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Where does pain in the elbow come from?

Pain in the elbow can be from a large variety of sources. Proper examination and history of the injury is paramount for determining the source of the pain. Elbow pain is often described as “Tennis Elbow”, “Golfers Elbow” or “Pitcher’s Elbow”.

While elbow pain can be very easily understood when the problem is due to trauma, many cases are not that directly related.

Pain experienced in the elbow may be directly related to what is called a “referral” or “radicular” pain pattern. This type of pain starts somewhere else and travels down a nerve, ending at a particular location. The elbow has a variety of nerves that end at the elbow, as well as several others that travel past into the wrist or hand.

Elbow Pain may be due to Medial or Lateral Epicondylitis

How does elbow pain relate to the spine?

The closest regions of the elbow (near the upper arm) are supplied by the nerves that come from C5/C6 in the neck. The lower part of the arm has nerves from C6/C7 and the back of the elbow are regions that come from C7/T1 in the neck.

What this means, is that any damage to (C5-T1) the lower neck and/or upper rib regions may cause pain in the elbow. Injuries to the neck such as spinal arthritis, disc herniations, upper shoulder/lower neck muscular strain, ligamentous sprains, whiplash, falls, or any sudden stopping movements may cause pain in this region, if it affects the nerves leaving the spine. The specifics of this type of nerve pain are identified on a separate article: Why does my arm hurt?

What if my pain isn’t from the spine?

Other pains in the arm might be related to the blood vessels in the neck and shoulder. Thoracic outlet syndrome (TOS) can be a very serious condition related to the blood vessels in the neck and shoulder.

If the muscles of the shoulder are overly strained, the blood vessels might be impinged. The impinged blood vessels then supply slightly less blood to the arm and hand. This reduced blood flow might start to cause regional pain (depending on the blood vessel affected) in the limb. Pain might be in the upper arm, hand, wrist, or elbow.

…and if it isn’t blood vessel related?

The final pain generator is typically the musculature of the forearm. Many people have tasks that require them to sit in one position at a desk, with potentially bad posture.

A poorly ergonomic seated position may cause excessive strain of the wrist. While the wrist joint may not start hurting immediately, the muscles of the forearm can very quickly become strained.

The larger muscles in the forearm (pronator teres, flexor digitorum and extensor digitorum) have their original attachment at the elbow. If this attachment becomes strained and irritated, pain will be felt local to that injury. Pain from this type of seated posture can be read about here: You’re sitting wrong.

How can chiropractic treatment help this?

With a proper diagnosis of where the source of the pain is, proper treatment can be given to resolve the pain. It is very important to determine if the pain is from the joint itself, muscular, radicular, or blood supply related. Each treatment method involves myofascial release of the restricted muscles, and joint manipulation, but the specific area and structures treated varies substantially.

Chiropractic manipulation is excellent for TOS and radicular type pain, but will not help much to resolve repetitive strain type injuries involved in golfer/tennis elbow. These types of injuries require more muscular treatments, with minimal manipulation.

Here at Herrington Family Chiropractic, not only does Dr. Herrington excels at spinal manipulation, but is also highly proficient at soft tissue manipulation. Utilizing techniques such as Myofascial Release Technique (MRT)[link], Graston[link], Soft Tissue Massage, Ultrasound therapy[link] and Low Level Laser Therapy (LLLT) [link] to ensure patients can be effectively treated for all their aches and pains.

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