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Written by: Paul A. Cook, MD

Elbow Injuries in Columbus

At some time in your life you may experience elbow pain. The most common cause of lateral elbow pain is lateral epicondylitis or tennis elbow. It commonly occurs after the age of 35 and occurs in both men and women. The outside of your elbow or lateral side is the focus or tenderness. Historically, the pain starts spontaneously and worsens with use. Overuse, or an increase in strenuous activity is often reported as the cause of initial symptoms.  Rest, ice and avoidance of aggravating activity are the first steps in treatment.  Because the cause or pathology is unclear, treatments are varied.  The proposed treatments range widely from neglect, therapy, braces, injections (local anesthesia, steroid injection, blood products), and surgery. It is evident by the number of treatments that no single treatment has overwhelming success. For this reason, initial treatment remains conservative, focused on neglect, activity modification, therapy, bracing and occasionally injections of steroid when pain is unrelenting. Greater than 80% of patients respond to conservative measures. Conservative treatment is divided into three phases.

Phase 1
1.)   Activity modification, avoid event that started the symptoms
2.)   Icing several times per day
3.)   Intermittent use of anti-inflammatory medication
4.)   Consider bracing

Phase 2
1.)   Begin therapy when initial symptoms decrease
2.)   Restore range of motion

Phase 3
1.)   Perform maintenance training program to prevent recurrence

This disorder can create severe frustration and impatience with the patient, physician and therapist.  Careful counseling and encouragement promote persistent conservative measures. At times, desperation ensues and surgery becomes the last resort.

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