Our Summary

This research paper discusses the issue of pain in the inner part of the elbow, a common problem that can be challenging for orthopedic doctors to treat. There are many potential causes including inflammation of the inner elbow, nerve irritation, ligament injuries, muscle strain, or snap in the triceps muscle.

Typically, good results are achieved by treating degeneration of the tendon originating from a group of muscles that flex the wrist and fingers. The primary approach is non-surgical treatments such as stretching, rest, changing activities, therapy, and injections.

If these non-surgical methods fail, other interventions could be tried, such as shockwave therapy, injections of platelet-rich plasma (a part of the blood that helps healing), prolotherapy (injections of irritant solution), and a minimally invasive procedure guided by ultrasound to cut the tendon.

Surgical treatments are tailored based on the severity of the problem, the involvement of soft tissues, and the presence of other diseases. The paper emphasizes that complaints about pain in the inner part of the elbow can have multiple causes and require a comprehensive diagnosis process.

FAQs

  1. What are the common causes of medial elbow pain?
  2. What are the nonoperative treatment options for medial elbow pain?
  3. When is surgical intervention necessary for medial elbow pain?

Doctor’s Tip

One helpful tip a doctor might tell a patient about elbow surgery is to follow the post-operative rehabilitation plan carefully. This may include physical therapy exercises, rest, and avoiding certain activities to ensure proper healing and recovery. It is important to communicate any concerns or changes in symptoms to your doctor during the recovery process to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for elbow surgery are those who have failed nonoperative management for medial elbow pain, such as stretching, rest, activity modification, therapy, and injections. Patients with conditions such as medial epicondylitis, ulnar neuritis, ulnar collateral ligament injury, flexor pronator strain, or snapping medial triceps may benefit from surgical intervention if conservative treatments are unsuccessful. Surgical treatments are usually considered based on the severity of the pathology, involvement of soft tissues, and presence of concomitant pathology. It is important for patients with medial elbow pain to undergo a thorough evaluation and have a broad differential diagnosis to determine the most appropriate treatment plan.

Timeline

Before elbow surgery:

  1. Patient experiences medial elbow pain, which may be caused by conditions such as medial epicondylitis, ulnar neuritis, ulnar collateral ligament injury, flexor pronator strain, or snapping medial triceps.
  2. Patient undergoes nonoperative treatment options such as stretching, rest, activity modification, therapy, and injections.
  3. If nonoperative management fails, intermediate interventions such as shockwave therapy, platelet-rich plasma injections, prolotherapy, and ultrasound-guided percutaneous tenotomy may be attempted.

After elbow surgery:

  1. Patient undergoes surgical treatment based on the severity of the pathology, involvement of soft tissues, and concomitant pathology.
  2. Patient may experience post-operative pain and swelling, and will need to follow a rehabilitation program to regain strength and range of motion.
  3. Patient may gradually return to normal activities and sports, with regular follow-up appointments with their orthopedic surgeon to monitor progress and address any concerns.

What to Ask Your Doctor

  1. What specific condition or injury do I have in my elbow that requires surgery?

  2. What are the potential risks and complications associated with the surgery?

  3. What is the expected recovery time and rehabilitation process after the surgery?

  4. Will I need physical therapy after the surgery, and if so, for how long?

  5. How successful is this type of surgery for treating my condition?

  6. Are there any alternative treatments or procedures that I should consider before opting for surgery?

  7. How many times have you performed this type of surgery, and what is your success rate?

  8. Will I need any special equipment or assistance at home during my recovery period?

  9. How long will I need to take off work or refrain from certain activities after the surgery?

  10. What follow-up appointments will be necessary after the surgery, and what signs or symptoms should I watch for that may indicate a complication?

Reference

Authors: Prabhakar G, Kanawade V, Ghali AN, Dutta AK, Brady CI, Morrey BF. Journal: Orthopedics. 2023 Mar-Apr;46(2):e81-e88. doi: 10.3928/01477447-20220719-06. Epub 2022 Jul 25. PMID: 35876779