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Arthritis (Expert Forum)
Pain in upper extremity joints since elbow surgery
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions and support regarding arthritis issues such as: Arthritis, Autoimmune Disease, Bursitis, Fibromyalgia, Gout, Juvenile Rheumatoid Arthritis, Lupus, Myositis, Neuralgia, Osteoarthritis, Polymyalgia Rheumatica, Rheumatoid Arthritis, Sciatica, Tendinitis, Vasculitis.
Pain in upper extremity joints since elbow surgery
by msquared16, Apr 01, 2004 12:00AM
I work as an Operating Room Tech. for 4 Orthopaedic surgeons in there own ASC. These men are wonderful people and treat me like a sister. Therfore I don't like to conplain to them, because I don't want special treatment.
I struggled with tennis elbow for 2 years. In that time I got 3 Depo-Medrol injections in it by our hand surgeon. Finaly needing surgery in Sep. of 2003. He discovered after getting in severe synovitis and after exploreing a bit found that the radial collateral ligament was badly torn. Both were reattached with Mitek anchors X 2, after chiseling the bone down to reastablish blood supply. That healed very well.
In the last month of my recovery from the surgery (Nov 2003) I got pain in the MC joints of the middle and ring fingers of the left hand. And the MC joints of the 1st.,middle and ring of the right. Swelling, pain,stiffness (could not get fingers to the palm in a fist) lasting all day, all night. So sore I could not rub lotion on them. I was takeing 50mg of Viox a day, and needed the pain meds far more for the hands than ever did on the elbow. Then after about a week, my wrists (bilateraly) started hurting too, and add to that over the ulnar head at the wrist, also bilateraly, there was a snapping of a ligament(like a rubber band)over the head of the ulnar, when I leaned on the hand like to rise from a chair or get into bed. The snapping could be heard from accross the room. Then, like it began, it left almost all the way after about 4 weeks. I was back to work by this time and working in alot of pain. The next day or the day after, I started getting pain in my upper arms. Thinking this was just from favoring the hands and wrists, I said nothing. After about 3 weeks I could not even turn over in bed, and missed my 1st. day of schedueled work in 15 years. The drs. insisted that I come in and see them, I did. My arms useless at my sides, I literaly could not force myself to move them. Diagnosis was bilateral bicipital tendonitis. After X-rays,was also diagnosed with impingment in both shoulders. He injected both shoulders, sent me for an MRI which was negitive for a rotator cuff tear.
Everything got better until about March 1st. now it is all starting again, not as bad, but still. Even though the pain is tolerable, my hands are very swollen and I can't make a tight fist. Snapping returned.
What has happened since the surgery? Does this happen to other people. I never had any aches and pains before the elbow started. I could ask any of our drs. But like I said before, I don't want to be treated special. And they will, and they won't take any money from me, which makes me feel uncomfortable.
I am a 48 year old female, married, non-smoker, non-drinker, no rec. drugs, I try to exercise 3-4 days a week, even though now it is just to walk 2-4 miles with my hubby and dogs.
Meds are-- Viox 50mg a day
Prinivil 40mg. a day (high BP)
Synthroid .075mc. a day
Multi Vitiman
I struggled with tennis elbow for 2 years. In that time I got 3 Depo-Medrol injections in it by our hand surgeon. Finaly needing surgery in Sep. of 2003. He discovered after getting in severe synovitis and after exploreing a bit found that the radial collateral ligament was badly torn. Both were reattached with Mitek anchors X 2, after chiseling the bone down to reastablish blood supply. That healed very well.
In the last month of my recovery from the surgery (Nov 2003) I got pain in the MC joints of the middle and ring fingers of the left hand. And the MC joints of the 1st.,middle and ring of the right. Swelling, pain,stiffness (could not get fingers to the palm in a fist) lasting all day, all night. So sore I could not rub lotion on them. I was takeing 50mg of Viox a day, and needed the pain meds far more for the hands than ever did on the elbow. Then after about a week, my wrists (bilateraly) started hurting too, and add to that over the ulnar head at the wrist, also bilateraly, there was a snapping of a ligament(like a rubber band)over the head of the ulnar, when I leaned on the hand like to rise from a chair or get into bed. The snapping could be heard from accross the room. Then, like it began, it left almost all the way after about 4 weeks. I was back to work by this time and working in alot of pain. The next day or the day after, I started getting pain in my upper arms. Thinking this was just from favoring the hands and wrists, I said nothing. After about 3 weeks I could not even turn over in bed, and missed my 1st. day of schedueled work in 15 years. The drs. insisted that I come in and see them, I did. My arms useless at my sides, I literaly could not force myself to move them. Diagnosis was bilateral bicipital tendonitis. After X-rays,was also diagnosed with impingment in both shoulders. He injected both shoulders, sent me for an MRI which was negitive for a rotator cuff tear.
Everything got better until about March 1st. now it is all starting again, not as bad, but still. Even though the pain is tolerable, my hands are very swollen and I can't make a tight fist. Snapping returned.
What has happened since the surgery? Does this happen to other people. I never had any aches and pains before the elbow started. I could ask any of our drs. But like I said before, I don't want to be treated special. And they will, and they won't take any money from me, which makes me feel uncomfortable.
I am a 48 year old female, married, non-smoker, non-drinker, no rec. drugs, I try to exercise 3-4 days a week, even though now it is just to walk 2-4 miles with my hubby and dogs.
Meds are-- Viox 50mg a day
Prinivil 40mg. a day (high BP)
Synthroid .075mc. a day
Multi Vitiman
Doctor's Answer
by Kevin Pho, MD, Apr 01, 2004 12:00AM
, Apr 01, 2004 12:00AM
With a negative MRI and the fact you are having bilateral symptoms, you may want to consider a rheumatological workup. Bilateral hand pain and swelling may be suggestive of rheumatoid arthritis.
For further evaluation, I would consider a complete blood count, thyroid test, ANA (anti-nuclear antibody) level, as well as markers for inflammation such as a sedimentation rate and C-reactive protein. Plain films of the hands and joints can be done to demonstrate if there is any erosion that can be suggestive of arthritis.
A referral to a rheumatologist would also be advisable. The tests mentioned here can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
For further evaluation, I would consider a complete blood count, thyroid test, ANA (anti-nuclear antibody) level, as well as markers for inflammation such as a sedimentation rate and C-reactive protein. Plain films of the hands and joints can be done to demonstrate if there is any erosion that can be suggestive of arthritis.
A referral to a rheumatologist would also be advisable. The tests mentioned here can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
I work in a rural Occupational Therapy clinic. Has anyone given thought to RSD (Reflex Sympathetic Dystropy) aka CRPS (Complex Regional Pain Syndrome)? This is not a common disease, but from the cases that we have seen at our clinic, your symptoms certainly seems to have progressed in a similar fashion. Here are some links that may be helpful.
I hope you can find some answers.
http://www.rsdhope.org (read "Description of RSDS first)
http://www.rsdrx.com
Best Regards,
Kim T