This information is not a definitive list but only a guide to possible causes of your pain which can be helped by your physiotherapist. There are a wide range of medical conditions that can cause your pain. An assessment by one of our physiotherapists will allow them to take a detailed history and perform a thorough examination to give a diagnosis. They can then treat you effectively or recommend a medical referral if it is required.
Medial collateral ligament injury:
The ligament that provides stability to the elbow joint can be damaged by trauma to the elbow which is normally excessive outwards movement of the hand and forearm. This can lead to pain and excessive movement in the inner elbow if damage occurs. This can effect lifting and carrying with the arm.
Physiotherapy can provide diagnosis of the condition and the severity of the injury, provide an expert opinion on when to seek surgical opinion if the injury is severe and management of symptoms with soft tissue release, strengthening and taping. Pain can be managed with acupuncture if needed.
Ulnar nerve entrapment:
The ulnar nerve runs in a small groove between the bones of the inner elbow. This groove turns a tight corner and altered loading of the elbow, excessive repetitive activity or blunt injury can cause inflammation and trapping of the ulnar nerve. This commonly results in pain on the inner elbow that can radiate down the inside of the forearm, sometimes numbness in the 4th and 5th fingers and possibly weakness of the small muscles of the fingers with fine movements.
Physiotherapy techniques that may help include nerve gliding exercises, soft tissue massage techniques, joint mobilisations and taping. Your physiotherapist may also look at your neck to treat any central component of the nerve pain that could be causing the symptoms.
Referred pain from the neck
Some pain experienced in the upper limb can be caused by nerve injury or compression in the neck. This commonly occurs when a specific nerve root is involved, such as the C8 or T1 nerves which refer their pain to the inner elbow area. This pain can also be associated with burning, tingling or numbing sensations.
Your physiotherapist will be able to determine if your pain is referred from the neck and identify which structures might be causing the problem by assessing muscle length, disc and joint health and movement and nerve involvement. Your treatment with us can then be tailored to include nerve gliding exercises, neck mobilisations, soft tissue techniques and neck exercises.
Osteoarthritis of the elbow joint
This commonly occurs in older individuals but can occur earlier if there has been damage to the joint, heavy use or a family history. Symptoms include aching, stiffness and sometimes reduced movement of the joint with crepitus or loss of the 'smoothness of movement'.
A physiotherapist can determine the possible causes contributing to the development of the arthritis and set you appropriate strengthening and stretching exercises. Techniques such as acupuncture, joint mobilisations and taping have also been shown to provide pain relief in osteoarthritis.
Medial epicondylalgia 'golfers elbow'
The pain is located on the inner elbow and can radiate into the underside of the forearm. It is worsened by activities such as gripping and repetitive movements of the wrist and hand such as opening tins and golf. It has been known as 'Golfers elbow' in the past for this reason. The symptoms can be similar to ulnar nerve entrapment and so need to be clearly assessed and managed.
Physiotherapy techniques such as taping, massage techniques, ultrasound, joint/tissue mobilisations, mobilisations with movement and acupuncture can be used to relieve symptoms. A graduated exercise programme and activity modification can also be used by a physiotherapist to remodel the tissue and aid healing.
Rheumatoid Arthritis
Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.
We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function.
Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.
We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:
- Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
- Wheelchair assessments
- splinting
Fibromyalgia
This condition does not involve inflammation but affects the fibrous tissues in many parts of the body ie. tendons, muscles, connective tissue etc. There can be a large number of tender points and a feel of generalized aching. One of the common tender points is on the inside of the elbow. There a number of other symptoms including fatigue, sleep disturbances, sensitivity to temperature, morning stiffness, numbness and tingling, irritable bowel, depression and dry eyes and mouth.
Physiotherapy can help people with this condition. There are pain relieving techniques that can be used and they are experienced in pacing you back to being able to exercise again and return to activities whether sport, work or hobbies that you were able to do before the condition started. They also are able to provide advice on how to cope with your condition and manage flare ups of pain.
Chronic Pain
Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.
Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related. We can also recommend top London pain consultants who can help you.
Other possible causes
Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:
- cardiovascular symptoms
- respiratory (breathing) symptoms
- gynaecological symptoms
- urinary or genital symptoms
- digestive symptoms
- immune system symptoms
- lymph system symptoms
- hormonal symptoms
- neurological symptoms
- dermatological (skin) symptoms
- medication side-effects
- virus
- infection
- cancer
- disease process
- psychological problem ie. depression, anxiety
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