Introduction:
We bend our elbow various times a day whether it is to just to reach a glass of water or a mere handshake , a sudden pain in the elbow gives us a lot of discomfort and restrict us from doing our day to day activities. Elbow pain may have numerous reasons like if you happen to strain your elbow or if your happen to injure it but a sudden pain in the elbow can be referred from your neck.
How your neck and elbow is connected?
Our human spine is very interesting; the main function of our spine is to protect our spinal cord and to create movements in our hands and legs through our nerves. Our spine is made up of bones called vertebrae which are stacked on one another and through these vertebrae our spinal cord passes which give our nerves at each level. If your take an example of our neck (cervical) vertebrae which are 7 in number C1 to C7. These "electrical cables" travel through the spinal canal carrying messages between your brain and muscles. Nerve roots branch out from the spinal cord through openings in the vertebrae (foramen).
Referred pain in the elbow can be caused by numerous structures in the neck, shoulder and upper arm.
Degenerative changes in the disc or herniated disc can narrow the foramen the small openings on each side of the spinal column where the nerve roots exit and pinch the nerve root. This pinched nerve can give you pain in the elbow{1}.
Along with the pain in the elbow one can experience pins and needles and change in the sensations to the affected side of the arm. This type of referred pain to elbow always varies with your position of the neck or your neck movements.
How to manage it?
When it comes to managing the referred elbow pain one should remember to avoid prolonged activities or sustained postures. Keep your neck in sustained chin poke or forward head posture will create mechanical imbalances at your cervical spine and will in turn put load on your nerve root. To maintain any posture your muscles around the spine should be strengthen enough so that they absorb this mechanical load. So activation of the upper back and shoulder muscles and strengthening these muscles with resistive band and tubes is extremely important. Nerve sliding exercises to ease out the proper gliding movement of the nerve will help to decrease the symptoms of pain, tingling, pins and needles {2}.
If after a period of time physiotherapy treatment does not relieve your symptoms, your doctor may recommend surgery. There are several surgical procedures to treat this referred pain to your elbow. The procedure your doctor recommends will depend on many factors, including what symptoms you are experiencing, the location of the involved nerve root and whether your symptoms are continuous or they are intermittent {3}.
Prevention is always better than cure!
Avoiding sustained postures and including a proper exercise regime to maintain your fitness level will help to avoid these musculoskeletal problems.
Eat –Work-Exercise and Repeat!
References-
1] Eubanks JD. Cervical radiculopathy: nonoperative management of neck pain and radicular symptoms. Am Fam Physician. 2010;81(1):33-40.
2] Basson A, Olivier B, Ellis R, Coppieters M, Stewart A, Mudzi W. The Effectiveness of Neural Mobilization for Neuromusculoskeletal Conditions: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2017;47(9):593-615. doi:10.2519/jospt.2017.7117.
3] Okazaki T, Nakagawa H, Mure H, et al. Microdiscectomy and Foraminotomy in Cervical Spondylotic Myelopathy and Radiculopathy. Neurol Med Chir (Tokyo). 2018;58(11):468-476. doi:10.2176/nmc.oa.2018-0077
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