Cycling UK Forum

I am going through a lot of arthritic pain and discomfort, starting with my thumbs and shoulders.
It has come on quite suddenly and makes rides of over twenty miles progressively more painful.
I ride an e bike with flat bars and Ergo control bar end grips.
I changed my thumb shifters for grip shift and that has made a vast improvement, but now I am getting pain from my elbow joints.
After a longer ride, my elbow joints become stiff and sore and I lose a lot of range of movement in bending the arm at the elbow.
I cannot touch the back of my neck for a couple of days before the swelling subsides.
Is this Arthritic degeneration too?
Any ideas?

I strongly recommend talking to your GP.

Jonathan

Thanks Jonathan. I did that and saw the Practice physio who reckons the problem is onset arthritis.
I'm interested here in hearing from any cyclists who have suffered the specific symptoms of pain and inflammation in the elbow joints.
To be frank, I am very worried by my experiences over the last few months and with yet another pain, I see my cycling pleasure seriously compromised. Any help from folk afflicted similarly is sought.

As Jonathan says, this probably isn’t the place for medical advice. …and I don’t have any experience which might help you directly.
However, a couple of questions…..
Does the elbow pain only come on when cycling, or do other activities also cause it?
If I understand you correctly cycling pains started in your thumbs and shoulders ; you changed from thumb shifters to gripshifters and now your thumbs and shoulders are OK but you get pain in your elbows?
Did you make any other alterations to riding position for example?
Do you have a left grip shift on the bike or just a right one, and are both elbows similarly painful?

arnsider wrote: ↑7 Nov 2023, 11:21am ...
I'm interested here in hearing from any cyclists who have suffered the specific symptoms of pain and inflammation in the elbow joints.
...

I have in one elbow but I suspect there are so many possible causes and symptoms that my issues are likely different from yours (hence no benefit it recounting my situation)(.

When I had problems walking and with walking boots after a bit of "not giving up with GP" they x-rayed the area and got a definitive diagnosis rather than the "maybe it's ...". My foot problem was arthritis and they refered me to a podiatrist who made up some shoe/boot inserts to help. Maybe there are support things that could help you once they identify the cause?

I would suggest highlighting to your GP that it is limitimg and preventing you from your activities and that you are concerned about liosing what health and fitness you have through having to become inactive .. (Not suggesting you lie or exagerate, just that if the pain is stopping or limiting your activities it will probably impact overall health). I know my own GP gets more concerned to diagnose with things that are limiting my physical activities and could cause secondary impacts.

Ian

I don't think the elbow issue sounds like arthritis. While arthritis can do things like that, I had a similar issue a couple of years ago, and was diagnosed with tennis elbow. I got a prescription for naproxen and a referral for physio. It cleared up pretty quickly with treatment.

I think it is worth talking again to your GP, and maybe push for some additional tests. For example, when the joint is swollen, they can take a fluid sample that will help understand the root cause of the problem. X-rays and ultrasound can also help identify the type and treatment options. They x-rayed my elbows as part of the diagnostic procedure.

Arthritis is typically a gradual deterioration. However, there is more than one type of arthritis, and some can be treated more easily than others. Some types can be triggered by an infection, and if you've had covid, that can have lingering effects, including reactive arthritis.

I broke both elbows in 1976 and suffer some,maneagable discomfort .They have some arthritis and occasional flare ups,the last being due to mucking out a horse.Twisting the elbow joint under load for any length of time will cause pain .The only helpful thing I could think of in your case might be to alter the way your elbows are loaded on the bike.Straight bars rotate elbows to a somewhat abnormal position whereas fore and aft bar extensions allow a more natural position and if they are located inboard of the brake/gear levers this allows an "in between" hand position.Along with dense foam,a very comfortable hand position can be achieved.Worth a try.

arnsider wrote: ↑7 Nov 2023, 11:21am ...
I did that and saw the Practice physio who reckons the problem is onset arthritis.
I'm interested here in hearing from any cyclists who have suffered the specific symptoms of pain and inflammation in the elbow joints.
To be frank, I am very worried by my experiences over the last few months and with yet another pain, I see my cycling pleasure seriously compromised. Any help from folk afflicted similarly is sought.

Thanks.

Can I just check the wording there... is that the onset of arthritis or osteoarthritis?

As suggested by others I recommend another discussion telling them how much this is interfering with your life, and discussing a plan for drugs, possibly including topical non-steroidal anti-inflammatories.

On position: please could you add some photos of your general riding position, hands on bars, feet on pedals, and of your lower arms and hands on the bars.

Jonathan

Vorpal wrote: ↑7 Nov 2023, 2:09pm I don't think the elbow issue sounds like arthritis. While arthritis can do things like that, I had a similar issue a couple of years ago, and was diagnosed with tennis elbow. I got a prescription for naproxen and a referral for physio. It cleared up pretty quickly with treatment.

I think it is worth talking again to your GP, and maybe push for some additional tests. For example, when the joint is swollen, they can take a fluid sample that will help understand the root cause of the problem. X-rays and ultrasound can also help identify the type and treatment options. They x-rayed my elbows as part of the diagnostic procedure...

My "issue" is tennis and golfers elbow (both sides!!!).Saw an NHS physio (or rather a 1st contact triage physio) and she did a few checks, the most surprising was arm on chair arm rest and lift one finger (can't remember which one) and it hurt - apparently a good test for tennis elbow (or golfers elbow, can't remember which way round as I have both).

Ian

Jdsk wrote: ↑6 Nov 2023, 11:42pm I strongly recommend talking to your GP.

Jonathan

Psamathe wrote: ↑9 Nov 2023, 9:48am
My "issue" is tennis and golfers elbow (both sides!!!).Saw an NHS physio (or rather a 1st contact triage physio) and she did a few checks, the most surprising was arm on chair arm rest and lift one finger (can't remember which one) and it hurt - apparently a good test for tennis elbow (or golfers elbow, can't remember which way round as I have both).

Ian

My GP diagnosed the tennis elbow. She referred me for x-ray to make sure that there wasn't something else going on (as well?)

Many thanks for that.
The change to grip shift did not stop the shoulder and thumb pain, though it made shifting easier on my right thumb.
My experience of the NHS is not particularly good here, since all I get are the words "Arthritis" and "Ageing" I'm told it's progressive and incurable and that only pain killers are the answer, but no suggestions of which, how many and a proper regime.
No investigation of the elbow problem and certainly no offer of Xray investigation or specific physio.
The knock on effects on lifestyle and mental health don't always occur to GPs, some of whom think that an active sporting life into seniority is just hedonism and we should roll over and slowly atrophy.

arnsider wrote: ↑12 Nov 2023, 7:25am ...
No investigation of the elbow problem and certainly no offer of Xray investigation or specific physio.
The knock on effects on lifestyle and mental health don't always occur to GPs, some of whom think that an active sporting life into seniority is just hedonism and we should roll over and slowly atrophy.

I've never had such investigations spontaneously "offered" - I have to persist, say I'm not happy accepting the impacts and there must be something that can be done to help.

Impacts of these problems on my activities have never "occurred" to my GP, I have to explicitly point it out with the impacts.

That most GPs wont automatically pursue investigations & options and don't appreciate impacts on activities might be because for 99% of their patients things like cycling and an active life just isn't there. Such aliments don't affect people whose main aim is pondering who's going to be eliminated from next weeks Strictly. Active patients tend not to see their GPs as often as those spending their days staring at plasterboard.

Persisting for something to help and pointing out consequences can be done politely and tactfully without confronting, etc. My theory is that for years GP don't know their patients and don't have time to read pages of historic notes about personal interests prior to each appointment. I've not seen "my GP" (the GP I and listed as a patient of) for many years - I see a Nurse Practitioner or a Registrar or rarely whichever GP happens to have an appointment free. Ironically this different person every appointment can help as different individuals have different experiences and a different attitude so whilst one GP might "we don't have time to investigate further" a different person might feel "as active as possible for as long as possible".

Ian

Well, that is good advice and I have written a note for my GP.
I find that these telecom appointments are not very helpful as GPs set the adgenda and only want to deal with one item at a time.
I get what you say about polite persistence and it remains to be seen if it works on my Doc.
The web is an absolute minefield of You Tube offerings from everyone from nutritionists down through Osteos and Chiropractors to Faith Healers. Every single Foodstuff is championed on one side and derided by someone else, take for instance Eggs and Tomatoes, White Bread and vegetable oils. If you type in Shoulder impingement in You Tube, you will get literally dozens of Physios, Chiros and Osteos all claiming their method works. Where do you start?

arnsider wrote: ↑5 Dec 2023, 8:31pm ...
The web is an absolute minefield of You Tube offerings from everyone from nutritionists down through Osteos and Chiropractors to Faith Healers. Every single Foodstuff is championed on one side and derided by someone else, take for instance Eggs and Tomatoes, White Bread and vegetable oils. If you type in Shoulder impingement in You Tube, you will get literally dozens of Physios, Chiros and Osteos all claiming their method works. Where do you start?

I wouldn't start with an unconstrained search of the Web. And I wouldn't start with YouTube.

The crucial criterion is why you would trust the author.

For initial advice I would start with the NHS (different in each country):
https://www.nhs.uk/conditions/

For evidence I would start with NICE and the Cochrane Library:
https://www.nice.org.uk/guidance/published?sp=on
https://www.cochranelibrary.com/?contentLanguage=eng

And for information about the biology and pathology I'd start with Wikipedia:
https://en.wikipedia.org/wiki/Musculoskeletal_disorder

Jonathan