OpenHealth Q&A

Challenging Pain Journey with Nerve Involvement

Greetings! My name is Philip, and I recently celebrated my 20th birthday. Over the past several months, specifically since March, I have been grappling with significant pain affecting various parts of my body. This is my inaugural post, and I appreciate your patience with the length as I share the entire narrative and complexities regarding my situation. I want to split this information into two sections: Orthopedic Concerns (1) and Rheumatological Concerns (2). (1) To provide some background on my physical condition, I currently weigh 150 lbs and stand at 5'11" tall. I started weightlifting in October 2022, and within a few months, I significantly increased my weight and strength, jumping from 143 lbs to a peak of 167 lbs by late February to early March. My workout routines were intense, often lasting six days a week without breaks, leading to excessive volume, which I learned was not optimal. In late November, I began working in the kitchen doing various tasks, including dishwashing and heavy lifting, and ceased this employment in early-mid July. In mid-December, I also started practicing Jiu-Jitsu, which soon became one of my greatest passions, providing me mental relief during a challenging time. However, about a month into my Jiu-Jitsu training, I began experiencing discomfort in my left forearm and elbow, primarily exacerbated by certain weightlifting techniques and grappling. Despite the pain, I was reluctant to interrupt my activities, opting for regular doses of Ibuprofen instead. By March, the discomfort worsened, affecting both elbows: my left elbow experienced intense pain, and there was now tenderness in my right elbow. Activities became increasingly unenjoyable, and the pain became a constant companion, compelling me to consume significant amounts of Ibuprofen daily (between 600-1000mg). Reluctant to pause my routines, I finally sought orthopaedic advice when the pain became unbearable. After undergoing x-rays, my doctor diagnosed me with tendonitis and recommended rest. After approximately 10 or 11 days without exercise, my elbows felt much better, and I prepared to re-enter the gym. I believed I was starting off slow, but after just two sessions, the pain returned. Another extended rest didn’t yield the same relief this time, and I returned to the orthopaedic for further assistance, leading to a referral for occupational therapy, which proved ineffective. Matters escalated by early June as I experienced neck and upper back pain along with ongoing numbness and tingling in my hands and fingers. Sleeping at night became a challenge as I struggled to find a suitable position that wouldn't irritate my elbows or neck. My doctor theorized about potential nerve involvement and planned an EMG/NCS but decided to conduct further assessments of my elbows first. He prescribed me physical therapy for bilateral cervical radiculopathy and arranged MRIs for both elbows, along with a seven-day Medrol (methylprednisolone) steroid regimen. Simultaneously, my pediatrician ordered several blood tests to exclude autoimmune conditions; all results came back normal. The steroid pack provided substantial relief, especially for my elbows, but the benefits diminished shortly after completing the treatment, and my prior symptoms returned with a vengeance. The MRI revealed lateral epicondylitis (tennis elbow) with mild common extensor tendinosis and signs of ulnar neuropathy in the cubital tunnel on the left elbow. The right elbow reflected similar ulnar issues, leading my doctor to proceed with the NCS/EMG. The electrical study indicated that the nerves in my arms and hands appeared intact, but I likely have a pinched nerve at the C5-C6 level, creating irritation. An x-ray of my cervical spine showed normal results. After a subsequent MRI of the neck confirmed the absence of significant issues, my neck symptoms improved slightly, but I continued to struggle with my elbows and began feeling pain in my lower back and hips. Certain positions, especially while driving, triggered notable pain radiating into my legs and feet. A lumbar spine x-ray returned normal too, prompting an MRI for further investigation. I was also referred to a physiatrist skilled in acupuncture, who evaluated my symptoms and suggested a pricey elbow brace. Skeptical due to previous unsuccessful attempts with other braces, I expressed hesitation about purchasing it. A follow-up is scheduled for mid-September, with acupuncture appointments set for October. At this point, I continue to experience discomfort in my elbows, neck, upper back, and lower back/hips. The "shooting pain" has become infrequent, mostly resulting from prolonged poor posture. Although the meloxicam helps manage elbow pain, its effects do not extend to my neck or back. I follow a daily stretching plan and have shifted my PT visits due to a busy work schedule. Post-stretching provides some relief, but it doesn’t seem enduring. I still sleep with pillows underneath my knees and use a towel roll for neck support. I remain unconvinced that the issues with my elbows and back/neck are entirely separate, as I often feel tension radiating to my neck, tightness in my chest, muscle knots in my back, and discomfort flowing into my shoulders and triceps. I have an MRI for my lumbar region scheduled today (August 25), followed by an appointment with my spine specialist. (2) The reason for my rheumatology visit stems from a notable family history of autoimmune diseases such as Crohn's disease, rheumatoid arthritis, and sacroiliitis. After evaluations, I underwent blood testing and received a referral for an x-ray focused on my sacroiliac joints. My tests indicated elevated creatine kinase levels (218, exceeding the normal maximum of 200), while another assessed rheumatoid factor found normal levels. The HLA-B27 test for ankylosing spondylitis returned negative results. My recent follow-up with the rheumatologist five days ago revealed no significant abnormalities in the x-ray. Additional MRI tests for my sacroiliac joints and further blood tests for dermatomyositis and polymyositis were ordered. A follow-up appointment is scheduled in three weeks to discuss the findings of both tests. If anyone has insights or similar experiences to share regarding any of the topics mentioned, I would be incredibly grateful. I feel disoriented and eager to find ways to improve my situation, longing to return to activities I cherish. Thank you to anyone who takes the time to read my story or provide guidance; it truly means so much to me.

Answers (1)

8/25/2025, 5:12:27 AM

OpenHealth AI

Summary: Philip, it sounds like you are facing complex challenges with ongoing pain and potential nerve involvement in your elbows, neck, and back. It’s commendable that you've sought help and engaged with both orthopedic and rheumatological specialists. Let's focus on actionable steps you can take to manage your pain while working with your healthcare team.

Understanding Your Situation: From your detailed description, it appears that you have developed tendonitis in your elbows, possibly related to your intense physical activities, and you are also experiencing symptoms that may point to nerve irritation in your neck and upper back. The pain radiating into your legs and hips can add to the complexity, especially considering your family history of autoimmune conditions. It’s important to stay proactive about your health while being mindful of overaggressiveness in physical activities.

Next Steps:

1. Follow-Up Appointments: Ensure you attend all upcoming appointments, especially with your spine specialist after the lumbar MRI. They will be crucial in evaluating any potential issues that could be contributing to your lower back symptoms.

2. Structured Physical Therapy: Continue with physical therapy but consider refining your routine. Focus on targeted exercises that promote strength without overstraining the affected areas. Ask your therapist for a tailored program emphasizing flexibility, strengthening core muscles, and postural corrections to alleviate strain on your back and neck.

3. Pain Management Techniques:

   • Ice and Heat Therapy: Use ice packs to reduce inflammation in your elbows and heat pads on your neck and back to relieve muscle tension.
   • Pain Medication: Continue using meloxicam as needed for elbow pain but discuss with your doctor about other pain management options for your neck and back, especially if meloxicam isn't effective there.

4. Lifestyle Adjustments:

   • Ergonomics: Pay attention to your posture, especially when driving or working at a desk. Maintain a neutral spine position. Use adjustable chairs or lumbar rolls to support your back.
   • Activity Modification: Gradually restart activities like weightlifting and Jiu-Jitsu, listening to your body. Start with low-intensity or modified versions.
   • Regular Breaks: Incorporate breaks during activities that trigger pain. Consider a more gradual increase in physical intensity to facilitate better adaptation by your body.

5. Holistic Approaches: As you begin acupuncture, stay open to how it may help alleviate your pain. Additionally, consider mindfulness practices like yoga or meditation to help manage stress and promote relaxation and body awareness.

6. Stay Informed and Communicate: Keep a symptom journal to record activities that worsen or improve your symptoms. This information can guide discussions with your doctors and help you identify patterns.

Reassurance: It’s understandable to feel disoriented given the complexities of your symptoms and the variety of healthcare consultations. It's great that you are actively seeking solutions and support—continue to advocate for your health. Improvement takes time, but with a comprehensive approach, you can gradually work towards managing your symptoms effectively. If you have further questions or need clarification on any point, don’t hesitate to ask!