Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.
I am sorry to hear about your health as you have described above. As a Neurologist I frequently diagnose & treat this type of health situation, and I can certainly help you in this regard.
I see the pain that has been involving the inner elbow, forearm and wrist regions is not responding to the treatments you have tried so far.
While it appears there is some anxiety component too, but the primary issue appears as you have also put it correctly this is due to repetitive strain injury secondary to the nature of the job you have been doing. This type of pain is not uncommon in individuals who use their upper limbs a lot at their work place especially for repetitive tasks such as using computer, performing quick tasks, and also not working in the most ergonomic way etc.
If possible try to see a specialist such as a neurologist in the clinic so that you will receive a thorough clinical examination followed by certain relevant investigations that may include some of the following;
A) An X ray of the elbow, forearm and wrist regions
B) An MRI scan of the same regions mentioned above
C) A nerve and muscle test called as EMG/Nerve conduction test of the upper limbs
D) Certain blood tests such as the following;
2) Vitamin levels
3) ESR, CRP, ANA, RA factor, SSA (Anti Ro), SSB (Anti La)
4) Lyme titer – if risk factors are present
5) Comprehensive metabolic panel etc
Not necessarily all the above investigations may be necessary, the neurologist will be in a position to decide which ones among the above mentioned investigations are required in your case after conducting a thorough neurological examination in the clinic. And also if any of the above investigations have already been done then there is no need to repeat them. The precise & specific treatment plan will depend upon the results of the above mentioned investigations and in the meantime you may try some of the following general home remedies, as well as certain more specific therapeutic measures to help with the symptoms;
Maintaining good hydration
Healthy, Nutritious & balanced diet
Nutritional supplements such as Methyl Guard Plus (which is a combination of active forms of vitamin b12, vitamin b9/folate, vitamin b6, vitamin b2)
Elbow splint or brace
Customized physical therapy including gradual stretching
OT (Occupational therapist) consultation for ergonomic modifications at work place
Cold or heat compresses
Epsom salt compresses
Pain relieving skin creams/ointments such as Biofreeze, or Myoflex
Strong prescription NSAID pain killers such as Diclofenac oral, or Tramadol oral
Diclofenac pain patches over the painful areas
Diclofenac pain creams over the painful area
Lidoderm anesthetic skin patches over the painful areas
Nerve pain pills like Gabapentin (you are already on, but dose 100 mg three times/day is small dose so dose can be gradually optimized), or Pregabalin, or Amitriptyline
TENS (Transcutaneous Electrical Nerve Stimulation)
PRP (Platelet Rich Plasma) injection to elbow region
Prolotherapy injection to elbow region
Autologus whole blood injection to elbow region
ESWT (Extracorporeal shockwave therapy) etc
If above mentioned non-surgical-conservative measures fail then surgical treatments too are available (epicondylar debridement etc), but most patients do not require any surgical treatments, rather one or more of the above mentioned non-surgical treatments are sufficient to help with obtaining relief from this type of repetitive strain related pain.
To summarize once again;
1) Yes, this does appear secondary to repetitive strain or stress related injury to the elbow, forearm and wrist regions, especially the elbow region
2) A thorough evaluation and clinical examination in the clinic by a neurologist followed by certain relevant neurological investigations as mentioned above (X ray, MRI scan, Nerve & Muscle test, certain specific blood tests etc) can help us in confirming the diagnosis, and also in ruling out any other explanations for this refractory pain
3) The specific treatment will depend upon the particular diagnosis that will be made after the above investigations, and in the meantime please consider trying some of the above mentioned treatments
4) And very importantly please see this does not appear secondary to any serious or irreversible condition or permanent damage etc, rather this type of health condition can be diagnosed and successfully treated, so please not to be scared.
Wishing you a quick & complete recovery! And also Wishing you the best health!
All the very best!
Please let me know if you have any additional questions or if you want to discuss this further.
Assuring you the best services!
Dr Subbanna MD