Elbow problem?

I am a veterinarian of 56 years old. Few weeks back I experienced a severe pain in my left elbow joint. When I touched the joint it was really painful. Pain was radiating downwards too and found difficult even to lift a book. Consulted a doctor and he diagnosed it as 'Tennis elbow' and treated with Voltaren (Diclofenec sodium- 25 mg) for 1 week. No pain was experienced during the treatment. Once the drugs had benn withdrawn, it started again. Consulted a second doctor, he too diagnosed as the same condition and treated with Voltaren again, (100 mg slow release) nocte for 5 days. Today is the second day and I fell better.(1) Is this the condition known as 'tennis elbow' or some other condition?
(2) What shoud I do if I get the pain after 5 days again?
(3) Diclofenec sodium is a non steroid anti inflammatory drug. Should I use it for long?
(4) Do other tests necessary for a correct doagnosis?
(5) I am not diabetic. BP normal. Not pot bellied. Drink alcohol moderately almost every day
Answer:
Hi there,
answers:1%26gt; the condition called tennis elbow results from the accidental stretch-tear or an inflammation of the " origin of extensors of the forearm". Usually the "extensor carpi radialis" is affected.2%26gt; the condition requires rest and time to heal fully. Medicines like NSAIDs just alleviate the pain , thats all. If the pain is nagging you so much, the next option is a local Steroid injection (at the site of maximum pain) Its can be done in an ortho OP set up. Triamcinolone and Hydrocortisone are the steroids of Choice.3%26gt; If u are using it for long duraions, add an antacid or an H2 blocker/ proton pumb inhib such as Ranitidine 150 mg twice a day or Pantoprazole 40 mg Once daily. If you already are an ulcer patient or gastritis patient, its better to use low NSAIDs like Aceclofenac 100mg Twice daily. It is less gastric irritant.4%26gt;This disease requires only clinical skill to diagnose.
The cardinal question is this: Have you started feeling the pain since you recently twisted your clothes for drying them while washing? or Have you carried heavy weights recently with your aching arm stretched for long durations? The CLASSICAL CLINICAL SIGN IS A TENDER LATERAL HUMERAL CONDYLE.(thats the point of origin of extensors of forearm,) No other tests needed for the diagnosis.Xray and all are waste of money5%26gt; "A peg a day " has recently proven to have reduced Cardio Vascular risks in many thousands (the study rewsults came just a week back.) If thats your kind of moderate drinking, then keep on with it unless you have other risk factors! ALLthe BEST
Dr. Suraj,
Kerala, India.

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I have suffered with tennis elbow in my right arm for about 6 years and the only thing that worked for me was a cortisone injection placed in my elbow joint. After 3 days of a little discomfort I have had no major pain in my elbow since.Every now and then it gets a little achy so I wear a Wrist splint for a few hours. Not allot of people are aware that tennis elbow is actually caused by continuous strenuous wrist movement, the wrist movement causes the tendons to tear near the elbow joint.I was diagnosed after I had a scan on my elbow. I hope this has helped. :-)

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