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Power chair elbow

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    Power chair elbow

    I have excruciating pain in my elbow on the same side I use the joystick. Never had it until I was in the power chair. Everything seems to be adjusted properly in terms of armrest height. I use a roho accessory pad on the affected side as well as having tried 1 inch of T foam covered by a plush sheepskin armrest. No effect whatsoever.

    EMG/nerve conduction studies or inconclusive due to my level of quadriplegia (C6/C7) and the inability to test affected peripheral muscles in the hand. MRI showed nothing that corresponds to the level of pain I have. Just some extensor tendon issues. One injection has already proven ineffective. I have a prescription for an ultrasound directed injection into the tendon.

    I feel it may be ulnar nerve compression, requiring a possible transposition procedure to move it away from where it is getting compressed.

    I believe the chronic compression resulting from a static position wherein the point of the elbow experiences constant pressure as well as the elbow is maintained in a constant flexed position may be the cause of the pain. However, in my experience, unless it is on the MRI, no physician is going to do a procedure. And it is also my experience that the comprehensive orthopedic exam is pretty much a thing of the past and even the most highly regarded surgeons often do not even touch you or put you through all of the tests for a given joint.

    Does anybody have the same problem?

    When my arm begins to ache it generally means I have pushed my controller back, Generally from hitting against something. Also I was getting hand pain. I held the controller stick between my thumb and pointer finger. I tried putting a small ball over the stick. My son saw it went to a auto parts store and got me shifter knob. Solved all of my hand problems


      I use the body point dome mushroom shaped on my joystick. It greatly alleviates the joint stress created by a joystick pushing back to the webspace between the thumb and index finger, which hyper extends the first thumb joint up from the wrist. I plan on trying a brace for elbow extensor tendinitis, commonly referred to as tennis elbow, however, with my lack of sensation over much of the elbow. I worry about skin problems from the strapping.

      Do any quads out there use any of these braces and if so which one?


        I get some really nasty tennis elbow from mouse usage. Crags What kind/shape of joystick are you using on your chair? I have used different ones over the years and have the best results from the u-shaped one. The BodyPoint u-shaped joystick I currently have is the only controller I have never had an issue with. I have smashed my hand going through narrow doorways with other types of controller when my hand was kind of on the side of the control box. Other controller shapes did not work well on rough pavement - my hand got jarred off the joystick, really not cool in the middle of the crosswalk.

        If my elbow is sore from too much mouse use, and it can swell quiet a bit then, my u-shaped controller does not bother my elbow unlike a more standard controller. I have used the basic tennis elbow compression type strap/brace. The ones I used have a soft pad on the area that compresses the tender area that swells. The compression does help a lot with the swelling. I keep an eye on it and if it looks like the area under the strap is getting red, like it is on too tight, I loosen it up and have been fine. I think what helps the most with for avoiding the elbow pain from driving my chair is my hand is in a fairly neutral position palm down on my controller.


          What causes me great problems is that I also have a severe amount of pain on the medial side as well. This could be from ulnar nerve compression in the notch right behind the medial epicondyle.

          I was also thinking that the chronic force required to maintain a palm down position (pronation) on the armrest could be causing problems at the tendon attachment points at the elbow. In my power assisted chair, my elbow is not even on the armrest and with the stroking motion it is completely off the armrest for brief periods.

          The pain is so severe I cannot fall asleep, stay asleep or get back to sleep after I wake up, resulting in anywhere from 1 1/2 to 3 hours of sleep a night. I typically lay awake from2 o'clock onward. This has been going on for years and I really don't know how much longer I can live with this. When I go to bed I take Neurontin, Ambien, over-the-counter anti-inflammatory, tizanidine, and thc:cbd medical marijuana oil. This would knock out most able-bodied people for nine hours. With me, it barely makes a dent.

          The EMG nerve conduction study has been problematic due to my level of injury as a quadriplegic and inability to utilize the hand muscles for electrical activity. In the absence of that, you're not confined a surgeon to do it decompression.

          I went for a special MRI recently supposedly showed nerve inflammation and that too was negative, though I think the change would have to be quite dramatic show up on the MRI. The MRI shows anatomy, not function. So I don't know how the MRI would pick up electrical conductivity changes, if they were accompanied by anatomical changes, such as inflammation.

          Also, the test is done in extension, whereas many people have elbow pain when it is in flexion, due to the tensioning of the ulnar nerve around the bony prominence on the medial side.


            I have hand issues, partly from my work and hand surgery prior to accident. But when my hand starts to ache I wear my hand/wrist brace at night. For me it works very well, I think allowing them to relax in a correct position. I do so also for my neck by wearing a cervical collar when neck is sore.


              I have a soft wrist splint I occasionally sleep in at night. When my elbows get really bad I get swelling from the tennis elbow right above the elbow bone, and swelling from what they called golfers elbow above the joint on the inside.


                I would encourage you to try different types of "covers" on top of the joy stick. That may take away the issue. I would also look at your positioning. If you continue to have the problem, maybe try going back to whowever prescribed the controller/chair and see if they have any ideas.
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.