Stemcelldoc's Weblog

November 15, 2010

Elbow Pain: Finding the Missing Pieces to the Puzzle

At the Centeno-Schultz Clinic we are commited to identifying the source of a patient’s pain. 

Lateral epidondyitlits is a common source of elbow pain which often can be  treated successsfully with IMS and ultrasound guided PRP therapy.

When therapies fail to provide signficant and sustained relief, alternative explanations are sought.

BS is an athletic professional with severe bilateral elbow pain which had been unresponsive to conservative therapy.   PT, trial of NSAID, splints and injection with corticosteroids failed to provide significant relief.  She was referred for ultrasound guided PRP injections which provided modest improvement. Upon followup,  we performed a comprehensive evaluation and noted numbness in her fingers, neck pain and recreation of elbow pain with rotation of her neck.

BS”s MRI of the cervical spine was significant for disc bulges at several levels which narrows the central canal and compressed nerves.  She underwent x-ray guided cervical epidural injection completely relieved her elbow symptoms clearly identifying her neck as a major source of her debilitaing elbow pain.

BS’s MRI and a normal MRI are shown below.  They are side views (Sagital).  On the right is a normal MRI with the cervical discs outlined by red circles.  The spinal cord is the thick, dark structure that runs from the top of the image to the bottom and is bathed by white cerebral spinal fluid.(CSF).  BS’s MRI on the right is significant for several disc protrusion which narrows the cervical canal and irritates the exiting nerve roots.

 

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