. Retrieved from www.livestrong.com/article/236340-causes-of-pain-in-the-arm-between-the-wrist-elbow/

PassportSanté (2015). Arm pain. Retrieved from www.passeportsante.net/fr/Maux/Symptomes/Fiche.aspx?doc=douleurs-bras-symptome

Marsaudon, X. (2014). Pain in the arm. Retrieved from www.docteurclic.com/symptome/douleur-du-bras.aspx

Presles, P. (2013). Pain in the arm. Retrieved from www.e-sante.fr/douleur-dans-bras/symptome-maladie/683

Arm Problems, Non-Injury | HealthLink BC

Do you have an arm problem?

This includes symptoms like pain, numbness, and trouble moving the arm normally.

How old are you?

Less than 5 years

Less than 5 years

5 years or older

5 years or older

Are you male or female?

Why do we ask this question?

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Have you injured the arm in the past month?

Yes

Arm injury in the past month

No

Arm injury in the past month

Have you had arm surgery in the past month?

If a cast, splint, or brace is causing the problem, follow the instructions you got about how to loosen it.

Yes

Arm surgery in the past month

No

Arm surgery in the past month

Do you have a neck injury or other neck problem?

Yes

Neck problem or injury

Has sudden, severe weakness or severe numbness affected the whole arm or the whole hand?

Weakness is being unable to use the arm or hand normally, no matter how hard you try. Pain or swelling may make it hard to move, but that is not the same as weakness.

Yes

Severe or sudden numbness or weakness in the whole arm or hand

No

Severe or sudden numbness or weakness in the whole arm or hand

When did it start?

Think about when you first noticed the weakness or numbness or when you first noticed a major change in the symptoms.

Less than 4 hours ago

Numbness or weakness began less than 4 hours ago

From 4 hours to 2 days (48 hours) ago

Numbness or weakness began from 4 to less than 48 hours ago

From 2 days to 2 weeks ago

Numbness or weakness began 2 days to 2 weeks ago

More than 2 weeks ago

Numbness or weakness began more than 2 weeks ago

Do you still have any weakness or numbness?

Weakness or numbness that does not go away may be more serious.

Yes

Numbness or weakness is now present

No

Numbness or weakness is now present

Has the weakness or numbness:

Gotten worse?

Numbness or weakness is getting worse

Stayed about the same (not better or worse)?

Numbness or weakness is unchanged

Gotten better?

Numbness or weakness is improving

Is the arm blue, very pale, or cold and different from the other arm?

If the arm is in a cast, splint, or brace, follow the instructions you got about how to loosen it.

Yes

Arm blue, very pale, or cold and different from other arm

No

Arm blue, very pale, or cold and different from other arm

Has the pain:

Gotten worse?

Pain is increasing

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is improving

Do you have any pain in your arm?

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

How long has the pain lasted?

Less than 2 full days (48 hours)

Pain less than 2 days

2 days to 2 weeks

Pain 2 days to 2 weeks

More than 2 weeks

Pain more than 2 weeks

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Do you think the problem may be causing a fever?

Some bone and joint problems can cause a fever.

Are there red streaks leading away from the area or pus draining from it?

Do you have diabetes, a weakened immune system, peripheral arterial disease, or any surgical hardware in the area?

“Hardware” includes things like artificial joints, plates or screws, catheters, and medicine pumps.

Yes

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

No

Diabetes, immune problems, peripheral arterial disease, or surgical hardware in affected area

Are you having trouble moving your arm?

Pain or swelling can limit movement.

Is it very hard to move or somewhat hard to move?

“Very hard” means you can’t move it at all in any direction without causing severe pain. “Somewhat hard” means you can move it at least a little, though you may have some pain when you do it.

Very hard

Very hard to move

Somewhat hard

Somewhat hard to move

How long have you had trouble moving the arm?

Less than 2 days

Difficulty moving arm for less than 2 days

2 days to 2 weeks

Difficulty moving arm for 2 days to 2 weeks

More than 2 weeks

Difficulty moving arm for more than 2 weeks

Has the loss of movement been:

Getting worse?

Difficulty moving is getting worse

Staying about the same (not better or worse)?

Difficulty moving is unchanged

Getting better?

Difficulty moving is improving

Has the arm problem lasted for more than 2 weeks?

Yes

Symptoms for more than 2 weeks

No

Symptoms for more than 2 weeks

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines and natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Symptoms of infection may include:

  • Increased pain, swelling, warmth, or redness in or around the area.
  • Red streaks leading from the area.
  • Pus draining from the area.
  • A fever.

Certain health conditions and medicines weaken the immune system’s ability to fight off infection and illness. Some examples in adults are:

  • Diseases such as diabetes, cancer, heart disease, and HIV/AIDS.
  • Long-term alcohol and drug problems.
  • Steroid medicines, which may be used to treat a variety of conditions.
  • Chemotherapy and radiation therapy for cancer.
  • Other medicines used to treat autoimmune disease.
  • Medicines taken after organ transplant.
  • Not having a spleen.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

  • Severe pain (8 to 10): The pain is so bad that the baby cannot sleep, cannot get comfortable, and cries constantly no matter what you do. The baby may kick, make fists, or grimace.
  • Moderate pain (5 to 7): The baby is very fussy, clings to you a lot, and may have trouble sleeping but responds when you try to comfort him or her.
  • Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds when you try to comfort him or her.

Pain in children 3 years and older

  • Severe pain (8 to 10): The pain is so bad that the child can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain. No one can tolerate severe pain for more than a few hours.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt the child’s normal activities and sleep, but the child can tolerate it for hours or days.
  • Mild pain (1 to 4): The child notices and may complain of the pain, but it is not bad enough to disrupt his or her sleep or activities.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Light-headedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you’re having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.

When an area turns blue, very pale, or cold, it can mean that there has been a sudden change in the blood supply to the area. This can be serious.

There are other reasons for colour and temperature changes. Bruises often look blue. A limb may turn blue or pale if you leave it in one position for too long, but its normal colour returns after you move it. What you are looking for is a change in how the area looks (it turns blue or pale) and feels (it becomes cold to the touch), and this change does not go away.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Post-Operative Problems

Neck Problems and Injuries

Arm Injuries

Ouch! Shoulder pain and how to treat it

Some shoulder conditions may become more common as you age.

 Image: © vitapix/Getty Images

You probably don’t think about your shoulders much, until you suddenly experience pain in one of them. Shoulder pain can make a simple act — brushing and drying your hair, reaching behind your back to fasten a bra, or grabbing something overhead — seem like a monumental task.

As you age, you’re more likely to experience shoulder pain from a variety of common conditions. “Shoulder problems are very common,” says Dr. Arun Ramappa, associate professor of orthopedic surgery at Harvard Medical School. The pain can come on gradually or abruptly, and it may range from mild to excruciating.

Below are some of the most common conditions you may encounter, and some tips for how to address them.

What to do if your shoulder hurts

If you do experience shoulder pain, it’s not always possible to figure out the cause. Sometimes problems in other parts of the body are actually the source of the pain, which then radiates to your shoulder. This can happen with certain neck problems, including arthritis and disc herniations, says Dr. Arun Ramappa, associate professor of orthopedic surgery at Harvard Medical School.

In general, if you are experiencing a lot of pain or know you injured yourself, it’s best to see a doctor right away to have your shoulder condition diagnosed.

But if you have general, mild shoulder pain, try adjusting your activities, taking nonsteroidal anti-inflammatory drugs, and performing mild stretches to see if the pain improves on its own. However, if the pain doesn’t go away after a few weeks, you should consult your doctor.

Rotator cuff injuries and irritations

Your rotator cuff is a group of muscles and tendons that help tether your shoulder into the socket and allow you to move it in a circular motion. Some two million people visit a doctor each year for rotator cuff–related issues, according to the American Academy of Orthopedic Surgery (AAOS). Most problems with the rotator cuff fall into two categories: tears or inflammation. Suspect a rotator cuff problem if you have pain or stiffness in your shoulder when you lift your arm above your head to brush your hair or when you reach behind your back. “You won’t be able to do a lot of things you want to do, such as put dishes in an upper cabinet, play tennis, or do garden pruning,” says Dr. Ramappa.

Rotator cuff impingement. A rotator cuff impingement happens when there is irritation, inflammation, or compression of the tendons or bursa (the fluid-filled sac that sits between bones) in the shoulder. An impingement can be caused by an injury, but it can also just result from general wear and tear from daily life.

Rotator cuff tears. A tear in the rotator cuff will produce pain that is similar to an impingement but has one additional differentiating feature. “If the pain is associated with weakness, it is likely caused by a tear, and if you just have pain, it may only be a rotator cuff impingement,” says Dr. Ramappa.

A tear can be partial, whereby only part of the tendon is ripped away from the bone it is attached to. Or there can be a full tear, causing the tendon to completely separate from the bone. “Although younger people can have rotator cuff tears, they become more common as people age, possibly because the interface between the tendon and the bone weakens and becomes more susceptible to injury,” says Dr. Ramappa. “The prevalence rises with each decade of life.”

Compared with impingement, a tear is more likely to be caused by an injury. Common causes include falling on the ice, getting pulled by a dog on a leash, or tripping and landing on your shoulder. In other cases, problems crop up seemingly without cause. “You might suddenly notice pain when lifting something over your head,” says Ramappa.

If you suspect a tear or are experiencing sudden pain from an injury, see a doctor right away, because you may need surgery to fix the problem. But if you aren’t experiencing weakness and the pain is not severe, rest and anti-inflammatory medications may be enough to ease your discomfort.

Calcific tendinitis. Pain from calcific tendinitis comes from calcium deposits embedded within the rotator cuff tendons. While it’s unclear exactly what causes these deposits to form, some experts believe they may result from a healing process in the ligament gone awry. The condition causes sudden, severe pain that often starts in the morning. It’s more common in middle-aged and older adults and those who have diabetes.

Treatment is aimed at relieving pain and preserving range of motion of the shoulder. Options include anti-inflammatory medications, corticosteroid injections, and physical therapy. If the pain is severe or persistent, your doctor may suggest surgery to remove the deposits.

Adhesive capsulitis. Commonly referred to as frozen shoulder, adhesive capsulitis is caused by a thickening and stiffening of the tissues around the shoulder joint. It’s typically develops in people ages 40 to 60. Frozen shoulder is more common in women than in men and in people with certain medical conditions, such as diabetes, high cholesterol, or thyroid disorders.

Frozen shoulder can occur after a rotator cuff impingement, a tendon tear, or even minor injury. But why some people go on to develop a frozen shoulder is not clear, says Dr. Ramappa. Someone with shoulder pain may hesitate to move the arm as a result of those problems, which then leads to additional pain and stiffness. As a result, it may become virtually impossible to move the shoulder for weeks or months. The problem often goes away after a period of time — but that can take up to three years, according to the AAOS. Physical therapy is sometimes recommended for frozen shoulder, but this can be quite painful in some cases, says Dr. Ramappa. Other interventions include nonsteroidal anti-inflammatory drugs, corticosteroid injections, or, in some cases, surgery. “But in most cases, it responds well to nonoperative treatment,” he says.

Osteoarthritis. When people think of osteoarthritis, they may think of the knee and the hip, which are common sites for arthritis pain. But while osteoarthritis affects the shoulder less often, it’s not uncommon, says Dr. Ramappa. The condition develops when cartilage cushions between the bones in the shoulder erode, causing the bones to rub against one another. There are numerous treatments for osteoarthritis, including rest, modifications to activities, anti-inflammatory drugs, corticosteroid injections, and surgery in some cases, says Dr. Ramappa.

While you may be tempted to stop moving when you experience pain from osteoarthritis, doing so can actually make the problem worse because it allows the muscles to stiffen and shorten. This may ultimately make it even harder for you to move the way you want to.

Performing simple stretches two to three days a week (see “Simple shoulder stretch exercises”) can help keep your muscles flexible and reduce pain, provided your doctor approves.

Simple shoulder stretch exercises

Seated shoulder stretch

Primarily stretches the shoulder

Reps: 2–4Hold: 10–30 seconds

Starting position: Sit up straight on a chair. Put your left hand on your right shoulder. Cup your left elbow with your right hand.

Movement: Roll your shoulders down and back, then gently pull your left elbow across your chest as you extend your left arm. Feel the stretch in your left shoulder. Hold. Return to the starting position, then repeat on the opposite side. This is one rep.

Seated triceps stretch

Primarily stretches the back of the upper arm and the shoulder

Reps: 2–4Hold: 10–30 seconds

Starting position: Sit up straight. Place your right hand on your right shoulder. Clasp your right elbow with your left hand.

Movement: Keeping your shoulders down and back, lift your right elbow up toward the ceiling to the point of tightness. Feel the stretch in the back of your upper right arm and shoulder. Hold. Return to the starting position. Repeat on the other side. This is one rep.

Seated chest stretch

Primarily stretches the chest and shoulders

Reps: 2–4Hold: 10–30 seconds

Starting position: Sit up straight facing sideways in a chair without arms.

Movement: Roll your shoulders down and back. Clasp your hands behind you, intertwining your fingers so your palms face you. Gently lift your hands toward the ceiling to the point of tightness. Feel the stretch in the front of your shoulders and across your chest. Hold. Slowly return to the starting position.

Exercise photos by Michael Carroll

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Shoulder Tendinitis | Sierra Pacific Orthopedics

Shoulder Tendinitis, Bursitis, and Impingement

Shoulder pain is a common occurrence for athletes and people in general. A sudden traumatic injury to the shoulder, such as a fracture or dislocation, requires immediate medical attention. The athlete should contact his physician or go to the emergency room as soon as possible. Shoulder dislocations commonly occur in football, basketball, and snowboarding. Overuse or wear-and-tear injuries, instability problems, strains, and sprains are common in throwing and overhead sports such as baseball, volleyball, basketball, water polo, and swimming. Shoulder tendinitis, bursitis, and impingement are among the most common overuse injuries of the shoulder. The pain is usually felt at the tip of the shoulder and down the upper arm. The pain occurs when the arm is lifted overhead or twisted. As the shoulder inflammation becomes more severe, the pain will be present all the time, and it may even wake the athlete from a deep sleep.

Anatomy

The shoulder is a closely fitted joint. The humerus (upper arm bone), certain muscle tendons, and associated bursa (fluid-filled sacs that cushion bone to prevent friction), move back and forth through a very tight archway of bone and ligament called the coracoacromial arch. When the arm is raised, the archway becomes smaller, pinches the tendons, and can cause inflammation of the tissues. Pinching or impingement of the rotator cuff tendons can lead to tendinitis. If there is prolonged impingement, the rotator cuff tendon cuff can actually tear. Shoulder bursa can become inflamed and painful as surrounding muscles move over them, causing bursitis. Symptoms of shoulder tendonitis and bursitis, such as pain, swelling, stiffness, and weakness can last for a few days, recur, or become chronic.

Contributing Factors

  • Overuse. This is the result of repetitive overhead motions is the most common cause of shoulder tendinitis, bursitis, and impingement.
  • Weak muscles. When the muscles are weak, more force is exerted on the tendons and bursa, causing inflammation and pain.
  • Improper or inappropriate swimming or throwing techniques.
  • Strenuous training. One hard throw, overhead serve, or swim stroke may start the problem.
  • Previous injuries to the shoulder.
  • Loose shoulder joint. In the teens and early twenties, the most common shoulder injuries are due to joint instability. An unstable shoulder can be the result of how the joint developed or from a strong force that caused the shoulder to dislocate or sublux. A shoulder subluxation injury results in a milder amount of instability where the ball slips partially out of its socket.
  • Calcium deposits.
  • Impingement. The shape of the bones that form the archway of the shoulder or degenerative changes of these bones (bone spurs), which are the result of wear-and-tear, can cause narrowing and pinching of the rotator cuff tendons.

Treatment

  • Rest. Avoid activities that make the shoulder pain worse and caused the pain in the first place. The opposite shoulder and all other joints can still be exercised.
  • Ice. Ice (e.g., a bag of ice) can be applied to the shoulder for 20 – 30 minutes, 3 – 4 times per day initially and then 2 times per day. Apply ice for 15 minutes after any activity involving the shoulder to minimize additional inflammation caused by the activity. Ice massage is a very effective form of ice application.
  • Exercises. Stretching exercises of the shoulder and arm are essential to help improve muscle tendon flexibility and strength. These exercises help reverse the muscle weakness which results from the inflammation and enable the tendons to resume the usual demands and workloads of the sport (see section on Exercises).
  • Physical Therapy. This may be necessary to help reduce the shoulder inflammation. The physical therapist may use such modalities as ultrasound, phonophoresis, iontophoresis, friction massage, electrogalvanic stimulation, and soft tissue mobilization to treat scar tissue in the tendons caused by the chronic inflammation.
  • Medication. An oral anti-inflammatory may be prescribed or recommended. A shoulder injection of cortisone and a local anesthetic may be advised. The injection can help relieve the pain and tenderness and make physical therapy more effective. After an injection, the athlete should avoid return to sports for one to two weeks. A successful injection can often spare the need for surgery. Repeated injections should be avoided.
  • Surgery. Sometimes surgery is required to treat this condition. If shoulder impingement cannot be relieved and if bone spurs and calcium deposits are a likely cause, then surgery may be necessary to correct these problems. In most cases, arthroscopic surgery of the shoulder will be performed, requiring a limited number of small incisions and done as a same-day surgery. Certain injuries, such as complete tears of the rotator cuff, often require surgical reconstruction.

Diagnosing Shoulder Problems

In the majority of cases, the sports medicine physician can diagnose a shoulder injury with a thorough medical history and a comprehensive physical exam. There are more than 50 shoulder exam tests that the physician can perform, each one providing specific clues about the nature of the shoulder injury. The physician may order additional tests, such as X-rays, MRI scan, and arthrogram, to provide him with more information and assist him in the diagnosis. Time is an important component in the diagnosis and treatment of shoulder problems. Some shoulder injuries take a long time to heal, sometimes weeks to months. The diagnosis of “little league shoulder,” which is a stress reaction in the growth plate of the shoulder joint similar to a fracture, requires that the child stop throwing until the area heals completely.

Returning to Sports

Warming Up. The athlete should move all major joints through their complete range of motion several times before starting play. Stretching and strengthening exercises help prevent injury.

Playing the Game. When resuming the sport of choice, play at a lower intensity. In tennis, plan to rally for a short period of time and avoid difficult, problem shots. Play for a lesser amount of time or play doubles. Resume competitive play once the shoulder is healed.

Throwing Sports. Initially, an underhand or sidearm throw will be easier than an overhand throw. Warm up well. Throw easily and gradually increase to harder throwing. Start with the short-toss drill and gradually lengthen the throw. If there is no pain in the shoulder with the short toss, then begin the long-toss drill. Try to maintain a smooth throwing motion. When throwing, the athlete should rely more on his overall body strength, which will relieve some of the workload on his shoulder. Taking pitching lessons from a local pro can help with technique, form, and eliminate flaws.

Swimming. The breaststroke or side stroke will be easier to do initially than the front crawl, freestyle, or butterfly strokes. Sometimes the backstroke causes less pain. The athlete should do swim sprints early in his workout before he is fatigued. Consulting a swim coach may be necessary to help make changes in the stroke, swimming or diving style, thus improving performance and preventing future shoulder problems.

Exercises

Range of motion (ROM) exercises must be done twice daily to keep the joints mobile. These exercises consist of moving the joint carefully, as far as it can go in all directions. After the pain has subsided, shoulder muscles must be strengthened to prevent tendinitis, bursitis, and impingement from recurring. Do each prescribed exercise two times a day or more often if necessary.

Range-of-Motion Exercises

Start with the “pendulum swing.” Support yourself with your healthy arm as shown. Keeping your knees slightly bent, bend forward at the waist and let your injured arm hang down (or dangle from the bed). Then make circles with your arm, first in a clockwise, then in a counter-clockwise direction. Start with small circles and gradually make them larger. Add the criss-cross ROM exercise by moving your arm in a vertical direction, then in a horizontal direction. Repeat each exercise 50 times, and do 2 times/day.

With palm out, place the hand of your injured arm behind your back and reach up as high as possible as though you were going to scratch your back with your thumb. Repeat 15 times, 2 times/day.

The back portion of the shoulder joint can be stretched out in this position by gently pulling your arm across your body as shown. Repeat 15 times, 2 times/day.

Standing with arms close to your body and elbows bent to 90 degrees, hands pointing straight ahead, slowly move arms so that hands point out to the side. Lower your arms to your sides, then raise the injured arm overhead as shown, helping with your other hand. Repeat 15 times, 2 times/day.

Strengthening Exercises

Exercises With Weights or Resistance. These exercises can be done with cans of food, three- and five- pound dumbbell weights, or stretchable tubing or cord, available from medical-supply and sporting-goods stores. See examples of hand weights, wrist weights, and TheraBand tubing and bands in the Sports Med Store. Avoid raising arms above shoulder level. Biceps and triceps exercises may also be done with weights.

With elbows straight, thumbs turned toward floor, and arms about 30 degrees forward, slowly raise arms to just below shoulder level. Slowly lower arms to starting position and repeat.

Lie on your side as shown with injured shoulder up, holding elbow close against ribs. Slowly raise weight until it points to ceiling. Then lower to starting position. Repeat 10 times, 2 times/day.

Stretching. Behind your back, hold one end of a towel with your good arm at shoulder level, as shown. Hold the other end with injured arm. Raise towel with good arm as high as you can without pain. Hold five seconds, slowly lower, relax, and repeat. Repeat 15 times, 2 times/day.

I cannot give medical advice about how to treat a specific injury without evaluating the athlete first. While I may discuss general exercises to prevent and treat sports injuries, not all exercises are designed for all individuals or problems. A sports medicine physician should be consulted before starting any exercise program. If an athlete is experiencing any severe pain or discomfort, he should see such a physician and obtain a specific diagnosis and treatment plan. The exercises outlined here are general recommendations and are not intended as a substitute for professional medical advice.

Specialty Reference
Shoulder Center

90,000 How to relieve joint pain: a winning option for the pharmacy and the patient

Aching joint pain torments many, especially in the off-season. “Ohi”, “ahi”, “sighs” – what you just won’t hear from summer residents, athletes and those who decided to walk to work out of habit in good weather. The reason for these exclamations is a “cry for help” from the joints. Therefore, it is not surprising that with the arrival of heat, the owners of “diseased” joints begin to look into pharmacies with the hope of purchasing something to get rid of the exhausting pain.A pharmacist should remember that joint pain is just the tip of the iceberg. To achieve long-term results, it is necessary not only to relieve pain and “numb” inflammation, but also to protect the cartilage tissue, which is the “buffer” between the joints. Elena Gordienko, head of pharmacy No. 15 of the LEKFARM LLC pharmacy chain, spoke about how to achieve this.

Chondroprotector of legendary German quality SUSTAMAR reached Ukrainian pharmacies. “SUSTAMAR is a new generation chondroprotector from Germany.The highly concentrated extract of martinia fragrant in its composition (480 mg in 1 tablet) provides a triple effect: reducing the severity of pain and inflammation, as well as protecting the cells of the cartilage tissue. With prolonged use, SUSTAMAR inhibits the destruction of cartilage and the progression of the disease, allowing an increase in the range of motion of the joints, ”said E. Gordienko. That is, with the help of SUSTAMAR, patients who have been tormented by joint pain for a long time can kill 3 birds with one stone: relieve pain and relieve inflammation, as well as slow down the progression of arthritis / arthrosis.

Despite the fact that SUSTAMAR appeared relatively recently at the disposal of Ukrainian specialists, European colleagues have already appreciated its effectiveness and safety. This is confirmed by many years of experience in the use of preparations from martinia extract in Germany. The huge baggage of accumulated data obtained in more than 50 scientific works and studies conducted in Europe is an additional argument for the recommendation of SUSTAMAR. “The extract of martinia has demonstrated its effectiveness in the treatment of inflammatory (arthritis, tendinitis, tendovaginitis) and degenerative-dystrophic (gonarthrosis, coxarthrosis, spondyloarthrosis, osteochondrosis) joint lesions,” E.Gordienko, stressing that SUSTAMAR can help in the treatment of joint diseases in both relatively young and elderly people, in whom the disease has already “gone far” – developed polyarthritis or deforming osteoarthritis. In other words, the drug gives hope to patients who have long lost faith in the ability to be active without looking at joint problems.

Taking SUSTAMAR will help reduce the drug load on the body for those who cannot do without non-steroidal anti-inflammatory drugs (NSAIDs).“The use of SUSTAMAR in complex therapy reduces the need for NSAIDs,” said the head of the pharmacy. Many people know the reverse side of the medal of taking NSAIDs – stomach and kidney problems. What can we say about the burden on the wallet for patients. Therefore, the possibility of rejecting NSAIDs for joint pain is a real gift for patients. SUSTAMAR is able to provide just such a result: according to studies conducted, in 60% of cases, the drug helps to stop taking NSAIDs.Moreover, the safety of such therapy deserves special attention, since SUSTAMAR is created on a plant basis. This is an extremely important aspect in long-term treatment. “SUSTAMAR is also of interest for prophylactic purposes – as a chondroprotector to prevent joint damage during intense physical exertion,” added E. Gordienko.

SUSTAMAR on the pharmacy shelf: double benefit!

“Our pharmacy is actively working with SUSTAMAR. Pharmacists widely recommend the drug both in complex and in monotherapy to older people with complaints of joint pain, inflammation and stiffness during movement, to young people – as a prophylactic agent to prevent future joint problems, ” E.Gordienko. – Due to its impeccable reputation, SUSTAMAR has its “fans”. According to patients’ reviews, after undergoing treatment with SUSTAMAR, the severity of many unpleasant symptoms and manifestations of joint diseases disappears or significantly decreases. There are also regular customers of SUSTAMAR who have found a “remedy” in the preparation during the period of impending exacerbation of joint problems in spring or autumn, ”said the head of the pharmacy, noting that an additional plus is the convenience of using the drug – 1 tablet 2 times a day in a course of 4– 16 weeksIn especially advanced cases, it is possible to increase the dose. It is recommended to repeat courses twice a year – in autumn and spring, during the period of exacerbation of joint problems.

In view of the duration of taking SUSTAMAR, it is pleasant to emphasize its affordability. E. Gordienko notes that the price / quality ratio in relation to SUSTAMAR is fully justified. This provides a “sweet spot” for the pharmacy when working with SUSTAMAR. The patient receives an effective drug and the desired result, and the pharmacy receives profit from sales.“The location of SUSTAMAR on the shop window arouses the interest of buyers, and the qualified consultation of the chief executives contributes to the successful sales of SUSTAMAR,” E. Gordienko concluded.

By recommending SUSTAMAR, you can achieve your goals: take care of the patient’s health, ensuring a stable income and image of the pharmacy!

Press service of “Weekly APTEKA”

References are in edition

Tsikava Information for You:

90,000 common causes and treatments

Pain in the hands is one of the most common causes of people visiting a rheumatologist’s office.The hands are a very delicate mechanism, but at the same time it is able to withstand enormous loads. However, some diseases can practically immobilize the hands and cause severe pain in the joints of the hands.

Arthralgia – this is the scientific name for joint pain – does not just impair the quality of life. It deprives a person of the opportunity to work and perform basic everyday activities. There are a lot of diseases that can cause this symptom. Conventionally, the reasons for severe pain in the joints of the hands can be divided into two large groups – inflammatory and mechanical.Inflammatory pain in the hands is usually accompanied by stiffness in the affected joint and is relieved by movement. As a rule, there are other symptoms of inflammation – swelling or redness of the skin over the joint.

Mechanical causes – degenerative diseases or injuries – cause pain on movement. At rest, the patient feels noticeable relief. Usually, this pain in the joints of the hands is not accompanied by stiffness or numbness.

The most common causes of pain in the joints of the hands

Pain in the joints is a frequent companion of many diseases.Sometimes it is the nature of the pain that helps the doctor determine which disease the patient is suffering from.

Rheumatoid arthritis

This is an autoimmune disease in which the body’s defense system fails and begins to perceive its own cells as foreign. As a result, the joint begins to gradually collapse, causing inflammation and severe pain in the affected area. Rheumatoid arthritis can manifest itself both in the elderly and at a young age – 25-30 years. It usually develops symmetrically – that is, the same joints on both hands are affected.Over time, the joints become deformed, resulting in curvature of the fingers and loss of mobility.

Gout

The accumulation of crystals of uric acid and its derivatives in the joints can lead to gout, which is also called “meat-eating disease”, as it often develops in those who eat too much meat. Gout causes very severe excruciating pain in the joints of the legs, but as the disease progresses, the hands also begin to suffer. Characteristic gouty bumps form around the affected joints.Burning throbbing pain with gout, as a rule, is especially strong at night, and by morning it subsides somewhat.

Osteoarthritis

Osteoarthritis occurs as a result of wear of the articular cartilage. Typically, this disease begins to develop in old age. With osteoarthritis of the joints of the hands, pain is noted in the small joints of the hands, the metacarpal-carpal joint of the thumb, in the elbow and shoulder joints. Symptoms of osteoarthritis in the wrist joint include pain during physical exertion, painful sensitivity to pressure in the area of ​​the injured joint, and limited mobility.

Arthritis

Arthritis, which is caused by infectious diseases that cause joint inflammation, is very common. There are two forms of arthritis:

  • acute arthritis – characterized by severe soreness, swelling, redness of the skin in the joint area and fever;
  • chronic arthritis – reminds of itself with painful sensations only from time to time.
Injuries

Fractures, dislocations and sprains are always accompanied by excruciating pain.Depending on the nature of the injury, the pain syndrome can be more or less pronounced. Usually, joint injuries are accompanied by swelling, redness of the skin, and limitation of joint mobility.

Treatment of pain in the joints of the hands

Severe pain in the joints of the hands is a big problem for the patient, who loses the ability to work normally and perform the most simple movements – for example, cannot fasten buttons or hold a fork.

Therapy, regardless of the cause, should be comprehensive, aimed at solving three problems at once – treatment of the underlying disease, restoration of hand functions and pain relief.

Of course, treatment depends on the nature of the disease. But pain relief and functional development of the hand during rehabilitation are subject to general rules.

The main remedy for relieving pain in the joints of the hands is medication. The largest and most commonly used group of drugs that have a pronounced analgesic effect are non-steroidal anti-inflammatory drugs. They relieve inflammation and pain, but have many unpleasant side effects, in particular from the gastrointestinal tract.

Glucocorticosteroid hormones are used to relieve pain caused by autoimmune diseases (eg rheumatoid arthritis). They have powerful anti-inflammatory effects and provide immediate relief.

Medicinal ointments, which include anti-inflammatory and anesthetic components, can also enhance the effect of drugs.

As part of complex therapy – or in cases where medication is contraindicated – the doctor may prescribe non-drug methods.

Non-surgical relief from pain in the hands

Pain in the joints of the hands is a symptom that accompanies many diseases, which are different both in terms of their occurrence and in the mechanism of development. Each disease has its own methods of therapy. With a correct diagnosis and adequate treatment, the pain gradually fades away. However, sometimes the healing process is delayed, the pain becomes chronic, and then the doctor’s task is not only to cure the patient, but also to relieve him of pain, as well as to prescribe a course of rehabilitation therapy.

To quickly relieve pain in the joints of the hands, a complex treatment is required, in which some methods complement others.

This approach has been perfected in the rehabilitation center. In the treatment of such diseases, the rehabilitation center uses the principles of Pain Management, which in English means “pain management”. The center’s specialists not only help to relieve pain syndrome, but also teach patients new behavioral models that allow them to relieve unnecessary stress from a sore arm.In addition, psychotherapeutic methods are used in pain management.

As a rule, the clinic employs doctors of various profiles – rehabilitation therapists, rheumatologists, neurologists and physiotherapists, as well as nutritionists, massage therapists and medical gymnastics specialists. The combination of medicinal and physiotherapeutic methods of treatment, supplemented by measures to restore mobility in the injured limbs, gives a quick and lasting effect. The patient not only gets rid of the underlying disease, but also gets the opportunity to return to normal life as soon as possible.

* License of the Ministry of Health of the Moscow Region No. LO-50-01-011140, issued by LLC RC Three Sisters on August 02, 2019.

Do not succumb to arthritis! How to help joints at home

Rheumatologists advise not to become hostages of your body, but to help yourself with the help of the means that are always at hand.

Until some time, arthritis was considered a disease of the elderly. Today the disease is rapidly growing younger, and people in their thirties can become its victims.The causes of joint pain are different – from physical exertion to disruption of hormones in the body.

Arthritis symptoms

Each movement gives a person discomfort, he feels pain, which intensifies. The disease can also manifest itself with a crunch in the joints, redness and swelling in the lesions.

First of all, the wrists, knees, shins and feet are affected. Both legs or arms can become inflamed at once. Then the pain goes to the shoulders or knees.Pain and stiffness appear in the morning, although the pain gradually disappears during the day. Subsequently, a person loses his appetite, his body temperature may periodically rise, general weakness, edema, and restriction of movements appear.

How to reduce pain

If you are overweight, try to get rid of it to reduce tension and pain in your spine and joints.

Take warm baths to soothe the pain.The water temperature should not exceed 37 degrees, that is, the water should be the same as you bathed your little children. Take a bath with pine extract or essential oils, turpentine works well. Even in the last century, the famous doctor Zalmanov practiced similar treatment. The duration of such a bath should not exceed 15 minutes.

Even if the movement hurts you, rheumatologists advise you to do exercises for joint mobility so as not to freeze completely.Your movements should be smooth, stress-free and in no way painful.

Do some simple exercises after waking up

1. Lying on the bed, slowly turn your head to the right and left, slightly straining your neck muscles at the extreme points of movement. Repeat 3-5 times.

2. Raise your arms slowly, then place them behind your head. Do all this while inhaling, lower your arms slowly as you exhale.Repeat 3-5 times.

3. Slowly squeezing your hands, bend your toes to a state of slight tension. Hold them in this position for a few seconds. Repeat the exercise 3-5 times.

4. Bend your knees slowly alternately, the heels should slide along the bed. Repeat 3-5 times.

Traditional medicine advises

Compresses warm, relieve swelling and pain.Take 100 g of dry mustard powder, 200 g of sea salt and a small amount of melted paraffin wax. Mix. This mixture is enough for 3 treatments. Place the mixture on sore joints. Cover the top with foil and wrap it with a shawl.

With swelling and pain, golden mustache ointment helps well. Scroll the grass in a meat grinder, squeeze in gauze. Mix the herb juice with any baby cream. Use daily, lubricating joints morning and evening.

Relieves swelling, pain, improves the condition of the joint, restores its mobility with a fresh cabbage leaf.Remember the sheet before the cracks appear. On the inside, apply a thin layer of honey. Apply to the affected joint and wrap a piece of cloth over it. Leave it overnight.

Lingonberry tea has an anti-inflammatory effect. Boil the herb and drink it for a long time. This broth removes excess fluid from the body, normalizes metabolism. Balances the amount of uric acid in blood and plasma.

Earlier, “Kubanskie Novosti” told how a decorative flower helps to heal the liver and strengthen the walls of blood vessels.

CAUSES OF PAIN IN THE SHOULDER AND ELBOW JOINTS

Dislocations of the shoulder area: The most common cause is injury: sports injury, fall, car accident. Like any dislocation, shoulder dislocation is also very painful, and if a person himself cannot return the shoulder to the anatomically correct position, you need to seek help from an orthopedic traumatologist.

Dislocations resulting from trauma are usually accompanied by more extensive injuries – tears or fractures.They require separate treatment. Young people under 30 have an 80% chance of re-dislocation after a shoulder dislocation. Therefore, young people are advised to undergo surgery to restore the anatomical balance in the joint in order to prevent re-dislocation. In the case of repeated dislocations, not only the ligaments of the joint are damaged, but also the bone. As a result, arthrosis may develop.

Lateral epicondylitis or tennis elbow – inflammation of the outer part of the elbow where muscle tendons attach to the outgrowth of the bone.These muscles connect the hand to the humerus. Muscle work provides hand movement. Tennis elbow is the most common elbow problem caused by specific tension, overload, or injury. Tennis elbow manifests itself as swelling and pain in the outer edge of the elbow that is aggravated by movement of the hand, for example, shaking the hand causes pain. One of the most common causes of epicondylitis is computer work.

To treat tennis elbow it is necessary to relieve the elbow joint.It is recommended to take anti-inflammatory drugs, and after consultation with an orthopedic traumatologist, attend physiotherapy classes. In some cases, if the problem cannot be eliminated in this way, surgical intervention is used to restore or release the affected tendon.

During the operation, the focus of inflammation is eliminated (by resection), the approximate location of which is determined even before the operation using ultrasonography. In the postoperative period for a long time (up to 8 weeks), it is necessary to provide a gentle regimen for the elbow.Working at the computer also needs to be limited.

Lateral epicondylitis or tennis elbow – inflammation of the inside of the elbow where muscle tendons attach to the outgrowth of the bone. The golfer’s elbow is the result of repeated flexion movements of the hand, resulting in overstraining of the flexor muscles of the hand and fingers, as well as excessive stress on the tendon attachments of these muscles, leading to inflammation, swelling and pain in the elbow joint.

To treat a golfer’s elbow, it is necessary to relieve the elbow joint.It is recommended to take anti-inflammatory drugs, and after consultation with an orthopedic traumatologist, attend physiotherapy classes. In some cases, if the problem cannot be eliminated in this way, surgical intervention is used to restore or release the affected tendons.

During the operation, the focus of inflammation is eliminated (by resection), the approximate location of which is determined even before the operation using ultrasonography. In the postoperative period for a long time (up to 8 weeks), it is necessary to provide a gentle regimen for the elbow.Working at the computer also needs to be limited.

“Frozen” shoulder in medicine is an unclear, but quite common disease affecting the shoulder joint. The disease can start suddenly, with shoulder pain that progresses to restrict movement. Frozen shoulder causes scar tissue to form in the capsule of the shoulder joint.

The cause of the disease has not yet been discovered in the world, but its course has been studied. The disease can last up to three years.When it is possible to relieve pain with the help of drug therapy, the patient, after consulting an orthopedic traumatologist, is advised to go to physiotherapy in order to restore movement in the joint. In cases where medical and physical therapy does not work, surgical treatment is recommended to free the joint from scar tissue, which restores the range of motion and eliminates the cause of the pain.

Rotator cuff tears. The four muscles of the shoulder joint that hold the humerus at the shoulder joint and provide movement are called the rotator cuff.These four muscles attach to the scapula, and their tendons attach to the greater tubercle of the humerus. Rupture of these tendons can occur as a result of trauma as well as wear and tear due to aging processes. If the tendons are damaged, the pain is usually more pronounced at night and is felt in a specific place – in the arm above the elbow, where the deltoid muscle attaches to the humerus (upper third of the shoulder). If the tears in the tendons are small, the limitation of movement is not pronounced, and only movements performed with a very large amplitude can be difficult.

If the rotator cuff is inflamed, the problem is treated with anti-inflammatory medications, physical therapy, and hormonal steroid injections. If such treatment does not give effective results, surgical intervention is used – the damaged areas are sutured, eliminating pain and restoring the range of motion.
Rotator cuff tears are treated surgically. Anti-inflammatory therapy in the event of a rupture is used only to relieve symptoms (pain and inflammation).

If the damage to the rotator cuff is left untreated, it is likely that over time the problem will need to be addressed with shoulder arthroplasty.

Shoulder recoil syndrome. Regular full-range shoulder overload during swimming, playing baseball or tennis, micro-injury or normal wear and tear of the joint with aging are the most common causes of shoulder kickback syndrome. At the initial stage, there is a slight pain in the shoulder, which a person can feel both at rest and during movement, pain radiates from the shoulder down the arm, sudden, sharp pain when lifting or grabbing objects.With the progression of the syndrome, pain appears at night, weakness and limitation of movements, it is difficult to make movements with your hands behind your back – for example, to open the zipper on a dress.

To treat recoil syndrome of the shoulder joint, it is necessary to relieve the joint. It is recommended to take anti-inflammatory drugs and, after consulting an orthopedic traumatologist, study and regularly do a set of physiotherapy exercises. In some cases, if it is not possible to solve the problem in this way, surgical intervention is used.

Elbow Knockback Syndrome often occurs after trauma or repeated microtrauma, such as in athletes. The patient experiences limited movement in one or more directions (unable to straighten or bend) or in both directions (unable to provide full range of motion).

To treat elbow kickback syndrome, relieve the joint. It is recommended to take anti-inflammatory drugs and, after consulting an orthopedic traumatologist, study and regularly do a set of physiotherapy exercises.In some cases, if it is not possible to solve the problem in this way, surgical intervention is used.

In the postoperative period, on the first day after the operation, a course of physiotherapy begins to restore the full range of motion of the joint.

“Mouse” of the elbow joint. As a result of injury or joint disease, a fragment of cartilage or bone enters the joint capsule. It usually causes a feeling of blockage and sharp pain when moving. The “mouse” of the elbow joint is treated surgically.During the operation, a fragment (articular mouse) is taken out freely “floating” in the joint.

Bursitis of the shoulder joint – inflammation that occurs in the mucous membrane of the shoulder joint. Signs of inflammation include pain, swelling, limitation of movement, and pain on movement. Inflammation causes overstrain of the shoulder joint, repeated microtrauma or isolated trauma to the shoulder joint, and calcific tendonitis, which causes lime crystals to settle in the rotator cuff tendon, forming a cavity or cavities and causing inflammation of the tissues surrounding the tendon.

Bursitis of the elbow – inflammation that occurs in the mucous bag of the elbow joint. The inflammation usually causes pain, swelling, and in rare cases, restriction of movement. The cause of bursitis can be trauma, infection, arthritis, as well as prolonged pressure on one or both elbows, for example, in representatives of specific professions – tinsmiths or installers of refrigeration / heating installations, who have to do part of the work leaning on their elbows.

Elbow arthritis is an inflammatory process in the joint, manifested by pain and limitation of movement.One of the most common types of arthritis affecting the elbow joint is rheumatoid arthritis. Arthritis can also be caused by physical work, which regularly causes strain on the elbow joints and injuries.

Non-surgical treatment for arthritis involves relieving stress on the affected joint, taking pain medications, steroid injections, and physical therapy. If such treatment fails to reduce pain, severe movement restrictions in the elbow joint are observed, surgical treatment is required.

Emergency surgical treatment is necessary in case of purulent arthritis (arthritis caused by an infection – a microbe). For example, diabetes mellitus and regular use of steroids (usually in people with autoimmune diseases) can contribute to infectious arthritis. Adequate surgical treatment of the joint performed in a timely manner increases the likelihood of a positive result.

Arthrosis of the shoulder joint. As a result of injuries, diseases, as well as the natural aging process, the shoulder joint is gradually damaged in humans.The cartilage is damaged, which in the joint protects the surfaces of the two bones from direct contact and friction. When the cartilage wears out, the direct contact and friction of the bones results in inflammation in the joint, pain, and as a result, limitation of movement.

Osteoarthritis is an irreversible process, but it can be limited or slowed down. For effective treatment of arthrosis, anti-inflammatory and analgesic drugs are used, as well as physical therapy – procedures whose purpose is to activate blood circulation around the damaged bone.After consulting an orthopedic traumatologist, it is recommended to study a set of physiotherapeutic exercises, the regular implementation of which allows you to maintain or even improve the existing range of motion of the diseased joint.

If this treatment fails to relieve pain and there is severe limitation of movement in the shoulder joint, surgery is required.

90,000 Elbow Pain Treatment: Why Does Elbow Sore?

  1. The structure of the elbow joint: Anatomy and function of the elbow
  2. What to do in case of acute pain in the elbow?
  3. Diagnosis of Elbow Pain
  4. Elbow pain after the accident:
    Dislocation, rupture of the biceps tendon, bone fracture, nerve contusion
  5. Joint overload and wear: Tendon sheath
    epicondylitis, bursitis, arthrosis, osteochondritis dissecans
  6. Systemic Diseases of the Body:
    Gout, Rheumatism, Osteoporosis
  7. Elbow Pain Treatment: Frequently Asked Questions

Elbow joint: Structure and function

In the complex structure of the elbow joint, three bones are connected.The humerus (Humerus) connects to the ulna and radius of the forearm. Often, the protruding process of the ulna (Olecranon) is called the elbow. The flexible joint of three bones, surrounded by one joint capsule, is called the elbow joint. © Viewmedica

The elbow joint is involved in every movement of the hand: grasping, throwing, supporting, hitting and lifting weights are not possible without a healthy elbow. Therefore, pain in the elbow limits the patient’s daily life and performance and does not give him the opportunity to play sports as before.The elbow joint is not simple in structure: At the same time, the elbow joint moves “up” and “down”, like a hinge. It can also rotate around its own axis. From this it follows that the elbow is constantly involved in all coordinated movements of the arm. The elbow joint is formed by three bones: the humerus (Humerus) and two bones of the forearm – the ulna (Latin ulna) and the radius (Latin radius). What can happen in this complex joint?

Schematic drawing of the elbow: The elbow joint is formed by three bones.Both bones of the forearm – ulna and radius – are connected to each other by an interosseous membrane, which is a soft hinge. The place of attachment of the tendons of the muscles of the shoulder (biceps and triceps) is located on the ulna of the forearm. The muscles of the forearm, which are responsible for the mobility of the hand and fingers, are also connected to the heads of the ulna and radius through tendons. As in the case of other joints, the condition of the cartilaginous surface is of great importance for painless mobility in the elbow. The elbow joint is surrounded by an articular capsule, the mucous membrane of which produces synovial fluid to improve cartilage nutrition.Thanks to the synovial bags (bursa) filled with joint fluid, numerous muscles, tendons and ligaments in the elbow remain mobile in relation to each other. © By OpenStax College [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

How is acute elbow pain treated?

As a rule, the patient himself knows the cause of his elbow pain. Elbow pain is often caused by falls, bruises, or excessive exercise such as tennis, golf, or badminton.

If you feel pain in the elbow, but the elbow is still mobile and has not had time to swell or become inflamed, the treatment can be carried out at home.

Almost always in this situation, pain is treated with anti-inflammatory drugs (Ibuprofen or Diclofenac), which are sold as tablets or sports ointment. Treating elbow pain with this method helps to reduce the swelling of the inflamed tissue and suppresses the pain syndrome. Despite this, the specialists of the Gelenk Klinik Medical Center in St.Freiburg in Germany does not recommend resuming training, participating in competitions, or going to work under the influence of painkillers. Try not to overload your elbow until the swelling is gone and you can move your arm freely.

A special bandage helps to keep an overtightened and overloaded elbow joint at rest.

If the pain in the elbow does not go away after three days, you need to see a doctor who will prescribe the correct treatment.

When is an urgent need to see a doctor?

Elbow pains often do not pose a particular health hazard to the patient.After every fall or bruise, it is not necessary to immediately see a doctor and prescribe treatment. Immobilization, resting the joint, and a cooling compress can help relieve elbow pain in a short time.

In case of what kind of pain in the elbow is it necessary to consult a doctor immediately?

  • Pain in the elbow that continues despite immobility and rest.
  • If ​​your elbow hurts, swells, and reddens with every movement or touch.
  • If, in addition to a severely reddened and swollen joint and pain in the elbow, you have a high fever.
  • If ​​the outer shape of the elbow is disrupted and the bone protrudes, contact the emergency room.
  • If, in addition to pain in the elbow, you cannot stretch or bend your arm.

How is the elbow examination performed?

What questions does the doctor ask a patient?

At the beginning of the examination, before prescribing treatment, the doctor asks the patient certain questions.In order to establish the true cause of elbow pain and prescribe targeted treatment, an orthopedic specialist will ask you questions about the situation after which you felt pain. Information about the patient’s age and health characteristics also helps the doctor determine which treatment for elbow pain is appropriate for him.

Are there common diseases?

Is your work activity associated with a particular workload? Are you fond of sports? Are there any loads repetitively?

Do you feel severe pain in your elbow and how does it develop?

Was there a specific injury with a fall or bruise?

Elbow Pain Treatment: Clinical Examination

During the examination, a specialist in our clinic will thoroughly examine the elbow for pain sensitivity to pressure, swelling, bruising, redness and overheating.

Elbow mobility testing reveals the presence of specific mobility limitations and blockages.

Laboratory data and blood test

If there are signs of bacterial inflammation or autoimmune diseases (rheumatism), a laboratory test is performed. If inflammation of the joint is suspected, a little fluid is withdrawn from the joint capsule using a special needle. If your doctor thinks you have gout or rheumatism, a blood test is done.

Treatment of Elbow Pain: Imaging Examination

Suspected damage to the structure of the elbow joint (articular surfaces, bones, tendons and ligaments) requires imaging.

Ultrasound of the shoulder shows or refutes the presence of a tendon or ligament rupture in the elbow. In addition, ultrasound examination provides information about the state of soft tissues in motion, which is possible exclusively with the help of this technique.

If there is a suspicion that bones or articular surfaces are damaged or broken, an X-ray is indispensable.

If you need a more detailed picture of tendon injuries and fluid deposits in the bones, magnetic resonance imaging (MRI) is advisable.

Elbow pain due to injuries, falls and accidents

Traumatic injuries

Traumatic injuries such as a bruise or a blow are often the cause of elbow pain. At first, such cases lead to stabbing pain in the elbow, which quickly disappears if rest is observed.

Hyperextension (overextension) or hyperextension of the elbow joint often leads to severe pain in the elbow.In the most extreme case, there is a dislocation of the elbow, after which it is impossible to bend and stretch the arm.

Overstretching and injury can cause tendon rupture. One of the most serious injuries is the rupture of the biceps muscle of the forearm at its base under the elbow.

Injury to the ligaments leads to instability of the elbow joint.

Traumatic injuries that entail a pearl of bones in the elbow are fraught with consequences. Our specialists in Freiburg successfully treat elbow fractures.

Medial image of tendons, ligaments and joint capsule that are damaged after elbow dislocation. Rupture of the lateral ligament of the elbow is especially common. Treatment of this pathology is carried out with the help of immobilization of the elbow joint with a plaster cast or orthosis. © bilderzwerg @ fotolia

Dislocation of the elbow

Symptoms of traumatic dislocation in the elbow

  • Stitching pain in the elbow
  • Restricted flexion
  • Absence of supination in the elbow (backward and outward rotation in the elbow joint)

Dislocation of the elbow is quite common as a consequence of falling on often.If a person tries to prevent it with an outstretched arm, then this can lead to overstretching of the elbow joint. In addition, dislocation of the elbow entails a complete displacement of the shoulder and forearm relative to each other, after which the position of the articular surfaces is disrupted. Sometimes dislocations of bones are accompanied by compression of blood vessels or nerves, as a result of which the entire arm below the elbow joint becomes pale and begins to grow numb. The victim cannot bend and straighten his arm.

If a person has a dislocated elbow, concomitant injuries may also occur, for which, even after the dislocation has been successfully repositioned, additional pain treatment is required.Also, with a dislocated shoulder joint, strong ligaments can be deformed, which contribute to stabilization in the elbow. The above additional injuries include:

As a result, the elbow joint loses its stability. It is worth noting that damage to nerve structures can cause sensory disturbances and weakness in the arm. In 80% of cases, elbow dislocation is a soft tissue injury affecting the tendons, ligaments and periarticular bursa. Sometimes the dislocation is accompanied by bone fractures of the shoulder joint….

What helps with elbow dislocation?

First of all, the shoulder and elbow must be adjusted – that is, placed in the original position. Only then can the treatment be started, namely the use of a plaster cast and later an orthosis. We draw your attention to the fact that the elbow joint should be bent at an angle of 90 ° and in no case should it be in an extended position. Treating the joint with remedial gymnastics to promote elbow mobilization can prevent the joint from hardening.

Elbow tendon rupture: Biceps tendon rupture

Symptoms of distal biceps tendon rupture

  • Audible cracking sound with tendon rupture
  • Biceps tendon rupture after strength training and lifting of the lower muscles
  • biceps

  • brachii) in the shoulder
  • Subcutaneous hemorrhage at the elbow
  • Limited flexion of the forearm
  • Restriction in the movement of the radius around the ulnar outward
  • Pain symptoms are not in the foreground

Often, tendon rupture in the elbow occurs when lifting heavy objects as a result of which a crackling sound is heard in the area of ​​the elbow bend.After that, the biceps lose their strength. A rupture of the distal tendon of the biceps brachii (biceps) is its partial or complete separation from the attachment point on the radius. This injury does not cause severe pain in the elbow, but limits the strength and coordination of the forearm. This injury is mainly typical for men who work in hard physical work or professional athletes. At the beginning, a hematoma is visible at the site of the rupture of the biceps tendon in the upper part of the forearm.

During a clinical examination, the elbow therapist may determine that the biceps are no longer palpable.Partial or distal tears should be diagnosed with MRI.

Biceps tendon rupture treatment

There is only one method to restore muscle strength and normal hand motility after a ruptured biceps tendon – surgical treatment. During the operation, the orthopedic surgeon reattaches the tendon in the forearm, thereby restoring the previous functions of the arm. Autogenous tendon transplantation is sometimes done. Since the loss of muscle mass due to rupture of the biceps tendon occurs at an accelerated rate, doctors at the Gelenk Clinic in Freiburg, Germany recommend starting treatment as soon as possible, even if the injury is not very painful.

Elbow Tendon Rupture: Elbow Lateral Ligament Rupture

Symptoms of a rupture of the lateral ligament of the elbow

  • Hemorrhage
  • Stitching pains in the elbow with exertion
  • Swelling
  • Pain when pressing on the elbow
  • Instability of the elbow

Rupture of the elbow collateral collateral ligament appears as elbow pain in the elbow. After such damage, the stability of the elbow joint immediately decreases.Often, a rupture of the medial (internal) lateral ligament of the elbow joint accompanies a dislocation of the elbow joint, which must be repaired immediately. In most cases, rupture of the ligaments leads to subcutaneous hemorrhage (hematoma).

With the help of X-ray, as well as MRI, the condition of the bones and ligaments is clarified in more detail. X-rays show injuries and bone fractures, while magnetic resonance imaging provides more accurate images of soft tissue and ligaments. In addition, MRI is the best method for visualizing partial collateral ligament ruptures of the ulna.

Treatment of collateral ligament rupture

Immediately after injury, the elbow should be cooled and elevated and then kept at rest. An elbow brace will help reduce swelling in your elbow.

If the diagnostic examination did not confirm the presence of the above pathology, the doctors of our clinic recommend keeping the injured elbow in a supporting bandage that completely immobilizes the elbow joint for four to six weeks. During this time, the ligaments can recover and regain their previous strength.

Surgical treatment of ruptured ligaments is sometimes necessary. Basically, surgeons perform minimally invasive (arthroscopic) treatment. If conservative treatment does not bring the desired result, the doctor may place an artificial ligament. Compared to the immobilization technique, this treatment speeds up the patient’s recovery process. This fact is very important for athletes and people involved in physical professional activities.

Stitching pains in the elbow and numbness of the arm due to damage to the ulnar nerve

Symptoms of an injury or pinching of the ulnar nerve

  • Feeling of numbness in the fingers
  • Stitching pains in the elbow
  • Pain associated with certain movements of the elbow
  • Weakness when grasping objects
  • Sensory impairment in the hand

Many nerves and tendons pass at the site of the narrowing of the elbow joint.These structures can be damaged by injuries to the elbow, which lead to dislocation or rupture of the ligaments. The ulnar nerve runs along the outside of the forearm, supplying the muscles of the fingers. Weakness when grasping objects, as well as disturbances in sensitivity in the hand, are the result of neuropathy of the ulnar nerve. Even with a simple blow to the elbow, the deformity of the ulnar nerve can cause stabbing pains and numbness in the arm.

Treatment of ulnar nerve neuropathy

Treatment of elbow pain that occurs after damage to the ulnar nerve is carried out using non-steroidal anti-inflammatory drugs NSAIDs.To restore the ulnar nerve, doctors recommend wearing fixation orthoses or applying a special splint at night.

In some cases, surgical decompression may be required to relieve pressure in the cubital tunnel, which is located on the inner side of the elbow joint. In this case, the ulnar nerve – the nerve of the peripheral nervous system – has a good chance of recovery.

Fracture of the radial head in the elbow

Symptoms

  • Stitching pain in the elbow
  • Impaired extension of the arms
  • Difficulty in flexing the arm
  • Limitation of forearm rotation
  • Swelling of the joint
  • Pain on pressure

Fall or falling with outstretched arms often leads to fractures of the ulna.At the same time, almost always there is a displacement of the ulna and radius in relation to the humerus. So, as a result of these injuries, some structures in the elbow are disrupted and a fracture of the radial head is formed, namely, a fracture of the upper end of the radius. This pathology refers to intra-articular and manifests itself as swelling and pain on the outer surface of the elbow joint. In some cases, a radial fracture is also observed, which is characterized by complete destruction of the radial head.

In case of fractures in the elbow joint, stabbing pains in the elbow immediately appear, as a result of which the elbow does not bend or unbend to the end.

About 20% of elbow dislocation results in bone damage and pain in the elbow.

Patients with osteoporosis are diagnosed with an elbow fracture more often than other patients. This is due to a decrease in the stability of the elbow joint during injuries and falls due to demineralization.

Diagnosis of fractures in the elbow is carried out on the basis of clinical indications using X-ray.MRI, in turn, helps to identify soft tissue abnormalities.

Treatment of an elbow joint fracture

In medicine, there is a wide range of methods for treating fractures in the elbow. Most often, the most effective treatment is with joint immobilization for 4-6 weeks. Complex fractures require fixation of bone fragments with special plates and screws. Sometimes, the treatment of fractures with an external fixation device is most appropriate. In the most difficult cases, doctors offer the patient another treatment, namely shoulder arthroplasty.

Anatomically, the muscles of the forearm are divided into flexor flexors. The round processes of the humerus are the place where the tendon attaches to the bone. Chronic overload or one-way movements can cause inflammation (yellow circle) and degeneration of enthesis – the junction of a ligament or tendon with a bone. Diseases of enthesis in medicine are called enthesopathy. Epicondylitis is an inflammatory and degenerative tissue lesion in the elbow, in which the pathological process touches the bone, periosteum, as well as the tendons attached to the epicondyle and the tendon sheath.© bilderzwerg @ fotolia

Elbow pain due to wear and tear and chronic overload

Elbow wear

Most often, patients begin to feel pain in the elbow after overload or excessive tension in the arm. The consequences of overvoltage are painful pathologies of muscles and tendons.

Epicondylitis: Chronic, stabbing pains of enthesis – joints of a ligament or tendon to bone

Symptoms of epicondylitis

  • Stitching pain in the elbow
  • Lateral epicondylitis: “tennis elbow”
  • Medial epicondylitis: “golfer’s elbow”
  • Pain during hyperextension (hyperextension) of the arm
  • Pain with hyperextension of the forearm

Most resistant the bases are lateral (“tennis elbow”) and medial (“golfer’s elbow”) epicondylitis.In the first case, the disease affects the outer side of the elbow, and in the second, the inner side.

Ulnar epicondylitis is a chronic and painful inflammatory condition of the entheses of the muscles of the forearm, fixed on the bony protrusions of the humerus of the elbow joint. At the same time, the junction of the ligament or tendon with the bone may swell and redden. Each form of stress on the extensors of the forearm immediately causes severe stabbing pain in the elbow.

Joint pain can be caused by various diseases.Enthesiopathy – inflammation of the area of ​​attachment of tendons or ligaments to the bone, is just one of such extra-articular pathologies. The cause of the development of enthesiopathy is called overload, from which it follows that this problem appears in people who are professionally involved in sports or hard physical labor. Untimely treatment can lead to chronicity of the “tennis elbow”. At the final stage of the disease, weakening and then complete destruction of the enthesis of the tendon of the muscles of the forearm is observed.

Treatment of epicondylitis

Treatment of epicondylitis in the elbow with an EpiPoint fixation orthosis (Fig. Used with permission from Bauerfeind AO)

Conservative treatment of epicondylitis is almost always advisable. As a rule, treatment of this disease with non-steroidal anti-inflammatory drugs (NSAIDs) as tablets (Ibuprofen, Diclofenac) or sports ointment speeds up the healing process.

In this case, relieving stress from the joint, as well as stopping the inflammatory process at the junction of the ligament or tendon with the bone, play an important role.In 90% of cases, exercises to stretch the muscles of the forearm with an unloading effect make the treatment of pain in the elbow and “tennis elbow” more effective. Fixing bandages also help to speed up the treatment, which, by means of specific pressure on the enthesis of the extensors of the forearm, reduce the degree of load in the elbow and promote its regeneration.

In difficult cases, doctors at specialized clinics in Germany offer patients botox treatment to reduce the stress of enthesis.

Pain in the elbow as a result of inflammation of the mucous membrane (Bursitis olecranoni): Inflammation and throbbing pain

Symptoms of bursitis

  • Swelling and swelling in the area of ​​the injured joint
  • Overheating of the joints
  • Pain when pressing on the lower part of the ulna
  • pain when leaning on the elbow

  • Redness of the skin
  • Limitation of mobility in the elbow
  • General signs of inflammation (fatigue, lack of energy)

Due to the high mobility of the elbow joint, sliding surfaces (periarticular bursa or bursa) in the elbow are exposed to heavy loads.Most often, the mucous bag under the olecranon is affected, namely under the process of the ulna. During this pathology, swelling, severe pain in the elbow, and sensitivity to touch are noted. Patients suffering from bursitis complain of severe pain in the elbow and swelling of the injured joint. In addition, bursitis is characterized by changes in the shape of the joint, redness on the skin, and overheating.

Definition of Bursitis olecranoni in medicine is called “student’s elbow”: Prolonged pressure, traumatic injury or overload in the elbow are the causes of this condition.When a person rests his elbow on the table, throbbing pains pass along the arm. Another cause of bursitis can be a bacterial infection.

Treatment of elbow bursitis

The doctor decides how the elbow bursitis will be treated depending on the cause of the disease. With purulent, bacterial bursitis, the patient is offered surgical treatment of the periarticular bursa with the elimination of the infection.

In case of rupture of the synovial bag of the elbow joint, conservative treatment is offered.This method involves complete immobilization with elastic bandages. In difficult cases, a plaster cast is used. Non-steroidal anti-inflammatory drugs (NSAIDs) can help treat pain and swelling in your elbow. Only drug-resistant chronic nonbacterial bursitis may require surgical treatment. Even after removal, the bursa recovers on its own.

Arthrosis of the elbow joint: Swelling and pain in the elbow with every movement

Symptoms of arthrosis of the elbow joint

  • Pain in the elbow when starting to walk in the morning
  • Immobility of the joint during flexion and extension
  • Overheating and swelling
  • Pain in the elbow, depending on the degree of load
  • Deformations and deviations from the axis of the elbow joint
  • nerves: Weakness when grasping objects and numbness of the hand

Wear of the elbow joint (arthrosis of the elbow joint) is much less common than arthrosis of the larger joints of the lower extremities (arthrosis of the hip joint, arthrosis of the knee joint, arthrosis of the ankle joint).As a rule, patients suffering from arthrosis of the elbow joint have previous diseases, which were accompanied by overload in the joint. Often, arthrosis of the elbow joint occurs in athletes involved in strength sports, for example, bodybuilders.

Arthrosis of the elbow joint is a progressive loss of mobility in the elbow due to premature wear of the articular cartilage and the joint itself.

Despite the fact that this type of arthrosis is not observed in patients as often as others, the pain in the elbow is very severe, as in other cases.

Treatment of arthrosis of the elbow joint

First, treatment is carried out with non-steroidal anti-rheumatic drugs (NSAIDs), which help to reduce inflammation in the elbow.

M Joint-preserving surgical treatments such as arthroscopy of the elbow or endoprosthetics help restore joint mobility.

In difficult cases, a complete replacement of the elbow joint with an endoprosthesis is performed.

Limitations of mobility and pain in the elbow as a result of osteochondrosis dissecans (Articular mouse) after aseptic necrosis

Symptoms of osteochondrosis dissecans

  • Insufficient extension and flexion of the elbow
  • Under exertion: Shooting or dull pain in the elbow
  • Deafness rest
  • Wear of articular cartilage

Stitching pains and mobility problems in the elbow joint can be caused by the articular mouse: The medical name for this term is osteochondrosis dissecans.An articular mouse or osteochondrosis dissecans is a free articular body that has separated from the synovial membrane or articular cartilage after aseptic necrosis and moves freely in the cavity of the articular capsule. A loose body can assume an unfavorable position and thereby cause blockages in the joint, as well as damage the articular cartilage. At the last stage of osteochondrosis dissecans, diffuse pains appear, as well as other pains in the elbow that limit mobility.Depending on the position of the articular mouse, Osteochondrosis dissecans or osteochondrosis dissecans are characterized by certain limitations in flexion and extension of the arm.

Fall injuries can cause a bone fragment to come off. Repetitive microtrauma can also cause osteochondrosis dissecans. Therefore, this disease is often found in young baseball and tennis players. Necrotic changes in the bone structure from which separation occurs are often explained by the exertion of excessive stress on the joint.As a rule, this disease occurs in children from six to ten years old.

The examination of this ailment in our clinic in Freiburg is carried out using a multilayer X-ray. MRI and CT scan supplements the results of X-ray examination. Orthopedic specialists Gelenk Clinics in Germany draw the attention of patients to the difference between osteochondrosis dissecans and arthrosis of the elbow joint.

Treatment of osteochondrosis dissecans of the elbow joint

In the case of osteochondrosis dissecans in children, doctors do not always recommend surgical treatment.After immobilization, as well as a change in the degree of loading of the joint, the disease disappears, and the bone fragment will again take root in the bone.

Patients over 20 years old receive only surgical treatment. The surgeon can offer arthroscopic treatment or open surgery, during which the separated fragment is fixed or removed completely. What exactly the doctor will do depends on the size of the bone fragment. In any case, a very important step is to remove it from the joint space in order to avoid blockages and damage to the articular cartilage.

Inflammation of the tendon sheath of the elbow

Symptoms of inflammation of the tendon sheath

  • Severe pulling pains in the elbow
  • Pain when moving the elbow
  • Overheating, redness and swelling in the elbow
  • Crunching sound in the elbow (crepitus)
  • Thickening of the tendons (hygienic cone)
  • Inflammation of the tendon sheath is an irritation of the connective tissue membranes. As a rule, tendons unite muscles and bones, and also provide the transfer of muscle energy to the human skeleton.The connective tissue membranes preserve and nourish the tendons with synovial fluid (joint lubrication). In addition, they support the sliding ability of the tendons in the body. Excessive strength training, as well as a short recovery period for the tendons, can damage the tendon sheath structure. Another cause of tendovaginitis is the mechanical repetition of any movement or action. If disorders of tendon structures appear at the site of attachment of the tendon to the bone (enthesis), doctors begin treatment for enthesiopathy.If inflammation develops in the tendon tissue, the patient is diagnosed with tendovaginitis.

    Treatment of inflammation of the tendon sheath in the elbow

    Treatment of this pathology is carried out with the help of immobilization of the elbow joint. In order for the treatment of this inflammatory process to be effective, the specialists of our clinic in Germany offer their patients high-quality orthoses and splints. Anti-inflammatory sports creams or tablets (Ibuprofen, Diclofenac) help to reduce inflammation and swelling of the tendon sheath.If the patient feels severe pain in the elbow, doctors offer an infectious treatment. Using local anesthetics, doctors help the patient to get rid of the pain in the elbow. In addition, this disease is treated with cortisone. However, cortisone treatment should not be repeated very often, as this can cause tendon weakness. In drug-resistant cases, surgical treatment is advisable, namely surgical decompression of painful tendons, during which the surgeon removes the inflamed tendon sheaths.Such treatment does not pose a danger to the patient, since these structures are capable of being restored anew.

    Elbow Tunnel Syndrome and Elbow Pain

    Symptoms of tunnel syndrome in the elbow

    • Stitching pains at the site of attachment of the tendons to the bone
    • Numbness of the fingers
    • Weakness when grasping objects

    All nerves that coordinate the movements of the arms and hands from the spinal cord also pass through the elbow. Symptoms of the development of tunnel syndrome include signs of epicondylitis as well as cubital tunnel syndrome, but without traumatic injury.The ulnar nerve (Nervus ulnaris) runs on the surface of the ulna. Light squeezing or pinching of this nerve is characteristic of the above pathology. The cause of the cubital canal syndrome (Latin Sulcus ulnaris Syndrom) can be sudden bruises in the elbow. Repetitive movements of musicians or the monotonous activities of office workers can lead to prolonged narrowing of the nerves and inflammation of the nerve sheaths. Most often, this disease affects the employees of shopping centers at the checkout counters, musicians and people who spend most of their time in the office.Pain and numbness in the 4th and 5th fingers, as well as impaired mobility of the hand, are consequences of ulnar tunnel syndrome, see (“Elbow tunnel syndrome”).

    Diseases of the whole body – causes of pain in the elbow

    Metabolic disorders and autoimmune pathologies also cause shooting pains in the elbow.

    Gout: Stitching pains and exostosis (swelling, swelling) of the elbow joint

    Symptoms of gout in the elbow

    • Sharp, shooting pains
    • Pain when pressing on the elbow
    • Formation of exostosis on the bursa under the elbow
    • Redness and overheating in the elbow
    • Temperature, fatigue
    • Swelling

    Gout – chronic metabolic disorder uric acid, leading to inflammatory deposits of urate crystals in the body, manifests itself not only in the legs and toes, but also in the elbow as a stabbing pain.Patients with gout have irregular elbow pain. The degree of damage to the upper and lower extremities depends on the stage of the disease. This is due to the fact that with gout, patients do not feel pain immediately, but only with the development of the disease. In addition, gout in the elbow joint causes deposits of uric acid in the bursa of the olecranon (the process of the ulna), as a result of which the synovial bag changes its original shape, becomes inflamed and swollen. All this is the cause of the elbow bursitis.This pathology is characterized by redness and overheating in the elbow, as well as the formation of solid foreign bodies by urate crystals, which are felt during the examination. This education in medicine is called “gouty lump”.

    Treatment of gouty elbow pain

    Treatment of gout involves the use of medication and metabolic monitoring. Qualified specialists of Gelenk Clinic recommend nutritional correction: By consuming less meat and alcohol, you can get rid of gout faster.The better the level of uric acid in the body, the less frequent gout attacks.

    Rheumatic pains and arthritis of the elbow

    Symptoms of rheumatitis of the elbow

    • Swelling
    • Stitching and dull pain in the elbow
    • Pain in the elbow at rest
    • Stiffness in the elbow in the morning
    • Temperature, fatigue

    Elbows pain is less common than in other joints. For the inflammatory process, due to arthritis, swelling, overheating and pain when touching the elbow are characteristic.Rheumatoid elbow pains have many causes: They often appear as a result of the body’s inflammatory autoimmune reactions to its own tissues. It should be noted that rheumatism negatively affects not only the joint, but also the general condition of the patient. As a rule, a person is tired, sad and complains of fatigue. In addition, inflammation of the joint also affects the cartilaginous surfaces, which contributes to the destruction of the articular cartilage and the appearance of arthrosis.

    h4> Treatment of rheumatic inflammation in the elbow

    Treatment of rheumatitis or arthritis of the elbow joint is carried out with anti-inflammatory medications.Non-steroidal anti-inflammatory drugs (NSAIDs) help relieve unpleasant rheumatic elbow pain.

    Osteoporosis: Increased Threat of Elbow Fracture

    Symptoms of osteoporosis:

    • Stitching pain in the elbow
    • Fractures after light forceful actions
    • Decrease in bone density

    Osteoporosis is a pathological decrease in the density of bones in the human skeleton. At first, the disease is painless. The risk group includes women after menopause.Men develop osteoporosis at an older age. A characteristic feature of the disease is an increased threat of fractures of the femoral neck, vertebral bodies and elbow joint. Loads that, with the initial bone density, do not have negative effects on the body, can lead to serious fractures in osteoporosis. Osteoporosis also limits the healing of bone structures: The healing time of the ulna after an osteoporotic fracture is automatically extended. The treatment of displaced fractures with special screws and plates becomes more difficult as implants lose their stability due to weakening of the bone.

    Treatment of osteoporotic fractures in the elbow

    One of the most important tasks in the treatment of fractures in the elbow is the prevention of osteoporosis: Mobility, foods rich in vitamins and minerals support the process of bone mineralization. In addition, osteoporosis is treated with medications that slow down the destruction of bone tissue. The specialists of our clinic in Germany recommend regular preventive examinations, including the measurement of bone density (densitometry).This procedure helps to recognize osteopenia in time and prevent osteoporosis.

    Frequently Asked Questions About Elbow Pain

    I have elbow pains at night at rest. What does it mean?

    Pain in the elbow at night or at rest without previous accidents, bruises or trauma indicates an inflammatory process in the body. So, patients suffering from metabolic disorders feel pain in the elbow even at rest.

    Gout, as a violation of purine metabolism, leads to inflammatory deposits of uric acid crystals in the periarticular bag of the elbow joint.

    Rheumatic inflammation in the elbow also causes pain at night or when the elbow is at rest.

    Stitching dull pains in the elbow indicate aseptic osteonecrosis, which can cause osteochondrosis dissecans of the elbow joint.

    How does elbow pain appear after strength training?

    Patients who are professionally involved in sports or whose work activity is related to physical activity, feel pain in the elbow more often than others.

    In middle-aged people, after lifting weights or exercising the biceps, a distal rupture of the biceps tendon of the elbow joint is often observed.

    A characteristic feature of this injury is a loud crackling sound and subsequent subcutaneous hemorrhage. After a tendon rupture, patients usually do not complain of severe pain in the elbow.

    Strength exercises can negatively affect the condition of the articular surfaces and lead to wear and tear of the articular cartilage and arthrosis pain.

    Overstrain of tendons, especially inflammation of the tendon sheaths, can also be the result of training or hard physical work. After that, patients are often diagnosed with inflammation of the tendon sheath of the elbow joint (tendovaginitis). This disease is characterized by inflammation of the tissues that surround the tendons and produce synovial fluid, thereby providing nourishment and free sliding of the tendons in the body.

    Pain when leaning on the elbow

    If you feel stabbing pain when you lean your elbow on the table (“student’s elbow”), although you have never injured your elbow before, this may be due to inflammation of the bursa (bursitis) of the elbow joint.

    Also, pain during this elbow position can be caused by diseases such as gout or rheumatism.

    What do the outside elbow pains mean?

    Pain outside the elbow joint is often caused by such a pathology as “tennis elbow”: inflammation of the tendons of the forearm at the point of attachment to the bone on the external epicondyle (round bone process of the humerus). Therefore, such elbow pains are called “epicondylitis” or “tennis elbow”.

    Bilateral elbow pain

    Often bilateral elbow pain indicates a disease of the whole organism.Such pathologies include, for example, gout or rheumatism

    At the same time, arthrosis may appear in several joints. Polyarthrosis first affects the joints of the fingers, and then spreads to the elbow.

    Treatment of elbow pain at home

    After deformities of the elbow joint due to trauma, it is necessary to move the elbow as little as possible, keep it at rest and, if necessary, apply cooling compresses to the elbow.

    Treatment of inflammatory changes in the structure of the elbow at home, which cause bursitis (inflammation of the joint capsule), epicondylitis (tennis elbow, golfer’s elbow) or tendovaginitis (inflammation of the tendon sheath) is carried out by wrapping with special insulated bandages soaked in sea salt.Due to its rich composition, sea salt reduces inflammation and pain in the elbow, as well as eliminates swelling. The sea salt wrap should be done several times a week for at least 20-30 minutes. This will allow the salt to be absorbed into the area around the joint and the treatment will be more effective.

    Pain in the shoulder, arm and elbow

    If you feel pain in the elbow, this does not mean that the elbow joint is damaged. There are also pains that radiate from the shoulder joint to the elbow.

    A violation of the structure of the rotator cuff often causes pain in the elbow.

    Pathologies such as stenosis of the cervical spine or herniated disc can cause not only neck pain and shoulder pain, but also pain in the elbow.

    Monotonous, repetitive movements can lead to (ulnar tunnel syndrome). This pathology is characterized by pinched nerves in the shoulder area, which cause pain, radiating through the elbow to the wrist joint.

    Pain in the carpal tunnel of the wrist joint, radiating to the elbow and shoulder

    Carpal tunnel syndrome or carpal tunnel syndrome causes numbness, itching and gradual loss of strength in the fingers.Pain caused by narrowing of the nerves can radiate back to the elbow and shoulder joint.

    Treatment of pain associated with operations

    This patient guideline is based on the Estonian treatment guideline “Perioperative management of acute pain”, approved in 2016. Treatment guidelines were compiled from a literature review based on scientifically proven evidence. The aim of the patient guide is to help patients manage postoperative pain and to provide answers to questions related to acute pain.Knowledge of pain management options helps patients actively participate in treatment. The importance of the topics covered in the patient guide, as well as the accessibility of its text, were assessed by patients with acute postoperative pain. The patient guide explains the following topics: what is acute postoperative pain, why is it important to treat acute pain, and how to measure it. Different chapters describe options for treating acute postoperative pain. The reader will receive an answer to the following questions: why the use of oral drugs is preferred for the treatment of pain, whether different pain relievers can be taken together, and what else can be done in addition to drugs to relieve pain.It also provides guidance on how to manage postoperative pain at home. The topics covered in the patient guide can be read in more detail on the web pages at the end of the guide (see Appendix 1).

    • Tell your doctor what medications (including pain relievers) you have used before, if you are allergic to any medications and if you have any side effects. This information is very important when prescribing the right pain reliever for you.
    • If ​​you feel pain, tell the nurse right away. Report pain also when pain is mild or at night.
    • If ​​you have any side effects with any medication, tell your nurse or your doctor right away.
    • Rate your pain on a ten-point scale, because based on the information received, it will be possible to provide you with the medicine for pain that is right for you. Do not exceed the maximum allowable daily dose of pain relievers.
    • If ​​the pain relievers prescribed for you do not relieve your pain while treating at home, and the pain intensity on a ten-point scale and after taking pain relievers is still more than five, please contact your family doctor or your doctor.
    • For mild to moderate pain, use alternative pain relievers in addition to pain medication.
    • During the period after surgery, it is important to be active and move as much as possible, this will help the body recover and reduce the occurrence of complications.
    • If ​​pain interferes with movement, report it to the nurse.

    What is acute postoperative pain?

    Pain is a subjective and unpleasant sensation that affects consciousness and impairs well-being. Acute pain is short-term, it most often has a well-defined area, a certain time of onset, as well as subjective and objective physical signs: heart rate and breathing become more frequent and blood pressure rises.Severe pain interferes with sleep and creates feelings of fear and anxiety. Acute postoperative pain occurs due to a surgical procedure or surgery. The severity of pain depends both on the severity of the operation and the size of the surgical wound, and on the pain threshold of the person. People feel and react to pain in different ways. Pain can also be influenced by the patient’s early pain experience, age, gender, cultural background, and psychological factors. In the case of children, pain can also be influenced by their parents’ attitude towards pain.

    Why treat acute postoperative pain?

    Postoperative pain does not need to be tolerated, as pain may increase the incidence of postoperative complications: recovery from surgery will be slower and therefore may increase the length of hospital stay. If pain is not treated, chronic postoperative pain is more common. Effective treatment of postoperative pain relieves heart and lung function, reduces the risk of venous thrombosis, and helps normalize digestion.

    How is the intensity of pain assessed?

    Assessing the severity of pain after surgery is a routine part of patient follow-up work. Pain is assessed regularly, and the frequency of assessment depends on the patient’s condition and the severity of the surgery. Since the sensation of pain is individual and subjective, only you yourself will be able to assess the strength of the pain experienced. The nurse will assess your pain regularly, both before and after taking pain relievers, both during rest and while moving. Based on the information received, it will be possible to draw up a pain treatment scheme that suits you personally.

    Different pain scales are used to assess pain. For example, the scale for the numerical rating is used in adults. It is used to assess the severity of pain on a ten-point scale, where zero means there is no pain, and 10 means the most severe pain you can imagine. The patient is asked to rate pain experienced in the past 24 hours using three different methods.
    Rate:

    1. force of existing pain,
    2. the weakest feeling of pain and
    3. the most intense feeling of pain.

    The arithmetic mean of the scores received will show the strength of the patient’s feeling of pain during the last 24 hours. Sometimes you are asked to choose words that would describe your pain. These words can be:

    • no pain
    • minor pain
    • moderate pain
    • severe pain
    • very severe pain
    • unbearable pain

    Figure 1.

    Numeric Pain Scale Sometimes the face scale (FPS-R) is used to assess pain (see Figure 1).Figure 2) or the so-called face scale. This scale can be used, for example, in older children. The child will need to explain the face scale so that he can use it to assess his pain. The child will need to explain the scale as follows: “This face (point to the leftmost face) shows that there is no pain at all. Other faces (point to each face from left to right) show that the pain is getting worse and worse. The face on the far right shows that he is in great pain. ” After the explanation, the child can be asked which face shows how much it hurts now?

    According to the person chosen by the child, the assessor will be able to give the indicated pain a score of 0, 2, 4, 6, 8 or 10 points, counting from right to left: 0 = not painful at all.10 = very painful. You cannot use the words “sad” or “joyful” in your assessment. It is imperative to clarify that we are talking only about how the child feels, and not about the external expression of the face.


    Figure 2. Facial scale for assessing the severity of pain ( FPS-R )

    The above scales are used not only to assess pain in older children, but also for patients with mild to moderate mental disorder. For young children, infants and patients with severe mental disorders, a behavior scale is used, in which the nurse assesses the intensity of pain. Patient vital signs, such as heart rate, blood pressure, blood oxygen, and behavior (facial expression, anxiety, sleep), are taken into account for these pain severity scales.

    To achieve the best result in the treatment of pain immediately
    inform the nurse if you feel pain – even when the pain is mild or if it started at night.
    Do not endure pain!

    How to treat pain after surgery?

    In the treatment of postoperative pain, different drugs are used with different routes of administration.In addition, the use of alternative methods is allowed, which can be used in case of mild to moderate pain.

    In order to prescribe a suitable pain treatment, it is important to know which medications (including pain relievers) you have already used, if you are allergic to medications and if you have any side effects. When prescribing a medicine, modern principles from the medical field are taken into account regarding the operation performed to you and painkillers.

    The choice of a suitable pain reliever, the dose of medication and the duration of treatment depends on both the severity of the pain (mild, moderate or severe pain), the type of pain (whether there was, for example, wound pain or nervous pain), the person himself (elderly, child, pregnant and dr.), as well as from concomitant diseases.

    Take medication regularly (at regular intervals) to achieve the best effect of pain relievers. Pain relievers of different effects are often combined.

    Groups of painkillers

    As pain relievers, drugs are used, which are divided according to the type of mechanism of action into three main groups:

    1. Simple pain relievers. For example, paracetamol, ibuprofen, and diclofenac.
    2. Opioids. Medicines in this group are divided into weak opioids – for example, tramadol, codeine, and strong opioids – for example, morphine.
    3. Supportive medicines. They are used, for example, to treat nervous pain.

    Paracetamol

    Paracetamol is often the first choice for mild to moderate pain. Paracetamol differs from other pain relievers (for example, from ibuprofen and diclofenac) primarily in that it does not have an irritating effect on the mucous membrane of the digestive tract.Side effects are rare when taking paracetamol. The most severe possible side effect is liver damage, which is rare and occurs most often due to drug overdose. Paracetamol should be used with caution in liver and kidney failure, chronic malnutrition, or alcoholism. The child should be prescribed paracetamol according to his age and weight.

    If medications are additionally used (for example, the so-called teas for influenza), which include paracetamol in combination with an anesthetic, you need to ensure that the amount of paracetamol taken per day does not exceed the permitted daily dose (for adults, 4 grams per day).

    Nonsteroidal anti-inflammatory drugs or NSAIDs (ibuprofen, diclofenac, ketoprofen, dexketoprofen, naproxen, etc.)

    If the analgesic effect of paracetamol is too weak (an hour after taking paracetamol, the pain intensity is still more than five points), then in case of mild or moderate pain, for example, ibuprofen, ketoprofen, naproxen, diclofenac or other drugs from the same group should be taken according to the instructions for use the medicine listed on the medicine information sheet.

    These drugs have analgesic, antipyretic and anti-inflammatory effects, but their use is contraindicated in case of gastrointestinal ulcers. These medicines should be used with caution by patients who have cardiovascular diseases. The risk of side effects in the digestive tract is greater in older people and in those who take large amounts of NSAIDs. The occurrence of side effects in the digestive tract does not depend on the method of taking the medications – medicinal suppositories with NSAIDs and injectable forms of drugs are also not suitable for patients with ulcers in the digestive tract.The strength of the harmful effect on the digestive tract differs for different drugs of the NSAID group. Ibuprofen is believed to be the least harmful to the digestive tract.

    Depending on what concomitant diseases you have, some pain relievers belonging to this group may be more suitable for you than others, and this must be taken into account when prescribing treatment. For children, ibuprofen is most often used, it is prescribed according to the age and weight of the child.

    Opioids or narcotic pain relievers (codeine, tramadol, morphine, fentanyl, oxycodone, pethidine, etc.)

    In the case of severe pain, opioids are used in addition to the aforementioned groups of drugs. Common side effects of opioid use are nausea and vomiting. The nausea-inducing effect of opioids is weakened by long-term use. Constipation is another common side effect.

    Supportive medicines such as gabapentin, pregabalin.

    Supportive drugs are drugs that were not originally developed as pain relievers, but were later discovered to be useful in relieving certain types of pain. For example, gabapentin and pregabalin were originally used to treat epilepsy. These medications are often used to treat chronic nerve pain. They are also effective in treating postoperative pain, reducing pain and the need for other pain relievers.

    If you experience any side effects, notify your nurse or doctor right away!

    After surgery, pain relievers can be taken:

    • Oral
    • by injection into a vein or muscle
    • via epidural catheter
    • with medicated candle

    Oral pain relievers are preferred after surgery.Oral medication is as effective as injected medication without pain or injection-related complications such as hemorrhage, inflammation of the injection site. Oral pain relievers are suitable for all types of pain relief, but you must be able to eat and drink.

    Vein injection

    If you cannot take the pills by mouth because of the operation, the nurse will inject your medicine through a cannula into a vein.The pain relieving effect will come within a few minutes. Once you start eating and drinking, you can return to your pill medication again.

    After a major and painful operation, pain relievers can be taken using a special pain pump, with which you yourself can adjust the dose of the pain reliever (opioids) in the vein. This is called Patient Controlled Pain Relief or PCA (short for Patient Controlled Analgesia).

    For taking painkillers, use a special pump that will allow you to receive painkillers as soon as you feel the need. The doctor will calculate the appropriate dose of the medicine for you and enter it into the pump’s memory. If you feel pain, press the button and the pump will inject the appropriate amount of medication through the cannula into the vein. There is no danger of medication overdose as the pain pump is programmed according to your needs.

    The pump button must be pressed by yourself, you must not let anyone else do it.If the dose of the medication calculated for you is not sufficient and does not relieve pain, inform your nurse or doctor, who will adjust the dose of the medication given according to the severity of the pain. The PCA pump is also used for children if the child’s age allows it to be used and is able to understand how the pump works.


    Figure 3. PCA pump

    Muscle drug administration

    The administration of painkillers by injections is tried to be avoided, since, due to heterogeneous absorption, the effect of anesthesia may be less than the expected effect.In addition, the injection can be painful.

    Administration of medicine using medicinal suppositories

    Sometimes, if taking painkillers by mouth for some reason is not possible, medications can also be taken through the rectum. Medicated suppositories are often used to relieve pain in young children.

    Medication via epidural catheter

    Using local anesthesia, if necessary, the anesthesiologist will place a thin plastic tube (epidural catheter) in the epidural space surrounding the spinal canal before the operation.The epidural space is located in the spinal canal, where the roots of the nerves that transmit the feeling of pain pass. The medicine injected there affects the roots of the nerves and thus prevents the spread of the pain pulse. Therefore, the introduction of drugs into the epidural space is one of the most effective methods of pain relief.

    Opioids and local anesthetics – a mixture for local anesthesia – are continuously injected into the epidural catheter through an automatic syringe throughout the day. The analgesic effect begins no later than 20 minutes after the start of the medication.


    Figure 4. Inserting an epidural cutter

    Epidural pain relief can cause:

    • Nausea and vomiting – these are relieved by anti-nausea medication
    • Weakness and numbness of the legs – they go away on their own
    • Urinary Disorders – If necessary, a catheter is placed in the bladder
    • Decreased blood pressure – blood pressure monitored regularly
    • Head or back pain – tell your nurse or doctor.If a headache occurs after surgery while undergoing home treatment, contact your doctor immediately.

    Nerve plexus block

    Nerve plexus blocks are used most often for anesthetizing the extremities. Blockages are done both with a single injection and with the use of a catheter, which is installed next to the nerve plexus, and is needed for the constant administration of the drug (local anesthesia).Medicines are injected through the plexus catheter either with a single injection or with an automatic syringe.

    The effect of alternative pain treatment methods on postoperative pain is small, therefore you should not use such methods separately, but only in conjunction with pain relievers. Alternative methods reduce anxiety and feelings of tension throughout the hospital stay. Most methods, such as music therapy or distraction, are safe and can be used without special training or additional tools.If the pain is mild or moderate, then in addition to pain relievers, you can use the methods from the list below. For more information on the different methods, ask your ward nurse.

    Cold compress

    Cold leads to constriction of blood vessels and bleeding in the damaged area slows down. If you have no contraindications, you can use a cold compress to reduce swelling and pain in the operation area. As a cold compress, you can use special gel packs sold in pharmacies, any packaging from the freezer is also suitable.Wrap the cold bag in a towel and then place it on the damaged area and fix the compress if necessary. The towel will protect fabrics from possible local exposure to cold. Keep the cold compress in place for 20-30 minutes in a row, then pause for 10-15 minutes and repeat the procedure if necessary.

    Transcutaneous electrical nerve stimulation or TENS

    TENS, or transdermal electrical nerve stimulation, is a pain management method in which electrical impulses are used to relieve postoperative pain.

    Physiotherapy

    Physiotherapy is recommended to be added to the postoperative treatment regimen, as it reduces the risk of complications and facilitates the recovery of the body after surgery. Physiotherapy is performed by a specialist. He will explain to you why you need to start moving as quickly as possible after the operation, teach you how to take the most comfortable and relaxed posture after the operation, how to prop your body with pillows or the operating area with a bandage.In addition, he will teach you breathing techniques, as well as movement exercises.

    Music therapy

    Listening to music reduces anxiety, slightly reduces the severity of postoperative pain, and the stress response associated with pain is less common with music. Therefore, the need for opioids is also reduced.

    If you enjoy listening to music and it relaxes and calms you, then we recommend that you take your favorite music with you to the hospital with you.You just need to remember that your favorite music may not be liked by other patients, so we recommend that you use headphones when listening to music.

    Psychological Methods

    This includes various relaxation techniques, daily self-activity training, distraction, and positive visualization techniques.

    Using a variety of psychological methods throughout your hospital stay can help reduce feelings of tension and anxiety.With the help of them, you will more easily cope with the situation that has arisen. Both the severity of pain and the need for pain relievers will decrease to a small extent.

    For distraction, you can solve crosswords, put puzzles, play electronic games, etc. You can also use relaxation techniques to relax specific muscles or to reduce general feelings of anxiety and tension.

    In the case of children, it is also important to use different psychological techniques to reduce feelings of anxiety and pain, and to do this throughout the entire hospital stay.The child becomes more calm if he is already explained to him what awaits him before admission to the hospital.

    Play is an effective method of distracting attention for a child: both during the postoperative period and during procedures. Games in which the child will be an active participant (for example, electronic games) are more effective than the usual distraction.

    Listening to your favorite music is particularly good at reducing pain and anxiety in older children.For newborns, physical contact is important (being on the breast of mom or dad), the benefits for reducing pain during procedures and after surgery will be from massage, and from breastfeeding, and from sucking the nipple.

    When you are discharged from the hospital, you will be given recommendations on how to treat pain at home: what painkillers you may need, how much and how often you will need to take them. They will also tell you about possible side effects and what to do if they occur.Pain relievers for home use may not necessarily be the same as those you received at the hospital.

    Ask your doctor where you can go if you have a problem. Make sure your doctor is aware of which medications have previously caused you problems. This will help avoid possible complications associated with medications.

    Houses:

    • Take pain relievers regularly as directed by your doctor. You can always check information about the prescribed prescriptions, including the regimen for taking the medicine prescribed by your doctor, in the prescription center of the state portal (www.eesti.ee → Services → Citizen → Health and healthcare → Prescriptions).

    • Get enough rest. If you have trouble sleeping, tell your doctor.

    • While sleeping or doing deep breathing exercises, prop your body with pillows.

    • To reduce pain, you can use alternative methods approved by your doctor: cold or warm compresses, listening to music, massage, substitution therapy (being in a position that relieves pain, supporting the body with pillows, etc.)

    • If for the treatment of acute postoperative pain you must use opioids at home, then driving will be prohibited, and you will not be able to use devices / mechanisms that require special attention.

    • If the pain relievers prescribed by your doctor do not relieve your pain (the pain is still greater than five on a scale of ten), then contact your doctor or family doctor.

    In Estonian and Russian:
    www.regionaalhaigla.ee/et/valuravi
    www.valu.ee
    Website of the Estonian Association of Anesthesiologists
    video: Amanda goes to surgery

    In English:
    www.mayoclinic.org/pain-medications/art-20046452
    www.preop.com.au/postop.htm
    www.cuh.org.uk/sites/default /files/publications/PIN1304_TENS_pain_service_v4.pdf
    patient.info/health www.painaustralia.org.au/healthcare-professionals/patient-resources.html

    Used literature

    Allred KD, Byers JF, Sole ML. The effect of music on postoperative pain and anxiety. Pain Manag Nurs Off J Am Soc Pain Manag Nurses. 2010 Mar; 11 (1): 15-25.

    Crowe L, Chang A, Fraser JA, Gaskill D, Nash R, Wallace K. Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain. Int J Evid Based Healthc. 2008 Dec; 6 (4): 396-430.

    Engwall M, Duppils GS. Music as a nursing int ervention for postoperative pain: a systematic review.J Perianesthesia Nurs Off J Am Soc PeriAnesthesia Nurses Am Soc PeriAnesthesia Nurses. 2009 Dec; 24 (6): 370–83

    Johansson K, Nuutila L, Virtanen H, Katajisto J, Salanterä S. Preoperative education for orthopedic patients: systematic review. J Adv Nurs. 2005 Apr; 50 (2): 212-23

    Macintyre PE, David A Scott, Stephan A Schug, editors. Acute Pain Management: Scientific Evidence (3rd edition) 2010.

    Vaajoki A, Pietilä A-M, Kankkunen P, Vehviläinen-Julkunen K. Effects of listening to music on pain intensity and pain distress after surgery: an intervention.J Clin Nurs. 2012 Mar; 21 (5-6): 708-17.

    Wood S. Postoperative pain 2: patient education, assessment and management. Nurs Times. 2010 Nov 23; 106 (46): 14-6.

    IASP Taxonomy. (2012). International Association of the Study of Pain.
    www.iasppain.org/Education/Content. aspx? ItemNumber = 1698 & navItemNumber = 576 # Paintolerancelevel

    INFARCT WITHOUT PANIC

    Heart attack without panic

    But what is it all the same – this myocardial infarction? It happens when part of the heart muscle simply dies off abruptly, as it ceases to be supplied with oxygen.It is easy to understand that most often a heart attack occurs from diseases of the heart arteries (for example, their narrowing), which cease to perform their main job – to provide our heart with “fresh” oxygen-enriched blood.

    “The pain started in the right shoulder. Then she crawled to her chest and got stuck somewhere under the left nipple. Then, as if someone’s calloused hand penetrated the chest, grabbed the heart and began to squeeze it like a bunch of grapes. Squeezed slowly, diligently … The heart stopped.No, at first it fell down, like a sparrow falling on a window pane.

    … Suddenly [someone] grabbed a huge rusty nail, put it to the patient’s chest and nailed him with a strong blow of his fist …

    – Take out the nails, I can’t take it anymore! – the patient pleaded “- this is how the remarkable Soviet Georgian writer Nodar Dumbadze described the arrival of the disease (in the novel” Call of Eternity “). And he knew these sensations firsthand.

    A heart attack strikes absolutely unexpectedly.And in the first minutes (God forbid, if minutes) you confront him alone, and you need to know how. According to statistics, almost 40% of deaths occur from it.

    True signs

    Sudden pressing, constricting, or “burning” or “tearing” pains in the chest. The pain can spread to the back and both arms, to the jaw, and even to the abdomen. Anxiety arises, but what is there anxiety – panic, an all-consuming fear of death, followed by shortness of breath and severe sweating.

    By the way, many consider one of the signs of a heart attack – the body’s almost complete indifference to taking nitroglycerin. This is generally true, although nitroglycerin can provide some pain relief for a while.

    When is the most frequent occurrence of a heart attack

    He may come seemingly for no reason, for example, in a dream. Remember that the most dangerous time is 4-6 o’clock in the morning, when our blood becomes the slowest. If at this time you or your loved ones feel unwell – call an ambulance – do not wait for it to “resolve” by morning.

    A heart attack is accompanied by unbearable physical activity. And of course – emotional stress. So, in 1950, at the World Cup in Brazil, after the final match, where the home team lost to Uruguay, 8 people were hospitalized with a heart attack. And that’s just the audience at the stadium. And in the country, no one counted them at all.

    Hangover syndrome is also a great companion of a heart attack.

    What everyone can do

    – If there are characteristic signs of a heart attack, even with their weak intensity – without hesitation, call an ambulance.

    – Never drive yourself!

    – If you are at home alone, leave the door open.

    – Open the windows.

    – Place a nitroglycerin tablet under your tongue. Drink aspirin (chew better). It thins the blood and can relieve torment. Sit or lie with a pillow under your back and head so your upper body is slightly higher than your lower body. Bend your legs at the knees – it will be easier for the heart to supply blood.

    Risk factors

    There are two groups of them, as in any disease.Those that we cannot change (but we can soften and prepare), and those that are in our hands.

    The first are:

    – Heredity. There were strokes and heart attacks in the family – a great reason to be careful.

    – Paul. Men are more prone to heart attacks than women. For various reasons, including a more risky lifestyle, they are more likely to develop atherosclerosis – a disease of the arteries – which leads to heart attacks.

    – Age.In this matter, women are less fortunate, since their age of increased risk begins with the onset of menopause, when hormones cease to protect blood vessels. Men have “youth” for 10 years longer.

    What you can control yourself

    Violation of lipid metabolism, or speaking in Russian – cholesterol level. Analysis for this level can be done at any clinic for free. We need cholesterol to build the same walls of blood vessels. But when there is a lot of it, it clogs up these vessels.Hence – heart attacks and strokes.

    Pressure. If you often have it above 140 to 90 – a good reason to see a doctor and start taking medication.

    Smoking. Here doctors are categorical – to quit once and for all. Even a few months of smoke-free life can make a completely healthy citizen out of “pre-infarction”.