Tendonitis

[rachelmanija]

Specifically, medial epycondylitis aka "golfer's elbow." Both elbows, worse in the left.

Yes, I am seeing a doctor and doing occupational therapy. However, it keeps flaring up, probably because it is not possible for me to not type for weeks on end (even if I cut out all non-work typing-- it's the work typing that's the big problem.) And when I do manage to cut down on typing, I still have to wash dishes and lift stuff and talk on the phone and otherwise use my elbows.*

Has anyone found any supplements or other forms of supplementary treatment that are helpful? I'm already taking glucosamine/chondroitin.

*I am considering getting a phone headset. Has anyone else found that this made anough of a difference to be worthwhile?

*I am very, very, very reluctant to try voice-activated software. For reasons that are too long to type out, it would also be impossible to use for at least sixty percent of everything I do, and would only cut out one of about forty steps of everything else I do.

Comments

[jonquil.livejournal.com]

Take paper cup. Fill with water. Stick popsicle stick in. Put in freezer.

Once a day, ice down your elbows along the tendon until they are cold to the touch.

Not fun, but it helps. (This was prescribed by my OT when I came down with my now-chronic tendinitis.)

[(Anonymous)]

Second the ice. Also you can just get those blue freeze things and take one out and wrap it in a dishcloth. Ice for 20 minutes at a stretch, no more--the blue things are no longer frozen by then.

[yhlee.livejournal.com]

Yikes. I'm sorry to hear that.

Have you had any luck with ergonomic keyboards (Kinesis (http://www.kinesis-ergo.com/) comes to mind but may be pricy--I've been coveting their keyboards for literally years)? Maybe a good keyboard would alleviate the problem a little?

[thomasyan.livejournal.com]

One word of warning. Maybe a simple split keyboard will work wonderfully, right out of the box, but some of the other configurations (e.g. keys in a bowl shape) might work well once you accommodate to them after an initial adjustment period to get used to new finger movements and positions. I imagine the pain could be the same or even worse at the start. This was the experience of a friend in school.

Also, make sure to check out the position of the non-alphanumeric keys. In school, I bought an expensive Adjustable Apple Keyboard, and the escape key (or something like that) was torture to reach and press. Plus, the Ctrl and Caps Lock keys were in today's standard position, which I hate, instead of the swapped position that I love. So I found someone with an old, cheap keyboard and did a straight swap. That was one of my best investments *ever*.

I see that rilina said she wrote drafts longhand, but when my RSI in my hand was really bad, writing hurt as much or more as typing. I write so little that writing tired and still tires out my hand very quickly.

[rilina.livejournal.com]

Writing longhand isn't necessarily easy for me, but for me the main benefit is that it offers variation from what I was previously doing. It was a break from all the keyboard use. Ditto for using a mouse: I mostly wasn't using a mouse before I got one; as telophase noted, something like a tablet or trackball might be better for your particular situation.

I see that other people have also mentioned braces; I don't know if they apply to elbow conditions as much as wrist conditions. (I was prescribed some for my wrists, but my elbows were treated with various types of PT, icing, and rest.) But they are a big help for wrist pain; if I forget to wear mine while sleeping for a couple nights, I can definitely feel the different in my hands and wrists.

[rilina.livejournal.com]

I was diagnosed with golfer's elbow, tennis elbow, and carpal tunnel this past fall when I had my RSI flare-up of doom. Like you, I couldn't cut down entirely on my typing (in my case, b/c of school and work). I realize you are probably doing some of the following, but here's what I've been doing with pretty good success:

- I use a cordless mouse and a separate keyboard with my laptop when I'm at home, and have set everything up so it's as ergonomically neutral as possible. Using my laptop too much, especially its trackpad, was a major culprit for me.

- I started drafting my writing longhand, and then only typing up later drafts on the computer. I also printed out drafts and did revisions on paper, rather than on screen.

I haven't tried any supplements.

- I don't use a phone headset, but I use my cellphone's speakerphone a lot.

- Regular icing. (My PT said I should be like a pitcher, and ice my wrists/elbows even when they weren't hurting.)

- When I'm at home and away from the desk (say, sitting on the couch watching tv or reading), I usually have a pillow on my lap so I can rest my forearms on it; it puts my wrists and elbows a more neutral position.

[chomiji]

Ow, sorry to hear this!

For this type of thing, icing it is indeed good. I'd do that after a session of work, or at least before turning in for the night. Warming it up (by working your elbows gently and maybe even by applying some moist heat) a bit before starting work may also help. The way I understand it, you want to increase blood flow in the affected tissue before you use it, and then reduce inflammation afterward.

Is your therapist covering issues such as your keyboard position?

[vom-marlowe.livejournal.com]

I got great results for my tendonitis with iontophoresis. I used the 'action patch' which had much longer staying power. You might be doing that already, I dunno know.

I'd er, plug my crazy random diet again, but I dunno if you're that desperate. It isn't perfect--as in I still do get pain--but I have almost zero tendonitis anymore. (The pain is at the surgery site, blah blah blah, and is related to rain/pressure changes and when I do stuff I'm not supposed to *looks shifty*.)

For the pain itself, I am loving loving loving my lidocaine patches. They're prescription, but worth asking about. Sometimes just being able to sleep pain free does great things for the body's ability to heal.

[sophia-helix.livejournal.com]

What diet? My mom has tendonitis that turned into some weird nerve damage condition, and has tried everything in the world (she's pretty much permanently disabled at this point). I'd love to have something new to share with her.

[vom-marlowe.livejournal.com]

It's called an anti-inflammatory diet. There are several versions out there; I do the one my mom got wrote down for me from her doctor's office waiting room. Basically, I avoid: nightshades (tomatoes, potatoes, eggplant, peppers); beef; dairy; corn; white stuff like bread (except rice); sugar/sweeteners/corn syrup; artificial colorings/additives, etc. I try to eat lots of: berries; brightly colored veggies and fruits and greens; whole grains; wild game meat (high in good omega fatty acids, since I am allergic to fish). I've heard several people tell me that they got good results just by cutting out the nightshades, so that might be a good place to start. It's PITA, but I can now walk my dog again. I bitch and moan, and still have some pain, but I can do it. Which is a pretty huge gain.

[telophase.livejournal.com]

As mine is in my wrists and not my elbows, these may not of use to you, but anyway.

If there is a way to immobilize your elbows while you sleep, try it. My wrist got better partly from wearing a wrist brace while sleeping, which provided a solid 6-8 hours in every 24 hours where the tendons were not being stressed from bending. If there's an elbow brace that will restrict your range of motion, try it. If the motions of your hands are contributing to the elbows, wrist braces might help.

Assess the ergonomics of all the various things you do, but especially typing. If it works better to have your elbows stretched out, or your forearms parallel to the floor, figure out how to prop your computer and keyboard to let you do that.

An ergonomic keyboard and a trackball instead of a mouse worked WONDERS for me. Also, my Wacom tablet allows me to switch to a pen-type tool for a while if I need to (usually when my thumb starts hurting). I have no idea if they have handwriting recognition software, but switching to a pen-type tool for scrolling and clicking and so on might help a bit. The smallest, cheapest Wacom is about $70-80. You probably don't want any other brand; they tend to suck. But I'd try a trackball first, since they allow you to keep your forearm still. There's also other devices like these (http://www.ergonomicresource.com/computermice.html). You can test my trackball, tablet, and keyboard when you're here, actually. They take a bit of getting used to.

I found that the mouse was the thing that really aggravated my wrist problem, due to:
--having to hold my hand in a cramped position
--making small, precise movements with my wrist
--resting my wrist on the edge of the desk next to the computer stand (it was a bad setup) compressed my wrist as I moused, which was bad for the tendons because it made them rub against each other and the tendon sheaths, making the inflammation worse in a vicious cycle.

Has little to do with my RSI, but I LOVE my phone headset. I can do all sorts of things while talking on the phone. I HIGHLY recommend one. I think that my wrist would be in more pain if I didn't use one, because the position I hold my hand in for the phone is similar to the one I did for the mouse. (I don't have a land line, just the cell, which is too small for comfort.)

[telophase.livejournal.com]

Aikido stretches are supposed to be good for the wrist and forearm, and my doctor recommended gently warming up with stretches before I did any work.

[thomasyan.livejournal.com]

The doctor didn't have any useful suggestions for supplements?

very, very, very reluctant to try voice-activated software

I dunno about voice-activated, but dictation software did not work well for me at all. So I think you are justified in feeling this way.

wash dishes

Is it literally dishes that are the problem? For me, it is pots and pans and big serving dishes and bowls that are awkward to wash by hand when my RSI flares up. Anyway, would paper plates and plastic utensils help a bit?

[maestrateresa.livejournal.com]

Headset, friend!
Stretching every 10-15 minutes when doing repetetive task, also friend!
Splints for resting, also good!

Teresa, OTR, retired

[raqs.livejournal.com]

Phone headsets seem stupid but they are actually teh bomb.

[sarge-5150.livejournal.com]

I don't know that the headset helped with the telephony since I don't use the telephone all that much (maybe once per day) but I find I prefer using a headset when I do.

[movingfinger.livejournal.com]

Everyone is giving you really good stuff to try, I don't have much to add beyond my own experiences with ripping good tendonitis. I'm sorry to hear you've developed such an annoying, frustrating condition. It can be beaten, though.

I had tendonitis before it was the cool thing. I found out that it wasn't arthritis when I went on a three-week hiking trip and my arms stopped hurting. So, rest really is best. If you have travel planned, plan it to eliminate any arm use like carrying (use a small backpack, don't lug luggage) and don't type.

Other than that, the only "supplement" that's helped in recurrals in our household is ibuprofen, 600 mg. The orthopedist said to eat it every 6 hours and he was right. It's a lot, but you're not taking it forever. You want to reduce the inflammation so that you don't get permanent nerve damage. Don't kid yourself into thinking it's better when it stops hurting. Don't drink (much, anyway) btw when you're taking this much ibuprofen, it'll hammer your liver.

Someone suggested braces. These are a good idea because it keeps you from lying on/crimping the affected area while sleeping, something it's surprisingly easy to do. They do help.

Your doctor and OT are probably helping you, but are you doing any upper body training with a PT-conscious or even PT-experienced trainer? There are a lot of upper-body strenghtening exercises that can alleviate tendonitis in the lower arm by training/enabling those upper muscles to do some share of the work. Often, especially in desk work, people overextend that lower arm part rather than do a more holistic reaching movement (for example). So ask your OT & doctor about improving your upper body tone, back muscles, and posture to relieve stress on the arms. It does work.

And when I do manage to cut down on typing, I still have to wash dishes and lift stuff and talk on the phone and otherwise use my elbows.*

Whoa. Stop right there. You have to wash dishes? You have another career as a dishwasher? Consider slumming it with paper plates and disposable cups for the duration. Plastic tableware. I am completely serious: if you notice that standing at the sink with your arms bent making small repetitive movements is exacerbating your tendonitis, then don't do that. Sure, you'll feel like some slob bachelor with the paper plate thing, but you want your arms back, right? Ditto, lifting stuff. What are you lifting? Any chance you don't need to do that? Any chance you could get someone to help? Wearing elbow braces conspicuously can assist with recruiting assistance!

The headset is a very very good idea! Try out several before choosing. Heads are differently shaped and a headset that leads to you, say, cocking your head a little to keep it from slipping off (such as one of my bosses bought for herself) will just cause more problems.

Other things that helped me: Adjust height of workstation and chair to keep arms in relaxed, neutral position. Raise monitor to eye level to prevent leaning, squinting, etc. Get better keyboard: this can just mean one with lighter action, as the punching-the-keys thing is very bad for the tendons. I feel the weirdly-shaped ones are overrated (by all means try one if you can get a loaner).

Very best of luck to you. You can and will beat this, it's a nuisance but it's solvable.

[hokelore.livejournal.com]

As others have already mentioned, ice is your friend.

Another thing to try, and it's actually hard to do for very long. Stand (or sit in an armless chair) and let your arms hang down at your sides. I knew an orthopedic surgeon who was big on this. He said people don't do enough of this, that if we did it more, there'd be less upper extremity ailments. I find it hard; I want to do something else with my arms. But I think it helps some over time, when I stay with it. Key word is "some".

I use naproxen or ibuprofen. They help a little, not much. I've heard of using essential oils, namely lavender or lemongrass. I can't tell that they work, but I when I have flare-ups, I dab them on anyway.

[kateelliott.livejournal.com]

Ouch. Good luck.

Ice - yes.

Headset - yes.


I particularly want to second the mentions of ibuprofen.

The one time I had severe wrist/tendon tendinitis (or something), I went on 600 mg ibu twice a day for three weeks (I probably cut down on aggravating activities as well), and that actually worked for me (this is the period when I briefly used voice activation software). Obviously it won't work for everyone, but it's worth a shot. I tolerate ibuprofen but not naproxen; others may have different tolerances.

I like the idea about hanging arms down.

[tacithydra.livejournal.com]

I have a headset and I am never going back.