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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56837
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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Elbow problems. I am now 56 years old and still a very

Customer Question

Elbow problems.

I am now 56 years old and still a very fit hard core runner. I am 5"10" and weigh 140 pounds. I have no health issues and no history of any health issues.

About 4 or 5 months ago I started to get problems in both elbows; left, golfers and right, tennis. Over time the tennis elbow has gotten worse.

I am not sure the two exactly coincide but after Christmas I was riding my motorcycle a lot more (I've been riding for about four years) and from late January I have had a new motorcycle which is extremely heavy at 903 pounds .

I have had previous problems with my left elbow recurring approximately 2 to 5 years ago and treated with cortisone shots (3 separate times). This was golfers elbow. Since then I have avoided any of the repetitive motions that may be causing it.

Both the golfers and the tennis elbow carry all the classic symptoms (I don't play golf or tennis) but the tennis is definitely getting worse and it is now extremely painful to even lift a cup of coffee and to bend and straighten the arm. I have never had symptoms of tennis elbow before.

I have tried icing and periods of up to 10 days on 400mg of Ibuprofen 3 times a day and for the last week I upped that to 800mg. This has seriously reduced the pain, certainly in the movement of the arm but nothing has gone away. I have only been on the motorcycle twice in the last three weeks in case this is part of the issue.
I have started to do some of the standard tennis elbow warm up and stretching exercises.

There is one further issue with the left elbow; during the night the carpometacarpal joint of the little finger seems to sort of dislocate from the other three carpometacarpal joints. No curling or other issues in the finger itself. This is fixed by flexing the hand but it is painful to do. Would seem to suggest an ulnar nerve issue.
No symptoms at all during the day.
No issues in spreading or pulling together fingers against resistance.
No problem straightening fingers.
No loss of feeling in the fingers.
No loss of grip strength.

Can you help?
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 1 year ago.

Hello from JA
What stands out in your post is....no assessment or professional intervention apparently.

No MRI scan of the neck?
Structural assessment by PM&R [physical medicine and rehabilitation}/

Any of these problems are liable to become chronic and more severe without the correct full body structural assessment and the correct manual therapies.

The finger for example could be a developing trigger finger in the long run.
Yes the little finger could represents an ulnar nerve problem, you are correct, and both can become surgical problems if not receptive of prompt manual intervention.

See an MD of physical medicine and rehabilitation for the correct assessment and manual therapies first, which might span from physical therapy to home therapies to electronic therapies, splinting and traction. It depends.

If ulnar involvement is suspected and MRI of the neck is needed.

Possibly of the elbow as well, this might be tendinosis at this point and x ray will not show this, but knowing it will dictate therapy....a period of immobilization followed by physical therapy, as one example.

OK. If you have further questions or details, use reply to expert.

Otherwise please choose a positive rating . But, still come back if you need to…think of something later, etc. Bonuses are appreciated.

Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56837
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 8 other Medical Specialists are ready to help you
Customer: replied 1 year ago.

Your answer is pretty clear but as it is "go see a doctor" I feel that a charge of $75 for this is excessive and I would like at least a fee reduction.

Expert:  Dr. Thomas, MD replied 1 year ago.
We have nothing to do with the fees.
We are paid by ja per positive rating.

I have given you much more than you say..the type of doctor, some of the therapies that might be needed, and the possibilities of what this can be, as well as the diagnostic imaging that will probably be needed.

What else is it that you need answered?

What has not been answered at this point:?
Customer: replied 1 year ago.

I'm not happy with the answer on this part of the question so I've tried to be more specific:


During the night the metacarpophalangeal joint of the little finger of the left hand seems to sort of dislocate from the other three metacarpophalangeal joints, moving slightly in front of the ring finger joint. No curling or other issues in the finger itself. This is fixed by flexing the hand but it is painful to do. Would seem to suggest an ulnar nerve issue.


No symptoms at all during the day.


No issues in spreading or pulling together fingers against resistance.


No problem straightening fingers.


No loss of feeling in the fingers.


No loss of grip strength.


No signs of clawhand.


No signs of Trigger Finger. No signs of any abnormality at all in any other finger joints.


 


I am left handed.


The hand has a tendency to be cold.


I have signs of golfers elbow in the left elbow.

Expert:  Dr. Thomas, MD replied 1 year ago.
This finger problem can be an ulnar nerve issue, but also can be a developing tendinitis...trigger finger.

Again, only a hand exam having you do certain maneuvers is going to see what this is....

Ligament damage in the joint might also affect things this way.

Again an MRI is the imaging of choice.
What further questions do you have.

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