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Proper functioning of the elbows (parts of the body that are also called the "upper extremities") – is necessary for daily activities. Writing, grabbing, driving, or lifting are severely limited if the muscles, nerves, joints, and bones in these areas are not working properly.

elbow-diagram-orthopedic-surgery

The design of the elbows and their daily use put them at risk for injury. In fact, according to the American Academy of Orthopaedic Surgeons, one-third of all acute injuries treated in emergency rooms involve the upper extremities.

Many injuries to these areas can be treated without surgery, and at BMC, physicians explore such options before considering surgery. However, there are times when surgery can be the better option. BMC surgeons are fellowship-trained in elbow surgery and have extensive expertise in caring for the elbows.

Conditions of the Elbow

Attached to the bicep muscle is the bicep tendon, which runs from the elbow to shoulder. A tear of the bicep tendon can occur, with symptoms ranging from a gradual or sharp, sudden pain in the upper arm, bruising, tenderness, immobility, or weakness. This tear can occur in the shoulder or the elbow. Injury and overuse of the shoulders and arms are the main causes of a tendon rupture. Common risk factors include age, lifting weights that are too heavy, shoulder overuse, smoking, and corticosteroid medications.

Diagnosing Biceps Tendon Rupture

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

X-Rays

A form of electromagnetic radiation with very high frequency and energy. X-rays are used to examine and make images of things such as the bones and organs inside the body.

MRI

This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be injected with a contrast agent for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implants.

Treatments for Biceps Tendon Rupture

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A class of medications, including but not limited to aspirin, naproxen, and ibuprofen, that are used for reducing pain and redness, swelling, and heat (inflammation) in arthritis and other painful inflammatory disorders.

Physical Therapy

Sometimes referred to simply as "PT," this is a type of rehabilitative treatment that uses specially designed exercises and equipment to help patients preserve, regain, or improve their physical abilities following injury, disability, disease, or surgery. Physical therapy can include therapeutic exercise, massage, assistive devices, and patient education and training.

Surgery for Biceps Tendon Tear

Though rarely needed, surgery may be required for patients with cramping of the biceps muscle or pain, or for those who need to regain their biceps strength completely, such as athletes or manual laborers. Surgery might also be considered for those with partial tears whose symptoms are not relieved with nonsurgical treatment. The goal of the surgery is to re-anchor the torn tendon back to the bone. A number of new procedures have been developed that involve only minimal incisions. Recovery may involve placing the arm in a sling, combined with therapeutic exercises to improve flexibility and strength. Physical therapy is particularly important following this type of surgery to achieve the best outcomes.

Tennis elbow, commonly known as "lateral epicondylitis," is the inflammation of the tendons on forearm muscles outside the elbow. Repeated, strong movement of the forearm like with tennis and other racquet sports, and activities like carpentry, painting, plumbing, and cooking can cause tennis elbow. Symptoms can increase over time and include pain and/or a burning sensation in the elbow area or weakness in gripping something.

Diagnosing Tennis Elbow

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

X-Rays

A form of electromagnetic radiation with very high frequency and energy. X-rays are used to examine and make images of things such as the bones and organs inside the body.

MRI

This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be injected with a contrast agent for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implants.

Electromyography (EMG)

A single-fiber electromyography measures the electrical energy traveling between the brain and muscles.

Treatments for Tennis Elbow

Physical Therapy

Sometimes referred to simply as "PT," this is a type of rehabilitative treatment that uses specially designed exercises and equipment to help patients preserve, regain, or improve their physical abilities following injury, disability, disease, or surgery. Physical therapy can include therapeutic exercise, massage, assistive devices, and patient education and training.

Bracing / Splinting

A splint, also known as a brace, is a rigid device that holds a body part in place so that it is unable to move. It is usually used as a treatment for a suspected fracture, sprain/ligament damage, or other injury. It can be applied by first responders in the event of trauma. Splints can reduce pain, aid in proper healing, and can also prevent further injury. They can be worn for several days or weeks to hold the body part in place for the duration of healing time.

Corticosteroid injections

Also known as cortisone shots, these are injections that may help relieve pain and inflammation in a specific area of the body. Cortisone shots are most commonly given into joints — such as the ankle, elbow, hip, knee, shoulder, spine, and wrist.

Extracorporeal Shock Wave Therapy

Shock wave therapy sends sound waves to the affected area of the body. These sound waves create "microtrauma" that promote the body's natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.

Surgery for Tennis Elbow (lateral epicondylitis)

This type of surgery may be an option for patients whose symptoms do not improve after 6-12 months of nonsurgical treatment. There are different types of surgical procedures for tennis elbow, which involve removing diseased muscle and reattaching healthy muscle back to bone. Based on each individual case, the patient's physician may recommend open surgery (which is the most common approach to tennis elbow repair), or arthroscopic surgery using miniature instruments and small incisions. Both of these options are usually outpatient procedures, with no overnight stay at the hospital. Recover after surgery can include the arm being placed in a splint for a short period of time, followed by rehabilitative exercises to regain flexibility and function of the elbow. Patients should ask their doctor when it is safe to return to athletic activity.

Osteoarthritis, or "wear and tear" arthritis, is a common degenerative disease that can affect any joint in the body. Osteoarthritis in the elbow happens when the cartilage that cushions the end of the bone wears thin or is damaged. Pain, immobility, and stiffness are the main symptoms. In the later stages of osteoarthritis of the elbow, patients may notice numbness in their ring finger and small finger - caused by elbow swelling or limited range of motion in the joint. As the body ages, osteoarthritis is quite common; it usually effects people over age 50. Past injury to the elbow may also cause osteoarthritis.

Diagnosing Osteoarthritis of the Elbow

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

X-Rays

A form of electromagnetic radiation with very high frequency and energy. X-rays are used to examine and make images of things such as the bones and organs inside the body.

MRI

This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be injected with a contrast agent for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implants.

Blood Tests

A common tool for disease screening, blood tests provide information about many substances in the body, such as blood cells, hormones, minerals, and proteins.

Treatments for Osteoarthritis of the Elbow

Nonsteroidal anti-inflammatory drugs (NSAIDs)

A class of medications, including but not limited to aspirin, naproxen, and ibuprofen, that are used for reducing pain and redness, swelling, and heat (inflammation) in arthritis and other painful inflammatory disorders.

Physical Therapy

Sometimes referred to simply as "PT," this is a type of rehabilitative treatment that uses specially designed exercises and equipment to help patients preserve, regain, or improve their physical abilities following injury, disability, disease, or surgery. Physical therapy can include therapeutic exercise, massage, assistive devices, and patient education and training.

Activity Modification

Physicians may prescribe general lifestyle changes to a patient, in order to help relieve the symptoms of their condition and improve their overall physical function and well-being. Depending on the medical condition being treated, activity modification may include: decreasing or increasing one's level of physical activity; added rest; beginning a new activity or exercise program; changing sleep habits; or modifying one's physical environment at home, in their vehicle, or at work.

Corticosteroid injections

Also known as cortisone shots, these are injections that may help relieve pain and inflammation in a specific area of the body. Cortisone shots are most commonly given into joints — such as the ankle, elbow, hip, knee, shoulder, spine, and wrist.

Glucosamine & Chondroitin Sulfate

Glucosamine is found naturally in the body. It stimulates the formation and repair of articular cartilage. Over-the-counter supplements come from animal sources. Chondroitin sulfate is another natural substance found in the body. It prevents other body enzymes from degrading the building blocks of joint cartilage.

Surgery for Osteoarthritis of the Elbow

When nonsurgical treatment methods have failed, surgery may be needed. If the elbow has limited wear or damage, or for patients with earlier-stage arthritis, arthroscopy – a minimally invasive surgical treatment – is an option. Arthroscopy involves removing any loose bodies or inflammatory/degenerative tissue in the joint. It also attempts to smooth out irregular surfaces on the joint. Multiple small incisions are used to perform the surgery: an outpatient procedure that is associated with rapid recovery. For joint surfaces that have worn away completely, joint replacement may be the best option. There are several different types of elbow joint replacement surgeries. The patient's surgeon can discuss the available options and determine the best surgical method for each patient.