Nonsurgical Treatment of Elbow Injuries

Elbow injuries may occur as sports injuries, traumatic injury from a fall, and osteoarthritis. They are often difficult to treat and can be debilitating. Many of these can be treated with nonsurgical management.

Traditional nonsurgical management with rest, icing, elevation and NSAIDS plus physical therapy are very successful in the treatment of elbow injuries. The goal is to relieve pain and improve function.

Adjunctive therapies include steroid injections and Platelet-rich Plasma (PRP). Steroid injections offer short-term pain relief but have limited utility because they inhibit the body’s natural healing ability.

PRP is a natural product refined from your blood to concentrate platelets at much greater levels than exist naturally. The concentrated platelets are a good source of numerous biologically active molecules essential to healing in response to injury. PRP therapy enhances the body’s natural healing abilities to treat elbow pain and soft tissue injuries for long-lasting pain relief and tissue repair which shortens recovery. Studies have shown that PRP treatment in the elbow significantly improves pain and elbow function.

Diagnosis of your elbow condition

Dr. Jonathan Godin is an elbow expert and a sports medicine doctor who treats common elbow injuries and conditions. Based in Vail Colorado Dr. Godin treats elbow injuries in children and adults. After diagnosing your elbow condition, he will discuss with you all available treatment options including nonsurgical management of your condition and offer his recommendations.

Common elbow conditions amenable to nonsurgical treatment include:

• Tendon injuries. Overuse injuries of the elbow tendons include tennis and golf elbow that cause pain on the inside of the elbow.
• Ligament injuries. Ligament tears are common throwing injuries that damage the ulnar collateral ligament. Elbow sprains are injury to the ligaments around the elbow joint.
• Elbow osteoarthritis is caused by wear and tear on the cartilage between the bones that results in bone on bone rubbing and pain.
• Elbow bursitis is inflammation of the bursae that cushion the elbow joint.
• Nerve injuries. Radial tunnel syndrome is a condition where the radial nerve that runs down the arm and into the hand becomes compressed or stretched. Ulnar nerve entrapment called cubital tunnel syndrome is compression or stretching of the ulnar nerve which runs through the elbow.
• Elbow fractures. Injury to the bony tip of the elbow can result from a hard fall or auto accident.

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow is a chronic repetitive stress/overuse injury of the extensor tendons of the forearm that causes pain on the outside of the elbow. While it is called tennis elbow it can occur with many activities including tennis, other racquet sports, golf, weight lifting, and repetitive activity during work as well as recreation. Repetitive use causes microtears in the tendons.

It is a common overuse injury that typically affects people over the age of 40. Tennis elbow can cause significant pain, disability and affect your ability to do your job. Untreated the pain can last 6-24 months.

Nonsurgical treatment may include rest, icing, over the counter medications to reduce pain and swelling, bracing, physical therapy, steroid injections, and PRP therapy.  80-95% of patients find that nonsurgical treatment is successful.

Ulnar collateral ligament (UCL) tears

UCL tears are common in athletes. Nonsurgical treatment involves rest, icing, anti-inflammatory medications, splints or brace at night and physical therapy, followed by strengthening exercises.  The focus is on alleviating pain and swelling and strengthening and stabilizing the elbow.

Most competitive athletes can return to competitive throwing after 3 to 4 months of nonsurgical management.

Conservative treatment of partial thickness UCL tears involves rest, anti-inflammatory meds, progressive strengthening and an interval throwing programs. However, only 41% of athletes were able to return to play within 25 weeks. PRP treatment for low grade tears shows great promise when combined with physical therapy to help reduce recovery time and avoid surgery.

Ulnar Nerve entrapment (Cubital Tunnel Syndrome)

First line treatment for mild cases involves the use of NSAIDs to improve pain and reduce swelling around the nerve. Additionally, bracing and specific exercises may help. When nonsurgical treatment fails to improve the condition, surgery will be recommended.

Radial Tunnel Syndrome

Conservative treatment for this condition will include over the counter pain medications to reduce pain and swelling, steroid injections to treat inflammation and bracing or splinting protects the elbow while it heals. When nonsurgical management fails to provide relief after a three-month trial, surgery may be recommended.

Elbow arthritis

Early osteoarthritis is typically treated with nonsurgical management. Treatment includes OTC pain management, rest, icing, physical therapy and activity modification. Supplemental therapies include viscosupplementation, injection of hyaluronic acid into the joint to restore

Elbow bursitis

Nonsurgical treatment focuses on reducing inflammation and activities that irritate the bursae.

RICE, activity modification, anti-inflammatory medications and steroid injections.

Elbow (Olecranon) fractures

This is a fracture of the bony tip of the elbow. Simple fractures can be treated with elevation, icing to reduce pain and swelling, over the counter pain medications and wearing a splint for six weeks, followed by physical therapy.

When you or a loved one suffers with elbow pain, contact Dr. Godin at The Steadman Clinic in Vail Colorado to schedule a consultation.