Question:I've been told my elbow pain and catching are caused by a piece of cartilage getting caught in the joint. Is surgery my only option?
Most orthopedic surgeons will advise patients with elbow impingement to try nonoperative or conservative care first. A two or three month trial of drugs and/or exercise is always a good idea.
Antiinflammatories are the first choice. The doctor may advise over-the-counter ibuprofen or a prescription dose. Steroid injections into the area of discomfort give relief of symptoms in many patients. Results may be permanent or only temporary.
Activity modification is worth a try while taking the medications. Avoiding repetitive motions while the inflammation is getting under control may help. A short course of supervised physical therapy is also an option.
The therapist will help you avoid positions and activities that make your symptoms worse. Your posture will be evaluated and anything contributing to the problem will be addressed. Exercises to maintain and improve strength and range of motion without increasing symptoms will be offered.
If none of this helps or only gives minimal relief from symptoms, then surgery may be the next step. The surgeon will remove the troublesome tissue. There's usually a rehab program after surgery. Modalities to control pain while increasing motion will be followed by specific exercises to regain strength.
Talk with your doctor about what options are best in your case. Express your interest in avoiding surgery and ask about conservative care. Give it at least three months before deciding the next step.David H. Kim, MD, et al. Arthroscopic Treatment of Posterolateral Elbow Impingement from Lateral Synovial Plicae in Throwing Athletes and Golfers. In The American Journal of Sports Medicine. March 2006. Vol. 34. No. 3. Pp. 438-444.
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