Elbow

I've tried conservative treatment for tennis elbow, but it hasn't helped. My doctor says surgery's the next step. He wants me to have an arthroscopic procedure. What's that?

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This procedure uses a special instrument, an arthroscope, that allows doctors to see inside the elbow joint without making long incisions. This "closed procedure" reduces the risks of surgery, such as infection and the development of scar tissue. It also appears to be very effective in getting rid of patients' symptoms.




I am having arthroscopy for tennis elbow. How soon will I be able to go back to work after surgery?

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If your results are as good as those in a recent study, you'll be back to work in no time. For the 16 patients in this study, most of whom had desk jobs, the average time before returning to work was six days. One 49-year-old woman was even able to work from home on the day of surgery. If you're in manual labor, it may take a little longer to get back on the job. The only patient in manual labor in this study took a month off after surgery.




I am having arthroscopy for tennis elbow. Will I be able to go back to sports after surgery?

in

If your results are as good as those in a recent study, you shouldn't have any problems getting back to sports. All 12 patients included in the study were eventually able to return to sports, with the exception of a 70-year-old man whose symptoms had lasted for 20 years before surgery.


You'll want to take it easy for at least a little while after surgery. Talk with your doctor or physical therapist about how to return to activities while ensuring a good recovery.




I've had pain in my elbow for years. Since getting treatment for it, I've heard my doctor and occupational therapist talk about the "carrying angle" of the elbow. What is so important about this angle, and are there differences in the elbow angles of males and females?

in

Imagine carrying a bucket with your arm at your side and your palm facing forward. In this position there is a slight outward bend at the elbow, the "carrying angle." Normally there is about a five to fifteen degree outward bend, five degrees for males and ten to fifteen degrees for females.




Whenever I bend my elbow, I feel a snap on the inside edge of the elbow. Could this be related to the numbness I feel in my hand?

in

The two may be related. The ulnar nerve runs through a tunnel behind the inside bump of the elbow, the medial epicondyle. This nerve passage is called the cubital tunnel. As the elbow bends, the ulnar nerve stretches. Sometimes the nerve will shift or even snap over the medial epicondyle. If the nerve has become irritated, it can cause numbness on the inside edge of the hand, including the ring and little fingers.




Could my age-old problem with golfer's elbow be causing numbness in my hand?

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Not likely. Golfer's elbow mainly causes pain on the inside bump of the elbow, the medial epicondyle. In severe cases, the pain may spread into the forearm. The fact that you feel numbness in your hand suggests there is more going on than golfer's elbow. Given the location of the ulnar nerve behind the medial epicondyle, along with your long history of golfer's elbow, your symptoms may be from a condition called cubital tunnel syndrome.




When it comes to tennis elbow, do steroid injections become less helpful the more of them you have?

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The more chronic a patient's pain, the more likely he or she is to need more intensive treatment, such as injections or surgery.


A recent study showed that the benefits of steroid injections decreased with the number of injections patients had. Patients who got relief after one injection avoided elbow surgery 88 percent of the time. But patients who had three injections avoided surgery only 22 percent of the time.




I've had pain along the outside of my elbow for a while. I've tried physical therapy in the past. My new doctor wants me to wear a brace and do physical therapy again. He thinks these things will keep me from needing surgery. Is he right?

in

Research shows that people with this condition--commonly known as tennis elbow--are twice as likely to need surgery if they've already tried bracing and physical therapy without success for their sore elbow.


A recent study looked at 97 patients with tennis elbow. Thirty-eight percent of the patients who had already been treated for elbow pain wound up having surgery, versus 19 percent of those who had not.




I need to have surgery for tennis elbow. My doctor says there are "open" and "closed" ways to do the surgery. What's the difference?

in

In open surgery, doctors make incisions in the skin to do the procedure. This allows them to open the tissues and see more of the elbow area. It may also increase the risk of problems from surgery, such as infection and the development of scar tissue.




Elbow Ligaments Hold Tight, Despite Heavy Strains of Athletics

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Keep bending a green twig back and forth, and it will eventually break. Keep pitching fast balls at 90 mph, and the shoulder joint will soon become stretched and loose. But what about the elbow joint? Do the ligaments that support the elbow loosen with the repeated elbow strains common to athletes?





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