Wrist or Hand Pain That Will Not Quit? What a Diagnostic Exam Checks First
Ongoing wrist or hand pain in Montgomery, AL? Learn what a diagnostic-first chiropractic exam checks first and when on-site X-ray is used. Call to schedule.
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If you're searching for a tennis elbow chiropractor in Montgomery, AL, you're probably past the point of ice packs and rest days. Elbow pain that lingers for weeks, especially pain that flares every time you grip a coffee mug, swing a racquet, or turn a wrench, is a signal that something structural needs a closer look. Before any care plan makes sense, the exam has to answer a more basic question: what kind of elbow problem is this, and where is it actually coming from?
That question matters more than it sounds. Outer-elbow pain and inner-elbow pain point to different tissues, different causes, and sometimes to a source that isn't the elbow at all. At Chiropractic Care Clinic in Montgomery, Dr. Elaine McNally DC starts every case the same way: find the cause first. Here's what that process actually checks first.
Tennis elbow, known clinically as lateral epicondylitis, shows up as pain and tenderness on the outside of the elbow, right where the forearm tendons attach to the bony bump called the lateral epicondyle. The hallmark complaint is a sharp or aching pain that worsens with gripping, lifting a bag, or extending the wrist against resistance.
Despite the name, many people with tennis elbow have never picked up a racquet. The condition is caused by repetitive stress to the wrist extensor tendons, and in Montgomery that stress shows up from a wide range of everyday sources:
The common thread is repeated strain on the same tendons without enough recovery time between uses. Over weeks or months, that repetitive load can outpace the tissue's ability to repair itself.
Golfer's elbow, or medial epicondylitis, is the mirror image of tennis elbow. The pain centers on the inside of the elbow, at the medial epicondyle, where the wrist flexor and forearm pronator tendons attach. People with golfer's elbow often notice pain when gripping, making a fist, or flexing the wrist, and some also feel tingling that runs into the ring and little fingers if nearby nerve structures are irritated.
Common contributors seen in Montgomery patients include:
It's tempting to assume that elbow pain on one side or the other is an open-and-shut case. In practice, lateral and medial epicondylitis can overlap, coexist, or be mimicked by other conditions entirely. Ligament strain, nerve entrapment at the elbow, and even early joint changes can produce pain patterns that feel similar to the patient but require different care approaches.
This is exactly why the distinction between outer-elbow and inner-elbow pain is treated as a clinical question, not a guessing game. A proper exam is built to tell the two apart, along with ruling out other explanations, before any recommendations are made.
When a patient comes in with elbow pain, the exam follows a structured sequence designed to narrow down the cause before anything else happens.
Patient history. The first step is understanding the pattern of repetitive activity: what the patient does for work, what sports or hobbies they're active in, when the pain started, and what movements make it better or worse. A plumber with inner-elbow pain and a desk worker with outer-elbow pain may both have epicondylitis, but the history helps confirm which tendon group is under stress.
Palpation of the epicondyles. Dr. McNally palpates both the lateral and medial epicondyle directly. Tenderness localized to one side versus the other is one of the clearest clinical markers for distinguishing tennis elbow from golfer's elbow.
Grip strength and resisted wrist movement testing. Because both conditions involve tendons that control wrist and finger movement, the exam includes resisted wrist extension (which typically reproduces lateral elbow pain) and resisted wrist flexion (which typically reproduces medial elbow pain), along with grip strength testing to gauge how much the condition is affecting hand function.
Range-of-motion assessment. The elbow, wrist, and forearm are checked for restrictions in motion, which helps determine whether the problem is isolated to the tendon or involves the joint more broadly.
On-site X-ray, when indicated. When the history or exam findings suggest something beyond soft-tissue strain, such as suspected joint changes, calcific deposits, or a need to rule out other bony causes of elbow pain, on-site X-ray imaging allows Dr. McNally to look at the joint directly rather than relying on guesswork. Having this diagnostic technology in-house means the exam findings and the imaging can be reviewed together, the same day, as part of one diagnostic-first process.
One of the most overlooked pieces of an elbow exam is checking the neck and shoulder. Pain that feels like it's coming from the elbow can sometimes originate elsewhere along the nerve pathway or the kinetic chain of the arm. Two patterns the exam specifically considers:
Because these referral patterns can mimic tennis elbow or golfer's elbow, the exam includes a check of neck and shoulder motion and nerve function alongside the elbow-specific testing. This isn't a diagnosis made on the spot. It's part of the systematic process of ruling things in or out before any conclusion is reached.
Lateral epicondylitis, medial epicondylitis, and referred pain from the neck or shoulder can all present with similar complaints of elbow discomfort, but they are not the same problem, and they don't respond to the same approach in the same way. Starting a care plan before confirming which of these is actually present risks addressing the wrong tissue entirely.
That's the reasoning behind a diagnostic-first approach: history, palpation, strength and motion testing, and imaging when indicated, all completed before any hands-on care begins. Once the exam findings point to a clear picture, care at Chiropractic Care Clinic typically draws on a multi-modal approach, which may combine chiropractic adjustment with other non-invasive therapies aimed at supporting the affected joint and surrounding tissue. The specific combination depends entirely on what the exam finds, not on a one-size-fits-all protocol.
If you're active in racquet sports and dealing with outer-elbow pain, it's worth reading more about how repetitive strain injuries from tennis, pickleball, and similar activities are evaluated on our sports injuries page.
What is the difference between tennis elbow and golfer's elbow? Tennis elbow (lateral epicondylitis) causes pain on the outside of the elbow and is linked to the wrist extensor tendons. Golfer's elbow (medial epicondylitis) causes pain on the inside of the elbow and is linked to the wrist flexor tendons. Both can result from repetitive gripping or wrist motion, whether from sport, work, or daily tasks.
Can tennis elbow heal on its own? Mild, early-stage irritation sometimes settles down with activity modification and time. However, elbow pain that persists for several weeks, keeps returning, or limits grip strength is a sign that the tendon isn't recovering on its own and a proper evaluation is worth pursuing before the pattern becomes chronic.
When should I see a chiropractor for elbow pain versus wait it out? If pain has lasted more than two to three weeks, interferes with work or daily gripping tasks, or keeps coming back despite rest, it's reasonable to have it evaluated. An exam can also rule out neck or shoulder referral pain, which won't improve no matter how much the elbow itself rests.
Does a chiropractor treat golfer's elbow too? Yes. The diagnostic process for golfer's elbow follows the same structured approach as tennis elbow: history, palpation of the medial epicondyle, resisted wrist flexion testing, range-of-motion assessment, and imaging when indicated, before any care recommendations are made.
Elbow pain that doesn't fade with rest deserves more than a guess about which side it's coming from. Whether the pain is on the outside of the elbow, the inside, or possibly referred from the neck or shoulder, the exam process is what separates an accurate diagnosis from a repeat cycle of symptoms. If persistent elbow pain has been slowing you down, consider scheduling a diagnostic exam with Dr. Elaine McNally DC at Chiropractic Care Clinic in Montgomery to find out, from source, not symptom, what's likely driving it. Call (334) 997-7463 or request an appointment online to schedule your exam.
