Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.
Tennis
elbow is a condition that produces severe, burning
pain over the bone at the side of the elbow. The medical term for tennis elbow
is lateral epicondylitis. The pain results from inflammation of the tendon that attaches
muscle to the bony projection (called the epicondyle) on the outside of the
elbow.
Tennis elbow usually begins with mild pain and can worsen
over time. The pain is worsened by pressing on the affected area, by lifting
objects particularly with extension of the wrist. Using a screwdriver can worsen
the injury and cause pain. In advanced cases, even simple movements of the elbow
joint can produce pain.
While tennis elbow affects up to half of people who
participate in racquet sports, most people who develop tennis elbow do not play
racquet sports. Work activities that involve frequent use of the forearm muscles, such
as meat cutting, painting, plumbing, or weaving are also associated with the
development of tennis elbow.
How is the elbow designed, and what is its
function?
The elbow is
the joint where three long bones meet in the middle portion of the arm. The bone
of the upper arm (humerus) meets the inner bone of the forearm (ulna) and the
outer bone of the forearm (radius) to form a hinge joint. The radius and ulna
also meet in the elbow to allow for rotation of the forearm. The elbow functions
to move the arm like a hinge (forward and backward) and in rotation (twisting
outward and inward). The biceps muscle is the major muscle that flexes the elbow
hinge. The triceps muscle is the major muscle that extends the elbow hinge. The
outer bone of the elbow is referred to as the lateral epicondyle and is a part
of the humerus bone. Tendons are attached to this area which can be injured,
causing inflammation or tendinitis (lateral epicondylitis, or "tennis elbow").
The inner portion of the elbow is a bony prominence called the medial
epicondyle. Additional tendons from the muscles attach here and can be injured,
causing medial epicondylitis, "golfer's elbow." A fluid-filled sac (bursa),
which serves to reduce friction, overlies the tip of the elbow (olecranon
bursa). The elbow can be affected by inflammation
of the tendons or the bursae (plural for bursa) or
conditions that affect the bones and joints, such as fractures,
arthritis, or nerve irritation. Joint pain in the elbow can result from injury or disease involving any of these structures.
A pinched nerve can be caused of a variety of conditions, for example, carpal tunnel syndrome, herniated disc, sciatica, arthritis, spinal stenosis, trauma, and more. Common symptoms of a pinched nerve include pain, numbness, tingling, and weakness. Treatment of a pinched nerve depends on the cause of the pinched nerve.
In the U.S., more than 2,000 people are diagnosed with bone cancer every year. There are many types of bone cancer. The most common forms of bone cancer are osteosarcoma, Ewing's sarcoma, chondrosarcoma, malignant fibrous histiocytoma, fibrosarcoma, and chordoma. Pain is the most common symptom. Treatment usually involves surgery, chemotherapy, and radiation therapy.
Cellulitis is an acute spreading bacterial infection below the surface of the skin characterized by redness, warmth, inflammation, and pain. The most common cause of cellulitis is the bacteria Staph (Staphylococcus aureus).
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.
Fractures occur when bone cannot withstand the outside forces applied to the bone. Fractures can be open or closed. Types of fractures include: greenstick, spiral, comminuted, transverse, compound, or vertebral compression. Common fractures include: stress fracture, compression fracture, rib fracture, and skull fracture. Treatment depends upon the type of fracture.
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Septic arthritis, or infectious arthritis, is infection of one or more joints by bacteria, viruses, or fungi. Symptoms and signs of septic arthritis include fever, joint pain, chills, swelling, redness, warmth, and stiffness. Treatment involves antibiotics and the drainage of the infected joint.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
With osteochondritis dissecans, bone and its adjacent cartilage loses its blood supply. Though osteochondritis dissecans can involve any joint's bone and cartilage, elbows and knees are most commonly affected. Though there is no known cure, arthroscopic surgery is frequently performed to remove the damaged cartilage and bone tissue from the joint.
Corticosteroids are a class of medications that are related to cortisone, a steroid. Medications of this class powerfully reduce inflammation. They are used to reduce the inflammation caused by a variety of diseases. Cortisone is one type of corticosteroid. For the purpose of this review, "cortisone" is used interchangeably with "corticosteroid."
Corticosteroids can be taken by mouth, inhaled, applied to
the skin, given intravenously (into a vein), or injected into the tissues of
the body. Examples of corticosteroids include prednisone and prednisolone (given by mouth), methylprednisolone sodium succinate injection
(Solu-Medrol) (given intravenously), as well as triamcinolone,
Kenalog, Celestone, methylprednisolone
(Depo-Medrol), and others (given by injection into body tissues). This
article describes the role of cortisone injections into the soft
tissues and joints.
Tennis
elbow is a condition that produces severe, burning
pain over the bone at the side of the elbow. The medical term for tennis elbow
is lateral epicondylitis. The pain results from inflammation of the 
Chronic Pain RSS
Healthy Living Tips
