Chronic tendonitis in thumb and elbows, and plantar fasciitis

by Ellen
(Calgary, Alberta)

I am a letter carrier for 20 years and I have been suffering with tenosynovitis in my right thumb and tendonitis in both my elbows and plantar faciitis as well,for the last 3 years.

My knees often ache after walking a lot. Is there a degenerative diagnosis that would cause this?

I have read through your website and it sounds like you actually know what you're talking about.


Joshua Answers:

Hi Ellen.

I don't know that it's 'degenerative' so much as you've been using your body exactly the same way for the last 20 years and it's finally catching up with you.

Tendonitis and Tenosynovitis are both the results of:

A. Repetitive motions over time
B. Muscle and connective tissue getting tighter and tighter over time.
C. Potentially not enough protein and other nutrient intake, like Magnesium (for Tendonitis).

I'm sure some doctor out there can find a degenerative diagnosis for you, but then what? Quit your job? Get onto prescription drugs?

Will that fix anything? It might reduce pain levels, but I wouldn't put my money on your structure reversing the pain dynamic is is slowly getting more and more locked into. Notice how it's been getting worse and worse the last three years?

You've read through my site so you've seen some/most of what I have to say about this.

So if there are any specific questions I can help you with, let me know.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Comments for Chronic tendonitis in thumb and elbows, and plantar fasciitis

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Feb 04, 2010
by: Ellen

Thanks for your answer. What do you know about prolotherapy? Is this an option that I should look into. I have been doing the ice dipping and stretches you suggest for 6 days now, with no improvement as of yet. Thanks for your time.


Joshua Comments:

Hmmm, no benefit at all from the ice dipping?

I get really curious when I hear that.

1. How many times are you ice dipping per day?

2. And you've Ice Dipped for 6 days...

3. Is the water COLD? Arctic cold?

I haven't seen much of prolotherapy. My mom does it for her thumb joints and seems convinced it's good, though she goes on a regular basis (which doesn't fit my criteria for a 'fix').

It is worth a shot, no pun intended. Depending on the doctor, the particular mix he uses to inject, and what exactly you have going on, it can be a good thing.

If you have issue in your hand, elbows, -and- feet, I would look more at systemic factors instead of spot specific factors. Look at both certainly, but there are various levels how the body operates.....

Feb 06, 2010
PART 3 - Tendinosis? - Chronic tendonitis in thumb and elbows, and plantar fasciitis
by: Anonymous

I have been doing the ice dips as you recommend, 10 times in a 2 hour period. As cold as possible, I add ice every time to make sure it stays cold.

For the past 3 years I have started my day with 3 advils. Now that I am trying to deal without painkillers at all, the ice does help in the moment but no lasting effects.

My feet are actually not so bad, I changed shoes, but my elbows are next to crippling. You said your mother goes for prolotherapy on a regular basis. How often is that? It looks very painful and I would think I need to be sedated to do it.

Thanks, Ellen.


Joshua Comments:

Hey Ellen.

I think my mom went once a month for a many months, and now it's down to once every 4 or 6.

And yes, she has to take a mild sedative. A needle into the thumb joint! Ouch!

So let's talk Ice Dipping.

How many times are you dipping? How many days in a row?

What -exactly- are the results? 1 minute relief, 5 minutes, dulls the pain, not at all?

You've been hurting a long time. Your Pain Causing Dynamic is ACUTE! Meaning, LOTS of pain enhancing chemical which can cause disabling pain.

I worked on a woman today that flew up from L.A. to see me. She had excruciating pain, had tried MANY other options, acupuncture, chiro, etc, and nothing had helped.

The point I want to make is, even though she was in near disabling pain, after some massage (squeezing the sponge, old stuff out, new stuff in) her pain was WAY down. She could roll her wrist with out exploding pain.

Get that pain enhancing chemical out, and that really changes things on a variety of levels.

I don't think she even had any actual injury. Not significant anyway. Probably Magnesium deficient, definitely Vit D deficient, and PACKED with pain enhancing chemical from Inflammation.

I suspect you're in the same boat.

We may have to shift you to something else, depending on your answers. It's possible you have a specific spot or two that is pumping out huge "I'm hurt" signals. We might need to target those.

Anyway, answer the ice dipping questions and let's go from there. The more specific you can be, the better.

Feb 08, 2010
giving up
by: Ellen

So you keep asking about the ice dipping. I did it for 8 days in a row. Do I have to do it for the rest of time?

Getting no benefit and doing more things that don't work is very depressing.

Worker's comp has now denied my claim that this injury is work related because they said that NOT working has NOT improved the injury and doing all the therapies the doctor has given has not improved anything.

My doctor at one time 3 years ago diagnosed neuropathic pain and prescribed anti-depressants. For the first injury I rested it for 3 years by doing different work and only part time. And pretty much still felt it, but was able to use it.

When I returned to full time it took only about a month and a half to get to a point of being unable to use my right elbow.

So I took over doing most things with my left arm. About two months of that and when I lifted a box I felt a tearing in my left arm. I have been pretty much off work since then.

So in essence everytime I re-injure it seems to be worse. One of my physiotherapists suggested a chronic pain clinic. So I get the feeling that because I'm not healing by traditional methods that now they're saying it's all in my head.

Thanks for your time, Ellen.


Joshua Comments:

Hi Ellen.

Yes, unfortunately, the medical profession has a tendency to say it's all your fault when they don't understand the problem and fail to help it.

Here's my big complaint with the medical community. So great, the dr. diagnosed you with 'neuropathic pain'. Ok, great. So what? HOw does that help you? Did s/he then look for the cause of the neuropathic pain? Nope.

Ok, so for 8 days in a row, you Ice Dipped in arctic cold water, 10 second dips a minimum of 8 times.

In my experience, when Ice Dipping has NO benefit at all after a week, when it doesn't lower the pain levels AT ALL, then there's two things to look at.

The first is nutritional deficiencies. Magnesium, B6, B12, Vitamin D.

Read through my Kerri's Free Chronic Pain Relief ebook. It talks about the above nutrients.

The other is, as you said, something worse than normal Tendonitis.

You said you felt something tear. If you have significant rip/tear injury, your body/tissue may still/now be sending acute injury signal, which makes the body constantly respond as if you are newly injured, thus the constant pain and constant output of new pain enhancing chemical.

Pumping out that chemical faster than the icing can counteract.

If you poke around, can you find the spot where you felt the tearing? How does it feel? Different than anything else?

Feb 19, 2010
by: Ellen

Extra-corporeal shock wave therapy. What do you know about this treatment. They claim 80% success rate.

I am looking into vitamin deficiencies. I have trouble thinking I could be very deficient. I do eat alot of spinach. That contains magnesium doesn't it? And because I work outside most of my day I would think that I get lots of vitamin D. As well I take a multi-vitamin daily.


Joshua Comments:

Hi Ellen.

What kind of multi-vit do you take? They're not all created equal, and most of them don't have much in them, much less very bio-available.

I assert that it's easier to be nutrient deficient that you'd think.

Also, north of 37 degrees latitude, north of San Francisco and Boston, from October to March, there's no Vitamin D in the sun.

So unless you soak it up in summer time, and don't shower with soap afterwords to wash all the Vitamin D production away....

Most everybody in the US is vitamin D deficient. Period.

Page on Vitamin D In Winter

And if you're gluten intolerant, that can set you up with Leaky Gut, which means you don't get all the nutrients of what you eat.

Low Vitamin D and low Magnesium are big players in chronic pain of various kinds.

So there's that.

Shock wave therapy, which is ultrasound, basically.

Sure, it's worth a try. I'm biased in that I only work with people that it didn't work for, so my view of whether it's effective or not is skewed.

Ultimately, other than the nutritional aspect, you need to A. Get circulation and B. Open up tight muscles and connective tissue structures.

If the ESWT will do that for you, great. Personally, I haven't seen it to be effective.

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