Common Elbow Problems
The most frequent problem that I see in my office tends to be pain on the outside of the elbow, called lateral epicondylitis or tennis elbow. It’s cousin, which is pain along the inside of the elbow is called medial epicondylitis or golfer’s elbow. Both of these conditions respond favorably to nonoperative management with physical therapy, anti-inflammatories, bracing, and usually corticosteroid injections. Rarely these require surgery for resolution, but when necessary, I will perform this either open or arthroscopically depending on patient preference.
The tip of the elbow can also become inflamed or become painful. This is called olecranon bursitis. Patients will often complain of a golf ball swelling around the elbow. This too responds favorably to strong anti-inflammatories and immobilization, but also can rarely lead to a surgery where the inflamed bursa is resected.
Biceps injuries also occur around the elbow. When there is a complete avulsion of the biceps tendon (biceps tear), this will almost always require surgery to repair and reattach the tendon. This is one of the most common tendon repairs that I perform around the elbow. The presentation is usually very similar in that patients will describe feeling a pop while lifting something heavy, have pain in the elbow, as well as bruising around the elbow. Weakness in forearm flexion and supination (turning the palm up to the ceiling) often accompanies this as well.
Triceps injuries can occur as well, although these are much more rare than injuries to the biceps. These will often require surgery as well.
Nerve compression can occur in and around the elbow. These may create numbness and tingling in the forearm as well as into the hand. EMG (electromyography) and nerve conduction studies can be helpful although not necessarily completely accurate in establishing a diagnosis. Often times, nerve compression will require decompression of the nerve surgically.
Elbow arthritis can create a myriad of problems requiring surgery as simple as a nerve decompression with bone spur removal which can be performed open or arthroscopically; all the way up to requiring an elbow replacement. I perform all of these surgeries, however, elbow replacements are growing increasing rare due to the success of treatments for rheumatoid arthritis. Additionally, while a male manual laborer may develop arthritic elbows, an elbow replacement would be generally not recommended due to a lifelong lifting restriction.
Throwing athletes will also injure their ligamentous complex around their elbow; the ulnar collateral ligament. This can be repaired at times, but often requires reconstruction. That is what “Tommy John” surgery does. I perform ligamentous repairs and reconstructions for athletes all across the Seattle and Puget Sound region.
Finally, I perform fracture work around the elbow. These usually require surgery to better approximate the joint surface which will lessen the risk of arthritis and instability around the elbow. Fractures may occur from elbow dislocations or from a simple fall onto the elbow. Common injuries are olecranon fractures, and radial head fractures. The former nearly always require surgery, while the latter can often be treated non operatively.
Do I need Elbow Surgery?
If you think you need elbow surgery, contact my office at 206-368-6100 for an appointment with Dr. Schwartz or contact us to further discuss this. Often, elbow surgery can be avoided with appropriate physical therapy and anti-inflammatory regimens; and this is always my goal. However, if these treatments fail or are not indicated, rest assured that my expertise will recommend what is best for you and your elbow!