What is Elbow Tendonitis?
Elbow Tendonitis begins with pain and point-tenderness from inflammation of the tendon sheaths. If left untreated, the tendon sheaths can become thicker causing even more pain. The tendon can also pull out of its attachment site.
Types of Elbow Tendonitis
There are two types of elbow tendonitis.
Lateral Epicondylitis and Medial Epicondylitis
There is lateral Epicondylitis, also called “tennis elbow” and medial Epicondylitis known as “golfer’s elbow.” The names are misleading as both forms do not just happen to tennis players and golfers.
Causes of Elbow Tendonitis
In younger people, tendonitis is usually caused by sports injuries and other activity-type injuries and overuse. In older people, tendonitis is usually the result of overuse and repetitive motion activities. Office workers are prone to tendonitis. Computer operators and other employees who work using the same repetitive motions over and over again are prone to elbow tendonitis and carpal tunnel syndrome. Both carpal tunnel syndrome and elbow tendonitis are also found in people with rheumatoid arthritis and diabetes.
Repetitive motion and overuse of the arms and hands cause micro traumatic changes in the tendons such as microscopic tears, edema (swelling), bleeding and pain. The pain is usually point-tenderness pain in and around the area of the affected tendon. It is called point tenderness because the patient is very clear on the area of pain and can point directly to it. The dominant arm/elbow is most often affected, but in cases of rheumatoid arthritis and other disease entities, both elbows can be affected. One can experience tendon rupture if the condition is not treated.
Elbow Tendonitis Treatment
The recommended treatment for elbow tendonitis is usually to apply an ice pack to the affected area and rest the elbow.
Wearing a splint such as the Imak Adjustable Elbow Splint at night is often recommended to immobilize the elbow during sleep. This gives the elbow total rest.
Anti-inflammatory medications may help, you can either get them on prescription from your doctor, or I recommend the world’s best selling over the counter anti-inflammatory therapy Penetrex® .
Often corticosteroid injections are required, typically in a series of 3 given over a 3-month period of time. Corticosteroid injections will give almost complete relief of pain and inflammation. If injections are the course of treatment, the patient is encouraged to rest the elbow as much as possible after being injected and apply an ice pack for 5-10 minutes on and off to reduce the inflammation. heat treatment is also sometimes be recommended. If conservative treatment is not effective, surgery is a last resort and often solves the problem.
Elbow Tendonitis Surgery
If surgery becomes necessary, a lightweight elbow cast is worn for about 3 weeks, and then physical therapy is ordered. Physical therapy is very important to teach the patient how to exercise the elbow and how to begin using the elbow again without causing further damage. Massage of the elbow after surgery is also helpful. Warm, moist heat is used to “loosen” up the elbow before exercise.
Finding a surgeon who specializes in tendon repair of the elbow is extremely important. A surgeon who specializes in arm and hand surgery is recommended. A small incision (usually less than 1 inch) is made and the surgery is performed with microscopic instruments and micro cameras to see inside the joint. This is known as laparoscopic surgery. Healing time has vastly improved over the years, and the patient is usually back to work in less than 8 weeks.
In conclusion, elbow tendonitis is a very common arm condition, but it is also very treatable with excellent outcomes. One needs to follow the doctor’s orders completely and you will usually be back to normal in a relatively short period of time.
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Tim Allardyce DO MCSP SRP