Elbow Pain – Ulnar Collateral Ligament Sprain

Ross Hauser, MDRoss Hauser, MD

A common cause of chronic elbow pain is an ulnar collateral ligament sprain. This ligament supports the inside of the elbow. It is responsible for holding the ulnar bone to the distal end of the humerus. In other words it enables the arm to flex, pivoting at the elbow. A patient’s complaint of pain on the inside of the elbow will cause a physician to examine the lateral epicondyle’s “sister,” the medial epicondyle and not look for the ulnar collateral ligament (UCL) sprain. For example, the diagnosing of the golfer’s elbow is often made without examining the ulnar collateral ligament.

A sprain of the ulnar collateral ligament refers pain to the little finger and ring finger. This same pain and numbness distribution is seen with aggravating the ulnar nerve. The ulnar nerve lies behind the elbow and is the reason why hitting your funny bone causes pain. Because most physicians are not familiar with the referral pattern of ligaments, patients with elbow pain and/or numbness into the little finger and ring finger are diagnosed with an ulnar nerve problem, Carpal Tunnel Syndrome. A more common reason is ligament laxity in the cervical vertebrae 6 and 7 or in the ulnar collateral ligament, not a pinched ulnar nerve.

A patient given the opinion that surgery on the ulnar nerve is needed for a pain complaint should obtain a second opinion from a doctor who is competent in the treatment of Prolotherapy. Surgery should be performed only after all conservative options, including Prolotherapy, have been attempted. Prolotherapy to the ulnar collateral ligament (UCL) is the most successful way to eliminate medial elbow pain

Golfer’s elbow or tennis elbow causes the elbow pain because the muscles that attach to these areas are attempting to repair themselves, causing inflammation. The treatment should not be to “anti-inflame,” as is the case with cortisone or with anti-inflammatory medications like ibuprofen. The correct treatment is to strengthen the muscle attachments which are inflamed due to the body’s attempt to strengthen the area. Prolotherapy to strengthen these muscle attachments is ‘very effective in eliminating chronic elbow pain.

Hand Pain

When it comes to hand pain, the most common problem involves the thumb because of its unique role in the hand’s function. Whenever a doorknob is turned, a screwdriver is used, or something is held, the thumb is part of the action. When typing, what part of the hand must continually hit the space bar? The thumb. Because thumbs have to work so much harder than fingers, it is usually the first to elicit pain. The thumb ligament that joins the wrist to the base of the thumb is called the radial collateral ligament, the same name as the ligament inside the elbow. The thumb ligament that joins the base of the thumb (the first metacarpal) to the succeeding joint (proximal phalanx) is the collateral ligament.

These two joints of the thumb, called the carpometacarpal (CMC) and metacarpophalangeal (MCP), are usually the first areas where pain is experienced. If the ligaments in these joints are not strengthened, arthritis will eventually occur. Arthritis starts the day a joint becomes loose. The looser the joint, the greater the chance it has of becoming arthritic. Arthritis in the thumb, as well as other phalangeal joints in the hand, are a major cause of disability, especially among the elderly. The progression of osteo-arthritis stops the day the ligaments become strong and are able to stabilize the joint.

In my opinion, Prolotherapy is the treatment of choice for patients suffering from stiff, sore hands or thumbs. Once the ligaments are strengthened, the pain and stiffness in the thumbs and fingers subside. Again, four Prolotherapy treatment sessions are usually all that is needed.

More Prolotherapy research citations can be found on this page on our site Prolotherapy research. To learn more about Prolotherapy and if it is the right treatment for your knee pain, please read our article Prolotherapy information for patients.