Introduction

Lateral epicondylitis, also known as tennis elbow, is a common cause of elbow pain. This condition typically develops from overuse, which causes repetitive damage to tendons that attach to the elbow. Interestingly, tennis and other racquet sports are not the only activities associated with lateral epicondylitis. It also commonly affects carpenters, weight lifters, auto-workers and other people performing jobs that involve repetitive motions.

Symptoms/Signs

Lateral epicondylitis typically presents as gradually worsening pain and tenderness over the outside (lateral aspect) of the elbow. Pain is often associated with activities. It may interfere with your ability to pick up objects or manifest as weakness of grip strength.

Evaluation

Your orthopedic doctor will review the history of your elbow pain and perform a physical exam. X-rays are used to evaluate for arthritis and other bony abnormalities of the elbow. Supplemental imaging tests, including MRI and ultrasound, may be used to help confirm the diagnosis and rule out other causes of pain.

Treatment

Non-Operative Treatment

80% to 95% of patients improve with non-operative treatment. This may include a period of rest or modifying your activities to prevent inflammation. Many patients benefit from bracing used to direct forces away from the injured tendon. Steroid injections may be considered in carefully selected patients. In addition, platelet rich plasma (PRP) injections have shown improved outcomes in several clinical studies.

Surgical Treatment

Your orthopedic surgeon will determine if surgery is indicated and discuss the risks and benefits with you. Surgery is typically performed in an ambulatory surgery center as an outpatient procedure. After the procedure, your elbow is temporarily immobilized in a sling to allow it to heal. Physical therapy is commonly utilized after surgery to help patients regain their strength and range of motion. The majority of patients have successful outcomes after surgery.

Introduction

An elbow fracture is a broken bone. There are 3 bones that make up the elbow: the humerus, the radius, and the ulna. Fractures typically occur due to a traumatic event. Attempting to catch your body when falling, sporting injuries, and direct blows to the elbow may result in an elbow fracture.

Symptoms/Signs

When a fracture occurs, patients experience severe pain, limited range of motion, swelling and often times bruising. Pain typically occurs with any elbow motion and may be relieved with immobilization. Some patients notice deformity of the elbow due to movement of the bones from their normal position. The severity of symptoms can vary greatly depending on the type of fracture.

Evaluation

Your orthopedic surgeon will review the history of your elbow pain and perform a physical exam. X-rays are the primary imaging technique used to evaluate the bones of the elbow and diagnose a fracture. Magnetic resonance imaging (MRI) and computed tomography (CT) may be ordered as adjunct imaging and can provide additional information related to your diagnosis and treatment.

Treatment

Non-Operative Treatment

The majority of fractures can be treated non-operatively. Cast immobilization is the most commonly utilized treatment. Non-steroidal anti-inflammatory medication is often prescribed to help with pain control. Sometimes, stronger pain medication is prescribed as well. Physical therapy can help patients regain their range of motion and strength after the fracture has healed.

Surgical Treatment

Some fractures do require surgical treatment and your orthopaedic surgeon will determine if surgery is indicated and discuss the risks and benefits with you. Surgery can be performed either in an ambulatory surgery center or a hospital depending on a patient’s general health. Surgery involves setting the broken bones and often times using a plate and screws to stabilize the fracture. Minimally invasive surgery and joint replacement are potential options for some fractures as well. After surgery, your elbow is immobilized for a period of time in a sling or cast to allow it to heal. Physical therapy is commonly recommended after fracture healing occurs to rehabilitate your elbow. Most patients are able to successfully resume their normal activities and even sports after surgery.

Introduction

Cubital tunnel syndrome is a compression of the ulnar nerve at the inside part of the elbow. It is caused by abnormal pressure along the nerve, which creates compression and restricts blood flow to the nerve.

Symptoms/Signs

• Irritability to the inner elbow
• Numbness and tingling to the small finger, outer ring finger and inner portion of the wrist.
• Muscle loss along the inner hand as well as between the thumb and index finger
• Weak grip

Diagnosis

A nerve study is a reasonable study to perform for several reasons. The nerve study helps in determining that the patient has cubital tunnel, how severe the nerve and muscle are affected, and the relative success that may be obtained following nonoperative or surgical treatment.

Treatment

Non-Operative Treatment

Cubital tunnel brace at night and during the day if tolerated to prevent elbow flexion. Avoid direct compression to the nerve at the inner elbow. Patients may take anti-inflammatories if tolerated without significant side effects.

Operative Treatment

Surgery may be performed to relieve symptoms by releasing soft tissue around the nerve to create more space and potentially moving the nerve in front of the elbow. Nerve transfer is an additional option to consider is severe symptoms of muscle weakness is present.