Elbow conditions are one of the most common afflictions affecting people of all ages. I have seen a tremendous rise in complaints of elbow pain with the various intense work out programs, such as CrossFit, that people are joining. Tennis and golfers elbow are the common names of lateral and medial epicondylitis, which are degenerative conditions of the muscle origins off the outside (lateral) or inside (medial) of the elbow. The condition results from overuse where partial tearing occurs of the common tendon off either side of the elbow. Significant stress arises at this site with heavy repetition gripping and lifting. The common names of tennis and golfer’s elbow arose from improper technique with using too much wrist motion in the stroke.
Presenting symptoms are common with both conditions. Pain originates on the inside or outside of the elbow and can radiate up and down the arm. Patients can usually point to one spot as the epicenter of their pain. Activities such as lifting a gallon of milk or coffee pot with an outstretched arm gives pain, and is worse with heavy gripping activities. Almost any repetitive activity from raking leaves to pruning bushes can cause these symptoms.
Treatment centers on offloading the stress on the tendon by rest and splinting. The best splint is a wrist brace such as a carpal tunnel brace because it is the wrist motion that activates the tendon. Using a wrist support while lifting keeps the wrist in neutral alignment which relieves the tendon. Forearm straps help and are easier to wear while lifting or playing sports, but are not as effective. Anti-inflammatory medications can help but must be used cautiously. Therapy such as active release from a chiropractor or health professional can alleviate symptoms. The most proven and effective treatment for significant symptoms is a cortisone injection. It can greatly reduce symptoms when combined with splinting and can provide long-term relief. Newer treatments are available such as platelet and stem cell injections which have helped certain qualified patients.
Surgery is the final option to alleviate symptoms. When nonoperative options do not control symptoms, I perform a specific surgery that targets the origin of the painful degenerative tendon seen in this condition. The good news is that the majority of patients can return to the activities that they love.
Overall, there is no reason to just put up with chronic elbow pain because there are many proven treatments available to treat these conditions. Most importantly, remember that an orthopedic surgeon, in this case a hand and upper extremity surgeon, is best able to properly diagnose and offer non-operative treatments prior to doing any surgery.
Dr. Zimmer is the founding director of Ohio Hand to Shoulder Center with locations in Beachwood, Chardon and Concord. For more information, or to make an appointment call 844-542-6363.
The Ohio Hand to Shoulder Center provides care for the hand, wrist, elbow and shoulder treating conditions such as fractures, sports injuries, arthritis, carpal tunnel syndrome, tennis elbow and many other painful disorders. Patients receive expert diagnosis, imaging and testing; advanced surgical services and rehabilitation. Both traumatic and arthritic conditions are treated with the latest reconstructive and arthroscopic techniques. Non-operative care is always the first line of treatment before considering any surgery.