Last issue talked about the main causes of pain in the lateral elbow joint... condylar , he has an elegant name... "Tennis elbow" , so what is the main cause of pain in the medial elbow joint? The answer is medial epicondylitis of the humerus, and also has an elegant name... "golf elbow". How can you get "golf elbow" without playing golf? seems a bit weird, let’s start with a “cool” paragraph!
elbow pain is very entangled, and clarifying the cause is the key!
A certain king, a wolf walks like a tiger, is as strong as an ox, is as strong as a tower, is as strong as a fire, is sound like a barbarian, is good at fighting, is arrogant in the village, and the sea mouth is wide after drinking: "I have the courage of Lu Bu, but I am sorry to be born in the Three Kingdoms. If I am, taking the general's head will be like taking a piece of the ear." A certain Lang disdained: "You are brave enough to fight against the three heroes. You are good at fighting. Do you dare to fight the rounds of our dozens of young people?" "Why don't you dare? You will take turns to play!" Two benches and one table, a certain king kicked his bow left and right, wrestled his arm, and fought against the rounds of young people, even though he won, he was exhausted and gasped. Everyone congratulated him and praised his courage. In the middle of the night, you felt pain in your elbows, unable to sleep, unable to hold objects in your arms, unable to lift the warehouse, ashamed of your face, ashamed of opening your mouth, and endured for more than a month, but it was impossible to heal. I asked for treatment for me. After acupuncture and knife loosen the adhesion, the Chinese medicine was cured, and Zhou Yu recovered! Later, I mentioned this matter and laughed endlessly, and I will never be arrogant in city and wild ! The "cool" paragraph above
is based on real cases and is just for entertainment and education! Next, let’s talk about what is intrahumeral condyle inflammation .
Middle epicondylitis is also known as golf elbow. is related to a variety of factors. Common related factors include occupation, housework, sports trauma, and age and physical fitness. The medial epicondyle of the humerus is the attachment of the tendon of the forearm flexor muscle and pronounced teres. When the elbow and wrist flexor muscle are often flexed vigorously and the forearm is prone to pronounce, the ulnar flexor muscle is in a tense and contracting state, which can easily cause acute sprains or chronic strain on the attachment point of the tendon. If you do throwing, or if you fall, your palms support the ground, your elbow joints are straightened and your forearm is too tilted out, it can cause the attachment point of the forearm flexor muscle and protruding teres torn . Chronic strain is often caused by repeated flexion and extension of the wrist and elbow joints and rotation of the forearm, causing long-term wear of the tendons and ligaments. After the injury, bleeding of tendon attachment points can form hematoma, local injury inflammation, swelling and squeezing the ulnar nerve branch causes pain; if the treatment is not timely or improper, the hematoma will become mechanized and cause local tissue adhesion, and pain may be caused by the tendon pulling when the wrist flexion or forearm is pronounced. is especially painful when the wrist flexion and forearm pronation is pronounced. Sometimes it can radiate downward along the ulnar side, making the wrist flexion weak . The medial epicondyle of the humerus is obvious tender, and the ulnar flexor muscle and superficial finger flexor muscle have extensive tenderness. The resistance wrist flexor test was positive, and the pain was intensified during cold and at night. If you think about the sports posture of golf athletes, it will not be difficult to understand the pathogenesis of the disease.
You can also suffer from golf elbow without playing golf.
Pathological changes in medial epicondylar inflammation include collagen fiber degeneration and vascular fibroblasts at the origin of the flexor pronunciation of the medial epicondyle muscle, rupture and tear of tendons, accumulation of vascular granulation tissue and tendon necrosis, and secondary inflammatory responses. So are the pain on the medial elbow joints all golf elbows? Not necessarily. What we should most likely identify in clinical practice is to identify it with nerve root cervical spondylosis .
Nerve root type cervical spondylosis can also manifest as pain on the lateral upper limbs, which is easily confused with this disease. However, the pain on the lateral upper limbs of Nerve root type cervical spondylosis is radioactive pain, and there are sensory disorders in the hands and forearms, and there is no localized tenderness. This is the key point to distinguish this disease.
From the perspective of the motherland's medical point of view, This disease belongs to the category of "elbow fatigue" and "harm tendons". Deficiency of qi and blood and blood loss of blood are the internal causes of this disease; elbow trauma or strain, wind and cold are the external causes of this disease. peripheral needle, warm needle, fire needle, and moxibustion are all effective treatment methods.
After talking about diagnosis, let’s talk about treatment of . The treatment of medial epicondylitis of humeral is mainly conservative treatment. For most patients, the symptoms will disappear after treatment with relative braking, rest, physical therapy, oral non-steroidal anti-inflammatory drugs, topical drugs, local injections and other methods. However, some patients often have a short-term effect and are prone to recurrence. Why is this? As we mentioned earlier, most golf elbows are related to acute and chronic injuries to the forearm flexor tendon. In addition to being accompanied by local sterile inflammation, they often also have pathological changes such as scars, adhesions, contractures, and pressure. Oral or local drug injection often eliminates sterile inflammation, but do not handle the above pathological damage well. So how to deal with it? The author still recommends small needle knife therapy . The small needle knife used in clinical practice ranges from 0.6mm to 1.2mm in diameter, but the most commonly used is the 0.8mm 4-digit needle knife. There is a flat blade similar to a micro-screwdriver in front of the small needle knife. It pierces the tendon fibers. Through appropriate operation, the tendons can be avoided and the local adhesion, clamping, scars, and contractures can be completely relieved.
Small needle knife is a needle and a knife!
also has stubborn non-surgical treatment ineffective, surgical treatment can be considered. In terms of the choice of surgical incision, if the possible ulnar nerve translocation is considered before surgery, the incision can be moved to the posterior of the medial epicondyle of the humerus to facilitate the exposure of the elbow canal. The U-shaped tendon flap method can not only completely remove degenerate tissue, but also perform reliable repair to ensure the stability of the total flexor tendon. In short, open surgery is a reliable treatment for the treatment of refractory lateral femoral condylar and the last guard gate.
"Transforming medical treatment and popularizing treatment." I am Song Guozheng, a general practitioner of Weihai Traditional Chinese Medicine Hospital. Combined with vivid clinical cases, we use two thinkings of traditional Chinese and Western medicine to analyze and describe them in easy-to-understand language. I hope to provide a little help to my peers, friends and the public in terms of integration of traditional Chinese and Western medicine, health consultation, medical Q&A, academic exchanges, health care, and voice revelation! It is not easy to write. If you agree with my point of view, please follow or like it. If your family and friends also have this problem, please forward this article to them who need it. Thank you!
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