Body

What is Golfer's Elbow?

Also known as medial epicondylitis, golfer’s elbow occurs when the tendons that attach the forearm muscles to the inside of the bone at the elbow become inflamed. Similar to tennis elbow, this inflammation occurs with repetitive motion and overuse.

Causes and risk factors

  • Repetition of movement
  • Overuse of the muscle
  • Weakness of the area
  • Hurried golf swing

Symptoms

  • Tenderness
  • Swelling
  • Muscle spasm
  • Muscle weakness
  • Inflammation
  • Cramping

Diagnosis and treatment

Most cases of golfer’s elbow can be treated without surgery with rest, ice, compression, and elevation. In addition, consider modifying your grip and/or the use of a larger grip, if your symptoms are stemming from a racquet sport or golf. If your symptoms do not respond after six to twelve months of nonsurgical golfer’s elbow treatments, your doctor may recommend surgery.

Nonsurgical treatment options include:

  • Short period of rest
  • Keep your elbow moving to prevent stiffness
  • Avoid aggravating activities such as lifting/forceful gripping
  • Short term nonsteroidal anti-inflammatories (NSAIDs)
  • Massage to painful area to increase blood flow and desensitize
  • Stretching exercises to maintain flexibility of the elbow and wrist
  • Topical anti-inflammatory/pain relief creams
  • Compressive elbow wrap
  • Wrist brace
  • Acupuncture
  • Physical therapy

The vast majority of cases will resolve with this type of treatment, but symptoms may last for 6 – 12 months or longer.

Body

The biceps muscle is the large muscle in the front of your arm that help to flex your elbow and rotate your forearm. The distal biceps tendon is the tendon that connects the biceps muscle to your forearm. This tendon is a common source of pain and injury. In most cases, pain in the distal biceps tendon is related to overuse and tendonitis. At times, however; the tendon may tear either partially or completely. Biceps tendonitis/tears are most common in men aged 30 – 60, but may occur at any age and either sex.

Causes and risk factors

  • Repetitive lifting/forearm rotation
  • Overuse from work/sports
  • Traumatic injury from the elbow forcefully extending against weight

Symptoms

  • Pain, swelling, tenderness in the anterior forearm/elbow
  • Weakness/pain with elbow flexion and/or forearm rotation
  • In acute injuries, patient will often hear/feel a “pop” and develop significant bruising in along the elbow and forearm

Diagnosis and treatment

In many cases, the diagnosis is based on your history, symptoms, and exam. Plain radiographs (x-rays) may be obtained. If there is concern for a tear of the biceps, then an MRI of the elbow will often be ordered. Treatment depends on the extent of injury to the distal biceps tendon.  Tendonitis and partial tears are generally treated nonsurgically.

Nonsurgical treatment include rest, ice, nonsteroidal anti-inflammatory drugs (NSAIDS), and physical therapy. Activity modification is key, including avoiding aggravating activities. Most patients with tendonitis and/or partial tearing of the biceps can expect recovery and return to normal activity with non-surgical treatment. If conservative treatment options do not relieve your pain, your orthopedic surgeon may discuss surgery.

A complete tear of your distal biceps tendon can be treated either surgically or nonsurgically.  Your orthopedic surgeon should discuss options and relative advantages and disadvantages of both treatment options. With nonsurgical treatment, most experience some loss of strength but overall good function. Surgical treatment can maximize strength and function. It entails reinserting the torn tendon to its normal attachment on one of your forearm bones.

Body

Did you dislocate your elbow?

Elbow dislocation is an uncommon injury for most. The injury most often occurs during a fall with an outstretched arm/hand taking much of the force of the fall, sending that force through the arm to the elbow joint. There are several different types of dislocations, such as simple, complex, and severe, wherein blood vessels and nerves in the joint area may be damaged as well.

Causes and risk factors

  • Loose ligaments
  • Shallow grooved ulna bone
  • Medical history
  • Fall onto hand with outstretched arm

Symptoms

  • Pain in the arm
  • Deformed looking arm
  • Awkward twist in the arm at elbow
  • Bruising
  • Swelling
  • Numbness

Diagnosis and treatment

Depending on the severity of the dislocated elbow, this may at times be treated as an emergency and hospital attention may be needed. Simple dislocations can be treated by keeping the elbow immobile with a sling or a splint followed by physical therapy to aide in recovery. For more complex injuries surgery may be necessary – especially if elbow bone fractures and ligament repairs are needed as well.

Body

What is cubital tunnel syndrome?

Cubital tunnel syndrome, or ulnar neuritis, is inflammation of the ulnar nerve in the arm that results in numbness or weakness in the hand. The ulnar nerve is more commonly knows as the “funny bone” and gives feeling to the little finger and half of the ring finger. It also controls most of the little muscles in the hand that help with fine movements and some of the bigger muscles in the forearm that help you make a strong grip. Left untreated, long term cubital tunnel syndrome can lead to severe weakness and disability in the hand.

Causes and risk factors

  • Constant pressure on ulnar nerve at the elbow or wrist
  • Extensive leaning on the elbow
  • A surplus of fluid in the elbow
  • Direct force on the inside of the elbow
  • Arthritis of the elbow
  • Past fracture or dislocation of elbow joint

Symptoms

  • Tingling and numbness in fingers
  • Ring and little finger “falling asleep”
  • Lack of strength in grip and finger coordination

Diagnosis and treatment

If the nerve is compressed for a long time, irreversible muscle atrophy in the hand can occur. It’s important to see your doctor if elbow nerve pain symptoms are present for more than six weeks or are severe. The majority of treatments for ulnar nerve pain relief are nonsurgical such as anti-inflammatory medicines, splinting, or bracing the arm or nerve exercises to prevent stiffness. If symptoms do not subside, there are surgical treatments such as cubital tunnel release and ulnar nerve anterior transposition that an orthopedic doctor may discuss with you.

Body

What is bursitis of the elbow?

Bursitis is an inflammation of the elbow, in the small sacs of fluid (bursae) that cushion and lubricate the areas between tendons and bones. Bursae are located throughout the body. In the elbow they cushion between the pointy bone at the back and the loose skin. Should this become irritated, additional fluid will fill up the bursa and create bursitis.

Causes and risk factors

  • Extended pressure on the tip of the elbow
  • Trauma to the elbow, allowing extra fluid to fill the bursa
  • Infection such as puncture or insect bite, allowing for bacteria to enter the bursa
  • Medical conditions such as rheumatoid arthritis and gout

Symptoms

  • Swelling
  • Pain at the tip of elbow
  • Paint with elbow movement
  • Irritated skin at infection site

Diagnosis and treatment

Diagnosis and treatment are important with this condition, as with any damage to the elbow. If the bursitis is not related to an infection, nonsurgical treatments such as rest, ice, elbow pads, change of activity, and anti-inflammatory medicines can be effective. Occasionally, this can be treated with aspiration of the fluid and injection of a corticosteroid. If symptoms do not resolve, your doctor may discuss surgical treatment.

Body

A traumatic brain injury (TBI) occurs when a blow to the head or penetrating head injury disrupts normal function of the brain. About 1.7 million cases of TBI occur every year, according to the American Association of Neurological Surgeons. A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. It is a serious condition that requires specialized medical expertise. Visit the St. Charles Center’s concussion center to learn more about our comprehensive program to assess, treat, and rehabilitate individuals who have had a concussion.

Symptoms

Symptoms vary greatly and may be mild, moderate, or severe. They may include the following:

  • Vomiting
  • Lethargy
  • Headache
  • Confusion
  • Paralysis
  • Loss of consciousness
  • Dilated pupils
  • Vision changes (blurred vision or seeing double, not able to tolerate bright light, loss of eye movement, blindness)
  • Cerebrospinal fluid (CSF) (which may be clear or blood-tinged) coming out of the ears or nose
  • Dizziness and balance problems
  • Breathing problems
  • Slow pulse
  • Slow breathing rate, with an increase in blood pressure
  • Ringing in the ears or changes in hearing
  • Cognitive difficulties
  • Inappropriate emotional responses
  • Speech difficulties (slurred speech, inability to understand and/or articulate words)
  • Difficulty swallowing
  • Body numbness or tingling
  • Droopy eyelid or facial weakness
  • Loss of bowel control or bladder control

Treatment

Treatment option may involve emergency care to prevent further damage to your brain. If you had a penetrating head injury, you may need surgical procedures to correct damage to tissues and your skull, as well as medications to control fluid and prevent seizures. When a violent blow to the brain or concussion has occurred, patients will get a customized plan to return to activity and restore function.

Body

Hydrocephalus is often described as water on the brain because it is derived from two words “hydro” meaning water, and “cephalus” referring to the head. It is a condition where excess cerebrospinal fluid (CSF) builds up within the fluid-containing cavities of the brain called ventricles. This fluid is necessary for brain function, but too much can increase pressure in the brain and damage brain tissue. Hydrocephalus can occur at any age, but is most common in infants and adults age 60 and older.

Causes and risk factors

Hydrocephalus is usually caused by a disruption of the drainage system for CSF. This colorless fluid is produced in the brain and carries nutrients to cells, absorbs shock, and regulates pressure. It normally flows through and around the brain and then down the spinal cord, where it is absorbed by the blood stream. When the drainage system does not work properly, the ventricles swell with excess fluid and this raises the pressure within the brain.

Symptoms

Symptoms very greatly, but some common symptoms include the following:

Infants/Toddlers:

  • Abnormal enlargement of head
  • Nausea/vomiting
  • Downward deviation of an infant’s eyes
  • Drowsiness
  • Irritability

Adults:

  • Headache
  • Difficulty in waking up or staying awake
  • Loss of coordination or balance
  • Vision impairment
  • Memory loss

Treatment

Treatment may involve implanting a device called a shunt. This allows the excess fluid to drain out of the skull and into another area such as the abdomen or heart, where it is absorbed in the body. Once inserted, the shunt usually stays in place for the duration of the patient’s life. Sometimes additional surgeries are required to revise the shunt system. This ongoing condition requires continued follow-up care, but any complications that arise can usually be dealt with successfully.

Body

brain tumor is a mass of abnormal cells. It can be located inside your brain or next to it. Tumors can cause a wide range of problems throughout your body when they grow and press harmfully against the brain tissue. There are many types of tumors that can either originate in the brain itself, or come from another part of the body and travel to the brain (metastasize). Brain tumors may be classified as either benign (non-cancerous) or malignant (cancerous), depending on their behavior.

Common types of brain tumors

Meningiomas are the most common benign intracranial tumors, comprising 10 to 15 percent of all brain neoplasms. These tumors arise from the membrane-like structures (meninges) that surround the brain and spinal cord. Often, meningiomas cause no symptoms and require no immediate treatment.

Schwannomas are benign tumors in adults that arise along nerves. They account for about 8% of all brain tumors and commonly occur at the nerve of hearing (the 8th cranial nerve), which travels from the brain to the ear. Although these tumors are benign, they can cause serious complications and even death if they grow and exert pressure on nerves and eventually on the brain. Common symptoms include one-sided hearing loss and buzzing or ringing in the ears.

Gliomas are the most prevalent type of adult brain tumor, accounting for 78 percent of malignant brain tumors. They arise from the supporting cells of the brain, called the glia. The glia help to keep neurons in place and functioning well.

  • Astrocytomas develop from astrocytes, star-shaped glial cells that make up the supportive tissue of the brain. They may occur in many parts of the brain, but most commonly in the cerebrum. Astrocytomas can appear in various parts of the brain and can develop in people of all ages, but they are more prevalent in adults, particularly middle-aged men. Symptoms vary, but headaches, seizures, memory loss, and behavior changes are common.
  • Glioblastoma (GBM)also develop from astrocytes, but these aggressive tumors tend to grow rapidly and spread to other tissues. They are generally found in the cerebral hemispheres of the brain. GBM is more common in people ages 50 to 70, and more prevalent in men than women. Because they form and grow so rapidly, the increased pressure in the brain will create symptoms such as headache, nausea, vomiting, and drowsiness.

Causes

Brain tumors can occur due to a variety of factors, both genetic and environmental. Some brain tumors may be caused by genetic mutations that are inherited from a parent, while others may arise spontaneously due to mutations that occur during a person’s lifetime. While the exact cause of many brain tumors is still unknown, ongoing research is helping to uncover more about the underlying factors that contribute to their development.

Risk factors

Patients with certain genetic conditions (i.e., neurofibromatosis, von Hippel-Lindau disease, Li-Fraumeni syndrome, and retinoblastoma) also have an increased risk to develop tumors of the central nervous system. Exposure to certain chemicals may also increase the risk of brain tumors. Patients who have received radiation therapy to the head are also at an increased risk for new brain tumors.

Brain tumor symptoms

Brain tumors are complex and symptoms depend on the type and location of the tumor. Physical symptoms such as headache, nausea, loss of balance, weakness in one side of the body, vision or hearing changes, and seizures may occur. Behavioral changes may also be symptoms, such as confusion, impulsiveness, difficulty thinking, or personality changes.

Brain tumor treatment

Neurosurgeons use imaging techniques such as MRI or CT scans to help diagnose a tumor, and sometimes a biopsy is necessary. The treatment options for brain tumors (whether primary or metastatic, benign or malignant) depend on the type, size, and location of the tumor, as well as the overall health of the patient. The most common treatments include surgery, radiation therapy, and chemotherapy, either alone or in combination. Surgery may be used to remove all or part of the tumor, while radiation therapy uses high-energy beams to destroy cancer cells. Chemotherapy involves the use of drugs to kill cancer cells and may be given orally or intravenously.

Treatment plans are tailored to each individual’s needs and may involve a combination of different therapies. Close monitoring and follow-up care are also essential to manage any potential side effects and monitor for recurrence.

Body

A cerebral arteriovenous malformation (AVM) is an abnormal connection between the arteries and veins in the brain. This tangle of blood vessels can restrict or alter normal blood flow. Typically, blood flows from small arteries to capillaries, then into veins of increasing size and back to the heart. In AVMs, the blood flows directly from arteries into veins without passing through capillaries. As a result, blood that is under high pressure is allowed to flow through thin walled veins, and can lead to a hemorrhage.

Symptoms

Most people do not experience symptoms prior to a hemorrhage. If there are any symptoms, they may include:

  • Headache
  • Whooshing or pulsing sounds in the head
  • Seizures
  • Muscle weakness
  • Memory, vision, or coordination problems
  • Numbness or tingling
  • Hallucinations

Causes and risk factors

AVMs are uncommon, with only about 2500 new cases identified each year in the United States. They occur more often in men than in women and neurological symptoms generally appear between the ages of 20 and 40. The exact cause of AVMs is unknown, but the malformation is believed to develop before birth in early development.

Treatment

In many cases, an AVM is discovered because of a hemorrhage, or because a CT or MRI was ordered for another reason. The decision to treat a cerebral AVM depends on its location, the risk of future complications if it is left untreated, and the extent of neurological deficits that may be associated with its treatment. There are a number of surgical techniques, which may be used in combination for the treatment of AVMs, including stereotactic radiosurgery (highly targeted radiation therapy), endovascular embolization, and microsurgical resection of the AVM. These are complex lesions and the decision how to treat depends on the location and risk of complications.

Body

What is Achilles tendonitis?

The Achilles tendon is the largest tendon in the body. It connects the calf muscles to the heel bone. Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of your lower leg becomes irritated and inflamed. Tendons, unlike bone, can’t repair themselves. After tendons are torn, they create a “scar like” attempt to repair themselves and that tissue does not have the same properties as the original tendon in terms of strength and elasticity.

Causes and risk factors

Achilles tendinitis can result from an acute injury or repetitive stress to the tendon.

  • Increase in the amount or intensity of physical exercise, doing too much too soon
  • Tight calves
  • Bone spur where the tendon attaches to the heel can rub against the tendon and cause pain (insertional tendinitis)

Symptoms

  • Pain on the back of the heel that worsens with activity
  • Pain or stiffness along the tendon in the morning
  • Pain after exercising
  • Swelling

Diagnosis and treatment

Treatment of Achilles Tendonitis in the acute stage, or just a few weeks after the initial injury, are often immobilized in a boot or cast. That allows the tendon a chance to rest and not be stressed, helping with inflammation, swelling and pain. For more chronic patients that have had ongoing Achilles pain, using ice and heat alternatively often helps decrease pain. Treatment early allows for better, quicker results.

Patients should seek treatment from an orthopedic surgeon that specializes in foot and ankle conditions when they have significant swelling, changes in the soft tissues, or persistent pain for several weeks.