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Arm pain i reached my arm back slightly and ...

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I need some help. I will try to keep this brief - I was at work and reached my arm back slightly ( would definetly say not over extended) and felt a stinging burning like pain on the inside of my elbow. Thought it was odd so I tried to stretch my arm a few more time but the pain was still there, so I looked at the area and noticed a reddish mark not to dark but still noticable. Finished my day at work careful not to fully stretch my arm. Get home and check it out in the mirror so I can see the underside and there is a light bruise (like bruising from the inside) from my elbow to my armpit. Now fast forward to almost a month later - I cannot straighten my arm completely with out feeling a burning type sensation, the higher I raise my arm above my head the less I can straighten it without major burning like feeling, it also hurt worse when I try and twist my arm when its straightened. Another key element is if you touch my arm it hurts like if you are pressing on a bruise kind of hurt and this runs from my wrist to my upper arm in a curving type pattern. I went to the orthopedic figuring I would skip the middle man (my primary md) and it was a total joke. He took x-rays but didn't find anything. (no kidding its not my bone I told him that but what do I know). Moved my arm around a bit and asked me if it hurt and of course the ways he had me move it, it didn't hurt. Felt around my elbow and came to the conclusion that there was nothing wrong. When I insisted it hurt and he wasn't even checking the areas that hurt he said I must have sprained it or pulled a muscle. When I asked about a torn ligament or something he told me impossible to do that take a tramatic injury. Basically he was telling me because I didn't phyiscally hurt it I can't really be hurt. So he told me to go to physical therapy 3x a week for a month and if it doesn't feel better come back and maybe he will order an mri. Really I need to go to therapy for something that he doesn't even know what it is. A pulled muscle that hurts from wrist to top of arm? I can carry things with no problems and do almost everything else without any pain or burning feeling except when I need to reach up for something or if I keep my arm extended for long periods of time like driving (I have been using my left hand to drive)

Any suggestions on what this could be? Could it really be a pulled muscle after a month with no improvement? I have not yet tried the physical therapy because it seems like a joke and I don't have the money to waste because the Dr. was to lazy to take the time and really listen to what I was saying.

Any imput would be appreciated!

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replied October 12th, 2012
Especially eHealthy

The ligaments about the elbow are very stout and do require significant trauma to tear or rupture them. So, it is probably not any of the ligaments in that area.

There really isn’t much besides muscles and bone in the arm (part from elbow to shoulder), expect for the nerves and blood vessels running through the area. The muscles are bound be fascial sheaths. Their tendons attach the muscle bellies to the bones. Then, you have some subQ tissue and skin. There just isn’t all that much there.

If is very possible that you did strain a muscle belly, which caused some bleeding into the area (thus the “bruising”). The bleeding sets of a small hematoma (collection of blood). To get rid of the hematoma, the body first consolidates and then resorbs it. Sometimes, the consolidation of the hematoma can cause some scar tissue to form. This can tether structures around it, thus causing some pulling when the area is stretched.

But, the only what to deal with the scar tissue, is to stretch it and then rebuild the muscles around it. It is easiest to stretch newly forming scar tissue and somewhat difficult to do it once the scar has matured. But, it is always worth a try.

Physical therapy does not have to be formal in house therapy. Some patients can do the exercises on their own. Usually, one visit to the therapist to learn how to stretch the appropriate muscles and fasical bands, and which muscles to strengthen, is all that is needed. But, the patient does have to be diligent and actually do the therapy on their own. Unfortunately, many patients just do not do the therapy on their own. At the beginning of therapy, there is usually a few days of soreness that then starts to get better. So the patients will try the exercises once or twice, they get a little sore, and they are not cured, so they just give up, not realizing that it often takes weeks to months of concerted effort for the therapy to work. We always tell the athletes; for every day they are out of practice it takes two days to get back.

But, if you do the therapy diligently, and it does not provide significant relief, then you may need an MRI to see if there is anything else going on.

Hope you get to feeling better. Good luck.
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