What is Epicondylitis?
The epicondyle is the pointy prominence at the inside and outside of the elbow
Quickcare or ER?
Epicondylitis should be seen in a clinic setting.
It tends to be chronic and non emergent
Red Flags that will send you to the ER
- Severe pain
- Associated chest pain
- Numbness or loss of function to the arm
What will your doctor ask?Your doctor will want to know your symptoms. Remember, a symptom is your description of your condition. It is your story.
To better understand your symptoms, your doctor will want to know the following:
- How did the pain start?
- When did the pain start?
- Where is the pain?
- What makes it better?
- What makes it worse?
- Is there anything associated with it such as fever, swelling or numbness?
What else has your doctor asked about?
What will your doctor look for?Your doctor will look for objective findings during the exam. These findings are called signs.
Your doctor will want to make sure that the nerves and blood supply are intact.
Your doctor will want to make sure that the range of motion is intact.
You doctor will want to observe for gross deformity at the elbow itself. Quite simply, does it look out of place?
What is your doctor thinking?Your doctor will create a mental list of possible reasons for your signs and symptoms. This list is called a differential diagnosis
One consideration is involvement of a nerve called the ulnar nerve.…..This is typically associated with numbness of the ring and small finger.
Also, your doctor will consider a broken bone. It is possible to have a small chip fracture that may cause similar pain.
What is the treatment of Epicondylitis (Tennis Elbow)?
Like most musculoskeletal inflammations, anti inflammatories are key:
Rarely have I ever prescribed a narcotic for epicondylitis.
A elbow brace helps some but in not curative.
If there is no improvement, then I will send my patients to physical therapy. (3 sessions a week for 3 weeks)
How long will you have Epicondylitis (Tennis Elbow)?
Most of my patients have a significant recovery after 3 weeks.If after both the anti-inflammatories and physical therapy, then I will send them to a specialist called a Physiatrist. Sometimes medial epicondylitis treatment or lateral epicondylitis treatment requires injections of a steroid right into the elbow will bring the relief needed.
What has been your experience? How long did it take for you to finally feel better?
Let me tell you a Story…
One of our local factories is old, gray, and dirty. Kind of an eye sore to the image of California Clean. It’s a total through back to the early days of the Industrial Revolution.
The workers from the plant are always coming into the clinic for various injuries.
During one of my clinic shifts, I picked up the chart of one such employee. I read the history and physical. Pretty routine. 35 year old female factory worker with a sprained elbow.
When I walked in the room to see my patient, I was so surprised. I expected to see someone in work boots and overalls. Instead, she was a well-groomed young Hispanic lady with perfect hair and make up. On her lap was a designer purse. She sat up. Posture perfect. She carried a genuine goodness to her persona. And her looks….She looked better than the regional Avon lady.
“You work over there?” I asked as I pointed to the smoke stacks.
She did not know quite what to say
She made boxes for a living. For 8 hours a day, she used a glue gun. She and the glue gun were one. That metal tool never left her palm. It was almost an extension of her hand. Just the monotony of it all was mind-numbing.
I paused. I did not want to insult her. “Has anyone ever told you that you don’t belong there ……that you are not utilizing your talents in that factory?”
She responded, “Yeah, my sister tells me that all the time. She is trying to get me into selling Mary Kay.” She started to get tearful. “But my English…is not too good.”
In her mind, she created a barrier that simply did not exist. She did speak with an accent but her English was fine. And if accents were a limiting factor to success in America , then Arnold Swartzennegger, Henry Kissinger and Albert Einstein would have never made it here.
She did what so many of us do. She boxed herself in (no pun intended). She limited herself.
My advice was simple. Go back to school. Take the English classes. Develop and then share with the world that innate genius that God has given all of us. In her case, she needed to spread her genuine goodness.
I hope this helps
David Reyes MD