Elbow Pain Treatment in New York

The elbow is a complex hinge joint that assists in arm flexion and wrist rotation. However, it is also especially susceptible to tendinitis, sprains, strains, and medial and lateral epicondylitis. Fortunately, physician-approved programs of exercise for elbow pain and elbow pain support can help the injured patient recover strength and range of motion in the injured area and resume a normal life.

Elbow Pain Diagnosis

The first step in treating elbow pain relief is determining its origins. There are several closely related conditions with painful symptoms that result from injury or degeneration of the elbow.

Tennis elbow, or lateral epicondylitis, is an inflammation of the lateral epicondyle, a small protrusion in the humerus just above the elbow joint to which are attached four muscles that help extend the wrists and fingers—the supinator, the supraspinatus, the triceps brachii, and the brachiordialis—and a muscle that extends the elbow, the anconeus. When the lateral epicondyle is damaged as a result of tennis elbow pain and swelling, it can seriously impair the ability of the muscles to flex and extend the lower extremities.

Tennis elbow pains result from damage to the extensor carpi radialis brevis (ECRB), a muscle in the forearm that stabilizes the wrist. The ECRB can be damaged from overuse through constant backhanded-stroking during tennis (hence the name of the injury), which places strain on the tendinous muscles, causing micro-trauma at the tendon’s source of origin in the lateral epicondyle. As micro-trauma accumulates, the patient experiences severe elbow pains and inflammation. This is not limited to athletes who play tennis, but may afflict anyone who repeatedly overloads the muscles in their arms or shoulders.

In order to obtain a proper elbow pain diagnosis, a patient should be able to pinpoint the exact area where the pain is emanating. Individuals suffering from tennis elbow will report pain above their elbow when gripping or flexing, and in other areas of the elbow and forearm. Tennis elbow typically only affects one arm, the arm that is used most prominently in high-intensity sporting events.

Closely related to tennis elbow is a condition called “computer elbow” or “mouse elbow” that affects many of the same muscles of the wrist and forearm. Computer elbow typically results from repetitive or forceful movements of the fingers, wrist, and arm, and can develop because of too much force applied over a prolonged period of time. Specific movements that may place an individual at risk of developing computer elbow are sudden throwing motions, stressful gripping in combination with inward or outward movement of the forearm, and attempting to bend the wrist and rotate the forearm simultaneously. Symptoms may include extreme tenderness on the outer side of the elbow, tenderness when bending the wrist while strengthening the elbow, and burning elbow pain that can become chronic if not soon treated. Because the symptoms of tennis elbow and computer elbow are so similar, a physician may be needed to make a proper elbow pain diagnosis.

Radial head subluxation, or “nursemaid’s elbow,” refers to a condition in which two of the three bones that comprise the elbow joint are torn out of alignment. This typically affects children between the ages of one and four whose bones have not fully developed, though it may occasionally be found in older children as well. Frequently the immediate cause of injury is excessive pull on the arms; this may occur when a child is being swung by the arms or dragged along by one arm at a hurried pace.

Olecranon bursitis is one of the more common causes of bilateral elbow pain, or pain in both elbows. A bursa is a fluid-filled sac situated between bones and soft tissues providing a lubricant that prevents excessive friction between tissues during movement. The olecranon bursa is located at the tip of the elbow, and while in most cases it remains flat, it may become swollen or inflamed when a patient is suffering from bursitis. Causes of bursitis include sudden, traumatic injury and repetitive, prolonged pressure on the tip of the elbow. Symptoms include elbow pain and swelling, bilateral elbow pain, and limited range of motion in the elbow joint.

Exercises for Elbow Pain

Elbow pain exercises for tennis elbow include what are called the “super 7,” seven basic exercises for elbow pain that are designed to strengthen the muscles in the forearm and increase flexibility. For patients suffering with straightforward symptoms, these exercises are designed to bring complete elbow pain relief within four to six weeks.

In the first exercise, the patient stretches the muscles that extend the wrist. He or she should straighten the arm and push the palm of the hand down until a stretch is felt across the top of the forearm.

Like the first of the seven exercises for elbow pain, the second is designed to stretch the flexor muscles. However, its method of operation is an exact inversion of the first. The patient straightens her arms but keeps her palms facing the ceiling. She then pushes the palm downward until it faces the opposite direction from her. When performing this exercise the patient may sit in a chair. Once she has become accustomed to it, she may use a light weight such as a book or a hammer. This should be done five times per session, three times a day.

In the third exercise for elbow pain, the patient holds a weight in his hand with the palm facing the floor. Then, slowly extending the wrists upwards till the palm faces the opposite direction, he holds this position for between two to five seconds and releases. As with the previous exercise, this one should be done up to fifteen times a day.

In the fourth exercise, as in the third one, the patient holds a weight in his hand. However, this time he turns the palm up towards the ceiling. Then, pulling the wrist towards his body, he holds the position for five seconds and lowers slowly.

The fifth exercise is an exercise for strengthening the deviator muscles, the muscles that move the wrists from side to side. Holding a weight or small pipe in her hands, the patient points the thumb upwards. She then moves the wrist up and down as though preparing to hammer a nail in place. In order for this exercise to be effective, the patient should be careful only to move the muscles of the wrist.

In the sixth exercise, the patient strengthens the pronator and supinator muscles that twist the wrist by holding the pipe in her hand with the thumb pointing up and then turning the wrist inward as far as possible (eversion) and then outward as far as possible.

Lastly, in the seventh tennis elbow pain exercise, the patient performs a massage over the area of soreness by applying firm pressure on the injured area.

Elbow braces, or tennis elbow supports, are especially designed for the treatment of tennis elbow and golfer’s elbow. Typically elbow supports are plastic and U-shaped, designed to fit the upper forearm for the purpose of applying pressure to the extensor tendons or flexor tendons, protecting the tendon while reducing the pressures placed on them when the wrist is in use. When pressure is applied to the muscles, the tendons are less susceptible to sudden shocks and injuries.

The brace can be adapted to different uses depending on whether the patient suffers from tennis or golf elbow. Wearing it under the forearm with the larger end applying pressure to the lateral elbow treats tennis elbow, while turning it around the other way so that it’s worn over the front of the elbow will treat golfer’s elbow. Occasionally a physician may instead recommend the use of an epicondylitis brace, a neoprene support with a strap around the upper forearm that can treat both conditions.

How Do We Treat Burning Elbow Pain?

For patients suffering from tennis elbow, computer elbow, and bilateral elbow pain, the New York DNR can provide assistance. We offer elbow pain support by guiding patients in moderating their activity according to the demands of recovery, drawing up a program of exercise for elbow pain designed to repair tendon and muscle dysfunction.

A patient suffering the early stages of elbow pain and swelling should seek help as soon as possible, because conventional and home treatments lose their efficacy as time passes without treatment and injuries may become chronic. Dynamic neuromuscular stabilization helps rehabilitate the elbow and surrounding tissues on inflamed nerves and restoring motion in the joints. We use DNS and manual myofascial manipulation to improve motor control in areas causing nerve impingement, lengthening the myofascial tissue to provide more freedom for the nerves.

In more severe cases, such as pain in both elbows, our physicians may recommend biological treatments such as extracorporeal shockwave therapy (ESWT), an advanced regenerative treatment that does not require a sub-cutaneous incision and is therefore less invasive than surgery. A set of pressure waves is used to stimulate metabolism and enhance blood circulation, regenerating and restoring damaged tissue to accelerate the healing process.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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