You may know medial epicondylitis as golfer’s elbow, while lateral epicondylitis goes by the more common name of tennis elbow. They’re soft tissue injuries caused by overuse and both can be quite painful. Get the help you need for these and other elbow injuries by contacting the physicians at Georgia Hand, Shoulder & Elbow in Atlanta and Marietta, Georgia. They're orthopaedic specialists with the expertise to relieve your pain and provide treatments that will get you back to your favorite activities pain free.
Medial epicondylitis (golfers elbow) is a painful condition that affects the inside of the elbow. It commonly occurs in active people after the third decade of life. The condition can be related to a sports injury but is often associated with work or daily activities.
Usually, the condition occurs slowly and may not be related to a single traumatic event. Most patients have pain over the inside of the elbow. It may be related to exertion and overuse.
A history and physical examination will be done. Occasionally, the patients will need x-rays of the elbow and in more complex cases, an MRI may be necessary to help differentiate the potential causes of medial elbow discomfort.
Non-surgical treatment strategies are effective for this condition and should be the mainstay of the treatment program. We recommend that treatment begin by instituting changes that are likely to be effective and have low risk. If these treatments are unsuccessful, then additional treatment alternatives will be discussed.
Treatments that HAVE BEEN shown to be effective:
Treatments that have HAVE NOT been shown to be effective
Because most patients improve with the non-surgical strategies we suggest that you pursue these alternatives for at least 6 months. If you do not experience enough improvement after 6 months of nonsurgical treatment, then surgery is a reasonable alternative treatment.
At the time of surgery, the degenerated tendon is excised and repaired to the bone. For the surgery to result in significant symptom improvement, the repair needs to heal securely to the bone. After surgery, we use a program of occupational therapy to allow elbow range of motion but protect the repair site. 8 out of 10 patients have significant improvement in their discomfort after this surgical procedure.
Lateral epicondylitis is a painful elbow condition that commonly occurs in people after the third decade of life. While it is called "tennis elbow", it occurs in any active person and is related to work, life and play. The condition occurs when small micro-tears occur in the muscles that originate from the outside of the elbow. Because the blood supply to these muscles is limited and because the injury can occur from so many daily activities, the repair process is often incomplete. When the repair process is incomplete, chronic inflammation occurs which is painful.
Usually, the condition occurs slowly and may not be related to a single traumatic event. It can be related to overuse. Most commonly, patients have pain over the outside of the elbow.
In general, the diagnosis is made by history and physical examination. Occasionally, regular radiographs (x-rays) are necessary. In more complicated situations, an MRI may be recommended by your physician.
Non-surgical treatment strategies are effective for this condition and should be the mainstay of the treatment program. We recommend that treatment begin by instituting changes that are likely to be effective and have low risk. If these treatments are unsuccessful, then additional treatment alternatives will be discussed.
Treatments that HAVE BEEN shown to be effective:
Treatments that have HAVE NOT been shown to be effective
Almost all patients experience significant improvement with proven non-surgical treatment strategies. You may have to make significant modifications in your daily activities (at home work and play). To improve, you will need to do stretching exercises. The treatment is usually a "tiered" program that starts with the more simple methods of treatment. Usually, you'll be seen in the office at 4 to 6-week intervals to check on your progress and make adjustments to the program. Eight to 9 people out of ten gain satisfactory improvement with the nonoperative treatment program. Diseases such as fibromyalgia, diabetes mellitus, and rheumatoid arthritis are associated with a poorer outcome.
Once under the care of a physician, patients may be referred for physical/occupational therapy. The therapist will instruct patients on the proper way to perform exercises that can be done at home. The modified Mills exercises are designed to slowly stretch the muscles on the top of your forearm. The exercises need to be done at least 4 times a day for 3-5 minutes at a time. All stretching exercises should be done slowly and held at the end of the stretch to ensure that the muscle groups are maximally stretched. Some patients need to apply heat prior to stretching and will need to use ice for 10 – 15 minutes after stretching.
Because most patients improve with the non-surgical strategies we suggest that you pursue these alternatives for at least 6 months. If you do not experience enough improvement after 6 months of nonsurgical treatment, then surgery is a reasonable alternative treatment.
At the time of surgery, the degenerated tendon is excised and repaired to the bone. For the surgery to result in significant symptom improvement, the repair needs to heal securely to the bone. After surgery, we use a program of occupational therapy to allow elbow range of motion but protect the repair site. 8 out of 10 patients have significant improvement in their discomfort after this surgical procedure.
