Treatment for ulnar neuritis + golfer's elbow, watching the $
October 4, 2020 9:03 AM   Subscribe

Trying to find the best approach to treat these conditions. I like to start from the position of "Pretend I am a professional athlete, and my career depends on resolving this. What should I do?"

I will try to keep it short. Due to half a lifetime of computer work, I have developed RSI, Repetitive Stress Injury, consisting of ulnar neuritis and golfer's elbow a.k.a, medial epicondylitis.

I have seen an occupational therapist, hand and elbow specialist, and a physical therapist. They don't talk to each other, and I've wasted time and money trying to figure out the most effective way to treat this.

I understand there are various interventions for both, including nerve Hydro dissection, PRP (injection of Platelet Rich Plasma), and a surgical procedure where the degraded parts of the tendon are removed.

Just seeing a specialist for an evaluation and suggestions cost at least $400, with insurance.

All this to say, what am I missing? Where do people start when they are trying to come up with a treatment plan? And importantly, how does one determine the effectiveness of a relatively new procedure, like PRP? Yes, I can go to Pub Med, but I'm not the best person to interpret studies.

And while I would rather not spend as much as a decent used car on treatment, resolving this problem is incredibly important to me, and I will put the money in if there is good evidence of effectiveness for a treatment.
posted by 4midori to Health & Fitness (5 answers total) 1 user marked this as a favorite
I'd say what you might be missing is the possibility of an overactive immune system.

For example, if you have a history of bacterial infections, particularly anything long lasting or chronic, you might have reactive arthritis manifesting as RSI. It would be nice if you knew your HLA type, since it's much more common with HLA-B27, but I've never talked with anyone who knew their immunotype (and don't know my own).
posted by jamjam at 11:25 AM on October 4, 2020

Have you seen a massage therapist?

I don't mean someone who's all-in on the music and warmth and low lighting (not that there's anything wrong with that, it just won't help here). I mean someone with granite hands and no mercy.

That's what fixed my RSI, the symptoms of which sound similar to yours.
posted by humbug at 12:27 PM on October 4, 2020

You are looking for bandaids to be permanent solutions to a cut you keep self-inflicting --"repetitive stress" is in the name. The solution is to remove the stress (or degree of stress at least) that you are submitting your hands and elbows. If rest, and reduced volume aren't options, I would submit that taking a very careful look at your posture and ergonomics, and tinkering with it until you find what works for you is perhaps a better place to direct your attention than focusing on an unlikely silver bullet treatment that allows you to keep over-stressing your arms.

In other words, if you were a pro basketball player with a sore wrist in his shooting arm, I'd be looking at the form of your jump shot; if you were a quarterback who kept diving into contact to get that extra yard, I'd be questioning your judgment on the field; etc. Get at the root of the problem.
posted by drpynchon at 6:08 PM on October 4, 2020

Response by poster: Thanks, All. To clarify, I have almost completely stopped the movements that caused the RSI.
posted by 4midori at 7:09 AM on October 5, 2020

You might try reading the Cochrane Review for your particular ailment. I tried ulnar neuritis and got a great overview of the validity of various treatment options for ulnar neuropathy at the elbow. You might need to switch to a different condition, but the overviews are helpful to understand what doctors (well, randomized controlled trials) think about treatment options for your particular ailment. I find this useful to get a high-level view, rather than PubMed which can get into the weeds with individual studies unless you find a good meta-analysis or systematic review.
posted by librarylis at 4:41 PM on October 21, 2020 [1 favorite]

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