What Are the Most Common Causes of Humerus Pain?

Humeral epicondylitis is also known as student elbow, golf elbow. The epicondyle of the humerus is where the forearm flexors and pronator muscles attach. When you often flex your elbows and wrists and forearm pronation, the ulnar flexor muscles are in a tense contraction state, which can easily cause acute sprains or chronic strains at the attachment points of the tendons. Performing a throwing action, or supporting the ground with the palm of your hand when you fall, straightening the elbow joint and excessively eversion of the forearm can partially tear the attachment points of the forearm flexors and pronation circular tendons. Chronic strain often occurs in the wrist and elbow joints with repeated flexion and extension and forearm rotation, causing long-term wear and tear of tendons and ligaments. Hemorrhage at the tendon attachment point after injury can form hematomas, local trauma inflammation, swelling and pain caused by squeezing the ulnar nerve branch; if treatment is not timely or improper, hematoma mechanization causes local tissue adhesion, which can occur when flexing the wrist or forearm Pain is caused by the tension of the tendon, especially when the wrist is flexed actively and the forearm is pronation. Sometimes it can be radiated down along the ulnar side and the wrist is weak. The internal epicondyle of the humerus was markedly tender. At the same time, the ulnar flexor and superficial flexor muscles had extensive tenderness. The resistance wrist flexion test was positive. The pain increased during cold and nighttime.

Humeral epicondylitis is also known as student elbow, golf elbow. The epicondyle of the humerus is where the forearm flexors and pronator muscles attach. When you often flex your elbows and wrists and forearm pronation, the ulnar flexor muscles are in a tense contraction state, which can easily cause acute sprains or chronic strains at the attachment points of the tendons. Performing a throwing action, or supporting the ground with the palm of your hand when you fall, straightening the elbow joint and excessively eversion of the forearm can partially tear the attachment points of the forearm flexors and pronation circular tendons. Chronic strain often occurs in the wrist and elbow joints with repeated flexion and extension and forearm rotation, causing long-term wear and tear of tendons and ligaments. Hemorrhage at the tendon attachment point after injury can form hematomas, local trauma inflammation, swelling and pain caused by squeezing the ulnar nerve branch; if treatment is not timely or improper, hematoma mechanization causes local tissue adhesion, which can occur when flexing the wrist or forearm Pain is caused by the tension of the tendon, especially when the wrist is flexed actively and the forearm is pronation. Sometimes it can be radiated down along the ulnar side and the wrist is weak. The internal epicondyle of the humerus was markedly tender. At the same time, the ulnar flexor and superficial flexor muscles had extensive tenderness. The resistance wrist flexion test was positive. The pain increased during cold and nighttime.

Chinese name

Epicondylitis of humerus

Foreign name

internal humeral epicondylitis

Humeral epicondylitis I. Etiology and related diseases

The cause of epicondylitis of the humerus has not been fully identified. It is generally considered to be a degenerative change of the tendon and an inflammatory lesion caused by repeated tension of the common flexor tendon. The pathological changes include collagen fibers at the starting point of the pronation muscle of the medial epicondyle flexor Degeneration and proliferation of vascular fibroblasts, fragmentation and tearing of tendons, accumulation of vascular granulation tissue and tendon necrosis, accompanied by secondary inflammatory reactions. Humeral epicondylitis is related to a variety of factors. Common related factors include occupation, housework, sports trauma, and age and constitution.

Humeral epicondylitis II. Differential diagnosis

Diagnosis points: This disease is similar to the external epicondylitis of the humerus. It is mainly manifested as localized pain and tenderness in the medial epicondyle, and the local swelling is not obvious. If the forearm is rotated externally, the wrist is stretched back, and the elbow joint is straightened. Causes local pain to worsen. X-ray examination generally has no abnormal changes.

Those who need to be differentially diagnosed with epicondylitis of the humerus are:

1. Cervical Spondylosis

Nerve root-type cervical spondylosis can present as pain in the upper extremities and is easily confused with the disease. Radical pain in the upper extremity of the cervical spondylotic radiculopathy is radiation pain, there are sensory disturbance areas in the hands and forearms, and there is no local tenderness, which can be distinguished from this disease.

2.Humeral epicondylitis

Humeral epicondylitis also has elbow pain and limited movement, but it is mainly manifested as pain and tenderness in the epicondyle. When the forearm is rotated and the wrist is flexed, straightening the elbow joint can cause local pain to worsen. Straightening the elbow joint after the forearm is rotated and the wrist is back extended is obviously different.

Humeral epicondylitis III. Principles of treatment

1.Conservative treatment

The treatment of epicondylitis of the humerus is mainly based on conservative treatment. After rest, physical therapy, brace braking, oral non-steroidal anti-inflammatory drugs, topical medicine, muscle lateral training, prednisolone local injection, and medical education for patients After various methods of treatment, most patients disappeared.

2. Surgical treatment

Those who have failed non-surgical treatment can be treated surgically. The surgical anatomy is relatively simple. In terms of the choice of incision, if the ulnar nerve translocation may be considered before surgery, the incision can be moved to the humerus.

The rear of the medial epicondyle facilitates the exposure of the elbow. In short, open surgery is a reliable treatment method for refractory femoral epicondylitis. U-shaped tendon flap can not only thoroughly remove degenerative tissue, but also perform reliable repair to ensure the stability of the total flexor tendon. For patients with ulnar neuropathy, prophylactic release and anterior ulnar nerve are recommended.