Elbow and Back Pain: Seeking Clarity in Rehabilitation

Elbow and back pain?

Hello, three years ago, I started experiencing pain in my elbow and some discomfort in my back due to the weight of the cymbals (a percussion instrument) and excessive practice.
I later visited an orthopedic doctor who diagnosed me with tennis elbow.
I underwent physical therapy for about 2 to 3 months, but the relief was only temporary; I felt better right after the sessions, but the pain returned the next day.
My elbow often hurts, sometimes to the point where I can't sleep.

Afterward, I was referred to a traditional Chinese medicine clinic where they performed a technique called "bridging." The practitioner suggested that my elbow pain was due to an imbalance in my shoulders (one higher than the other).
After a few months of treatment, my elbow pain was not as frequent as before (though it still occurs occasionally), but my arm remains weak, and my back pain has become more pronounced.
It feels like there is a tightness along my back, and during warm-up exercises, particularly shoulder rotations, I feel something stuck in my back.
Additionally, sometimes I cannot tilt my head back without experiencing significant discomfort in my back, which is more pronounced in the mornings.
Later, I moved away for studies and visited another rehabilitation department at a different hospital.
The doctor diagnosed me with golfer's elbow and attributed my back pain to poor posture.
I am very confused about why the diagnoses from Western medicine differ so much from those at the traditional clinic.
While the traditional clinic seemed to alleviate my elbow pain, the two Western doctors provided similar diagnoses, yet the traditional clinic had a completely different perspective (claiming my elbow pain was related to my shoulder and back).

I feel lost and uncertain about whom to trust, and I am increasingly worried that I will have to live with persistent elbow pain and weakness in my arm forever...
I am only 19 years old, and I am genuinely concerned and frustrated.
I sincerely ask for your guidance.
Thank you very much.

Xiao San, 10~19 year old female. Ask Date: 2008/03/15

Dr. Pan Yingda reply Rehabilitation

Why is there such a significant difference between the diagnoses made by Western medicine and those from traditional martial arts clinics? It's not surprising! Different systems have different points of observation, which leads to varying interpretations.
Even among different specialties within Western medicine, doctors may arrive at different diagnoses.
Additionally, diseases can evolve over time, so even the same doctor may provide different answers at different times.
Regardless of the diagnosis you receive, I believe that it doesn't matter whether it's a black cat or a white cat; a good cat is one that catches mice! What matters is effective treatment! I won't discuss your previous issues, but based on the symptoms you've described, it's clear that there is a problem with your cervical spine.
You need to address this issue at its source.
You're only 19 years old, and with proper treatment, you will definitely recover.
If you're in Taitung, come see me; I'm confident that after one or two sessions, you'll feel significantly better.
For the remaining issues, I will provide you with some exercises to do at home, so you won't need to keep going for rehabilitation or seek other treatments!
Your previous doctor was correct; it started as tendinitis due to overuse, which you already know.
However, it may also be related to improper posture—such as uneven shoulders or spinal misalignment.
More likely, it could be due to lifting weights that are too heavy, causing shoulder imbalances or other postural issues.
Your current problem primarily involves the cervical spine.
Tennis elbow and golfer's elbow are both forms of tendinitis affecting the elbow.
When your palm is facing up, the pain on the thumb side indicates tennis elbow, while pain on the little finger side indicates golfer's elbow.

Reply Date: 2008/03/15

More Info

Hello! Thank you for sharing your experience regarding your elbow and back pain. It sounds like you've been through quite a journey with your symptoms, and it's understandable to feel confused and concerned given the different diagnoses and treatments you've received.

From what you've described, it seems you initially experienced pain in your elbow, which was diagnosed as tennis elbow (lateral epicondylitis) by an orthopedic specialist. This condition is common among individuals who engage in repetitive arm movements, such as playing percussion instruments. The pain often stems from overuse of the forearm muscles and tendons, leading to inflammation around the elbow joint. The fact that you found temporary relief with rehabilitation suggests that physical therapy can be beneficial in managing your symptoms.

However, the persistence of your pain, especially the return of discomfort after therapy sessions, indicates that there may be underlying issues that need to be addressed. The transition to a traditional Chinese medicine approach, where the practitioner suggested that your elbow pain was related to shoulder misalignment, is an interesting perspective. This highlights the holistic view often taken in traditional practices, which consider the body as an interconnected system. While some patients report relief from such treatments, it's essential to approach them with caution, especially if they diverge significantly from evidence-based medical practices.

The subsequent diagnosis of golfer's elbow (medial epicondylitis) by another orthopedic doctor suggests that there may be additional factors at play, possibly involving different muscle groups or tendons. The distinction between tennis elbow and golfer's elbow lies in the specific tendons affected, but both conditions can arise from similar repetitive strain injuries.

Regarding your back pain, which has been attributed to poor posture, this is a common issue, especially for young individuals who may spend extended periods in positions that strain the back muscles. Poor posture can lead to muscle imbalances and tension, contributing to discomfort and pain in the upper back and neck.

Given your age and the chronic nature of your symptoms, it is crucial to adopt a comprehensive approach to rehabilitation. Here are some recommendations:
1. Physical Therapy: Consider returning to a physical therapist who specializes in sports injuries or musculoskeletal disorders. They can provide tailored exercises to strengthen the muscles around your elbow and improve your posture, which may alleviate both elbow and back pain.

2. Ergonomics: Evaluate your daily activities, especially your posture while playing the drums or studying. Ensure that your workstation is ergonomically set up to reduce strain on your back and shoulders.

3. Strengthening and Stretching: Incorporate a routine that includes both strengthening exercises for your forearm and shoulder muscles, as well as stretching to improve flexibility. This can help address muscle imbalances that may be contributing to your pain.

4. Rest and Recovery: Allow adequate time for recovery between practice sessions. Overuse can exacerbate your symptoms, so it's essential to listen to your body and take breaks as needed.

5. Consultation with Specialists: If your symptoms persist, consider seeking a second opinion from another orthopedic specialist or a sports medicine physician. They may offer additional insights or treatment options.

6. Mind-Body Techniques: Techniques such as yoga or Pilates can improve flexibility, strength, and posture while also promoting relaxation, which may help with pain management.

It's essential to remain proactive about your health and seek out a treatment plan that resonates with you. Chronic pain can be challenging, but with the right approach, many individuals find significant relief and improvement in their quality of life. Don't hesitate to reach out for support from healthcare professionals who can guide you on this journey. Wishing you the best in your recovery!

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