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Elbow, Wrist and Carpal Tunnel Pain
Ross Hauser, M.D.
Eighty percent of chronic
elbow pain is due to a sprain of the
annular ligament, a ligament rarely examined by a family physician or an orthopedic surgeon.
Nearly all of our patients with chronic elbow pain tell us their doctors told them they have
tennis elbow
(lateral epicondylitis) and not a
sprain of the annular
ligament. The latest treatment for tennis elbow is the dreaded
cortisone shots! Cortisone weakens tissue, whereas
Prolotherapy
strengthens tissue.
Cortisone has temporary effects in regard to pain control whereas Prolotherapy has permanent effects. However, cortisone does have one permanent effect: Continual use will permanently weaken tissue. Anyone
receiving long-term
prednisone or cortisone shots will confirm this fact.
The annular ligament's job is to attach the radius bone to the
ulnar
bone or in other words, to enable the hand to rotate, as in turning a key or a screwdriver. Because of the tremendous demands placed on the
fingers and
hands to perform repetitive tasks, the annular ligament is stressed every day. Eventually, this ligament becomes lax and a source of
chronic pain.
Unfortunately, many patients with elbow and hand pain have been also
been misdiagnosed with
Carpal Tunnel Syndrome. Carpal Tunnel Syndrome refers
to the entrapment of the median nerve as it travels through the
wrist into the hand. The nerve supplies sensation to the skin over the thumb, index, and
middle fingers. A typical Carpal Tunnel Syndrome patient will experience pain and numbness in these areas of the hand.
Because most physicians do not know the referral pain patterns of
ligaments, they do not realize that cervical vertebrae 4 and 5 and the annular
ligament can refer pain to the thumb, index, and middle fingers.
Ligament laxity
can also cause numbness. Cervical and annular ligament laxity should always be
evaluated prior to making the diagnosis of Carpal Tunnel Syndrome. Surgery for
Carpal Tunnel Syndrome should not be done until an evaluation is performed by a
physician who understands the referral patterns of ligaments and is experienced
in Prolotherapy.
Seldom do patients find relief from the "Carpal Tunnel" complaints of pain in
the hand and elbow with physical therapy and surgery because the diagnosis is wrong. The most common reason for pain in the elbow referring pain to the hand
is weakness in the annular ligament, not from Carpal Tunnel Syndrome. Several sessions of Prolotherapy will easily strengthen the annular ligament and relieve chronic elbow pain.
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Use of Elbow Braces
Tennis
Elbow, Golfer's Elbow and Prolotherapy
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