Houston Methodist. Leading Medicine

Elbow FAQ

Question:

I finally figured out that I have a pinched nerve in my neck AND tennis elbow he same time. For the longest time, we thought it was just tennis elbow so nothing we did for the elbow helped very much. What can I do for the neck problem to help the elbow?

Answer:

It is important to have a clear diagnosis when trying to treat apparent (or real) lateral epicondylitis (also known as tennis elbow). Making the differential diagnosis is important because the treatment differs from trauma-induced (overuse) tennis elbow and cervical radiculopathy. Instead of just treating painful elbow symptoms locally (at the elbow), efforts are directed toward the neck as well. Unnecessary surgery can even be avoided. Cervical radiculopathy refers to pressure on a nerve in the neck. This condition is caused most often by spinal stenosis (narrowing of the opening where the nerve exits the spinal cord) or by disc protrusion. But this condition can also be caused by bone spurs, infection, or tumors. That's another reason it's important to have a careful and confirmed diagnosis. Now that you know you have both problems, attention should be directed toward improving spinal alignment, posture, and nerve movement. It's possible and even likely that the elbow problems developed as a result of the neck pathology. The C67 spinal nerve exits the cervical spine but supplies nerve messages to the muscles of the elbow. Impairment of the nerve in the cervical spine can result in weakness of the elbow muscles. Then even everyday activities can seem like overuse trauma leading to tennis elbow. A physical therapist may be the best professional to help you at this point. The therapist will evaluate you and design a program specific for your needs. Most likely the plan of care will include postural and strengthening exercises and manual therapy to restore normal neck alignment and movement. If needed, nerve mobilization techniques can be applied to help the affected nerves slide and glide smoothly. Neuromuscular training during daily activities and while performing work duties are incorporated until you can return to normal function and perform all activities in all positions (including uninterrupted sleep) without symptoms. Don't be surprised to find yourself doing postural, balance, strengthening, and flexibility exercises -- and not just for the upper half of the body. Attention to restoring symmetry and balance from head to toe may be necessary for the best results. It takes a minimum of four to six weeks to progress the exercises to get the full benefit and prevent recurrence of symptoms. Be patient and you should be rewarded with the results you want. Aaron Lee, and Ayse Lee-Robinson, MD. Evaluating Concomitant Lateral Epicondylitis and Cervical Radiculopathy. In The Journal of Musculoskeletal Medicine. March 2010. Vol. 27. No. 3. Pp. 111-115.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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