Hi. I’m hoping a fresh set of eyes–and those of someone who lifts–can help with what has become an incredibly frustrating situation for me. I’ll try to keep this brief. Elbow pain started two years ago, along with thumb pain/pain in the palm of my hand. My arm/harm feels weak, it’s tingling, nothing too painful but lots of weird sensations. And although it’s primarily in a couple areas, it really is from my elbow to my fingertips. A couple examples of what I’m experiencing: low bar squat but also brushing teeth and shaving (elbow, felt like a nerve issue), holding even an empty bar for bench pressing (palm/thumb), bending my wrist to flip a pancake or button a shirt (feels like a shock at my wrist. I’ve also noticed the underside of my wrist is very sensitive to touch. When I’m done riding my bike my arm feels numb. My fingers are frequently colder on the one hand than the other, and look like whiter. I’ve had two EMGs, elbow MRI and wrist MRI, none of which revealed anything. Had a brain and cervical spine MRI to rule out MS. I had a steroid shot for carpal tunnel and didn’t notice much relief. I’ve done physical therapy for everything from carpal tunnel to ulnar nerve entrapment. I took 8 months off from lifting and when I got under an empty bar to bench today, the pain in my palm, at the base of my thumb, was enough that I didn’t even try to push through it. I could type up 100 more examples, but the long and the short of it is this: what could be causing my symptoms that we wouldn’t have caught on these exams/tests or improved with physical therapy or time off? The thumb pain/pain in my palm just setting up with an empty bar feels like it should mean something, but what? I’ve seen the sports ortho like 10 times now and I’ve lost confidence in him, but not sure where else to go. Thanks in advance for any thoughts you have about my situation. Really appreciate what you guys do here.
Sorry to hear about this. I will say that this is an unusual presentation and there aren’t many diagnoses that immediately come to mind given the things that have already been evaluated, from a neuro-musculoskeletal standpoint.
Have you undergone any sort of vascular evaluation?
Thanks for the response. I don’t know what a vascular evaluation is, so I don’t think so.
You appear to have normal nerve function by EMG (i.e., no neuropathy), your MRIs of the elbow and wrist would typically be sufficient to evaluate the bones & soft tissues (muscles, tendons). The remaining area that does not seem to have bene evaluated are your blood vessels. You mention your hands/fingers being whiter and colder than the other side, which could be related to a vascular issue affecting blood flow to that area. This would still be odd to present with pain in the ways you describe, but it’s the only remaining aspect of the arm that does not seem to have been evaluated.
Thanks. Doctor has flip-flopped between CT and ulnar neuritis. I’m sure I’d get some relief of my elbow pain if we went with one of the various elbow surgeries that are possible (cubital tunnel release, ulnar nerve transportation), but with one of my significant issues being this thumb/palm pain, I’m a bit reluctant to go the surgery route if I don’t have a realistic belief that it could resolve all my symptoms. Is that a fair way to look at things? I don’t want to go the surgery route because “it might” help. Alternatively, it probably won’t hurt and will likely improve my elbow symptoms even if it doesn’t help with the thumb/palm stuff.
I’m not sure. This is a level of detail that would probably be best suited for a consultation with Dr. Miles.