Hi,
I am wondering if any of you have recurring pain at the back of elbows bilaterally? I have had cubital release surgery on my right elbow earlier this year, but the numbness in my ring and pinky has started again. I asked my Rheumy if this could be PsA related, she thought so, and said sometimes it is have to tell them apart. I was planning on getting the left elbow done, but if it will not help, might reconsider. The ultrasound imaging showed the right side ulnar nerve had ballooned to 25mm (almost an inch) in diameter, so we felt a release surgery was called for. It seems mechanical, as it mostly effects me lying down, either with my arms straight or bent, mostly when I am in a flare and fatigued.
The enthesis involvement is hard to differentiate from mechanical or OA conditions, but I have noticed less since being on Remicade, especially with my fingers and back.
Hey Jon,
I had cubital release on my left elbow 15 years ago. I ended up having to have a small corrective about 18 moths later as a small branch of the nerve somehow got attached to the scar. My left hand is almost as strong as my right and I still have a tiny amount of tingling in the fatty part of the palm where the nerve to the 4th and 5th fingers goes. But in general a success.
I have, though, the worst problems with enthesitis in both elbows. If I simply look at a heavy object, even a laundry hamper (which I admit I tend to overfill so I make fewer trips) my elbows puff up and look lumpy and they get very sore. I try to remember to wear a compression sleeve over my elbow and forearm if Iām doing something physical but I usually forget until itās too late. Fortunately the swelling goes down after slathering it with diclofenac cream for a few days.
I have started sleeping with a body pillow. This helps me keep my arms positioned in such a way that I donāt wake up with pins and needles in my fingers and swollen elbows. I also use it for my knees and itās long enough for that!
I think thereās a bit of mechanics and a bit of PsA for me. The mechanics make certain positions more/less comfortable. The positions Iād prefer to sleep in tend to stress the tendons too much. Oh and the nerve sometimes gets caught up in the shoulder although thatās easily fixed by changing positions. Iāve never really seen dramatic improvements of these symptoms with biologic medications so I think most of it is mechanical/postural with a large juicy dollop of PsA on top.
What Jane said @Jon_sparky . They tend to be pretty conservative in relocating the nerve with a cubital release and it frequently needs redone. Funny the subject just came up as Iām, off to Spokane tomorrow to schedule a redo of the one I had a year ago that is now failing as well as a partial redo of the shoulder replacemtn I had a few months later that has resulted in similar problems. It could also be a āneck issueā pretty common with the spondylitis version of PsA you have.
The entire US economy would likely collapse if Orthos one of the top two paying and most common specialties were to have a reduction in āactivityā at least they have cut back on knee roto-rooter surgery which was proven to be worthless (although the are doing over 20 (at 20 minutes a piece) this morning in our town of 50,000 which translates roughly1 million dollars into our struggling economy. At roughly 20 minute per procedure its a pretty good returnā¦ The folks in Washington DC should take note. FAR more succesful than anything they have come up with.
Every year after I meet my health insurance deductible and out of pocket maxes I wonder if I shouldnāt just sign up for hip replacement. I mean itās free to me after about April each year. And Iāll probably need one eventually. And now Iāll be reassured that Iām doing my part to stimulate the economy.
Well if you at all need it get it, you donāt want to have the best hip in the nursing home after years of sitting in the hotel while everyone else troped around the countrysideā¦
Well with the ballooned ulnar nerve it did seem like a necessary operation, I will try more conservative gliding exercises on the left elbow. I do have a moderate to severe nerve entrapment in my cervical C6-C7, but everyone thought better to do the easier surgeries first to see if they help.
The elbows have a lot going on mechanically due to years of overhead work lifting 30 lb fluorescent light fixtures over my head, they are much lighter design these days with electronic ballasts.
Maybe a MRI imagine of the elbows might be a good diagnostic tool before anymore surgeries. The US showed thinning of the tendon attachments, normally tied to tennis elbow, but could also be a result of PsA?
I have not thrown pots since I was dating a girl who did, but Iām surprised anyone can do anything after throwing a few. Tennis elbow on steroidsā¦
One of the marker symptoms my rhuemy said is tricep tendonitis. I had it so bad just above the backs of my elbows I could not lift a glass. It was so bad the doc could see the calcium deposits in the tricep tendons.
Well in my case it might be worth it Its endless shrimp month at the Red Lobster which just happens to be across the street from my ortho. if Mrs Lamb allows the cheddar bisquit its definitley a win!
I have permanently tender elbows. Itās PsA Iām sure. Luckily they rarely get any worse than that. Iād probably do better throwing pots than leaning on my elbows in a library all day, they no longer wish to prop me up.
One of my first inflammatory arthritis symptoms was elbow nerve pain (golf elbow, not tennis elbow.
Physical therapy (nerve flossing movements), elbow splints at night while sleeping, and nsaids helped me.
So what was the outcome of the cheddar biscuit story?
The Mrs. Lamb ordered a large basket of biscuits, I was so excited I almost
wet my pants. Then my sister wrapped them all up and put them in her purse
(They apparently planned it while I was at the docs.) While they enjoyed
extra Large FO FOO drinks I returned to the Docs office for an Arthrogram,
EMG, Spinal MRI and a Sonogram. They decided they want to do an open exam
of the shoulder and take tissue samples to look for any infection, and a a
C4-5 fusion. Still miffed over the biscuits I told them all to perform a physiologically impossible act and came home.
Thereās only one response to that Mr Lamb and thatās āpooā. So not fair.
Oops sorry I asked.
Just a minute now. Whose sister is she anyway? Shouldnāt she be on your side?
I suspect She was, just that Mr Lamb could not tell one side from the other at the time ā¦ 
My sis has been a practicing nurse for 57 years. She was a pediatric nurse practitioner for number of years. (Even had TV show) now she is the regional trainer/ trouble shooter for a nursing home chain. She used to do a lot of counted cross stitch, needle point and such before the PsA got her. Over her desk is a counted cross stitch that is gorgeous. Flowers etc. The saying: āNurse Ratched Was A Wimpā. Jen prolly has it Right.