Dr. Steven Rueda is one of the most sought after doctors for golfers elbow treatment in Palm Beach. Golfers elbow, also known as medial epicondylitis, is a condition affecting the tendon origins in the inner elbow. It receives the name “golfers elbow” as it is frequently seen in golf players.
Golfers Elbow Symptoms and Diagnosis
The symptoms arising from golfers elbow reflect the degenerative damage of the tendon insertion on the elbow. Some of the most common symptoms include:
- Pain in the inner elbow at the tendon insertion
- Pain with wrist resisted wrist flexion
- Pain with lifting and gripping
- Puffiness at the inner elbow at the tendon insertion
- Numbness and tingling of the small and ring finger
In some cases patients present with all of the symptoms, and in some cases only with some of them. The most common complaint is pain on the inner elbow at the medial epicondyle. Numbness and tingling are typical of cubital tunnel syndrome, and has to be ruled out during the workup.
The diagnosis of golfers elbow is given using a combination of history and physical examination. A typical history and examination performed by a hand surgeon are usually enough to diagnose the condition. An xray is typically needed to rule out any underlying elbow arthritis. Advanced imaging like MRI may be needed in some cases. Nerve studies may be needed to rule out cubital tunnel syndrome.
WHAT CAUSES Golfers Elbow?
The muscles that provide finger and wrist flexion have a tendon that originates in the medial epicondyle of the humerus. In golfers elbow, this tendinous origin undergoes degeneration leading to weakening and inflammation. As a result, patients experience pain at the location of the tendon origin with activities that cause wrist bending.
Golfers Elbow Treatment Options
There are five main ways to treat golfers: activity modification, therapy, splints, steroid injections, and surgery. Treatment begins with activity modification to reduce damage and irritation from overuse. This usually means reducing the intensity of the activity that triggers the symptoms (playing golf, lifting weights, etc).
Therapy and exercises are essential for a good recovery and usually are done together with activity modification. These focus on stretching and strengthening of muscles in the affected area. All these conservative treatments are recommended for at least 9 months prior to consider other options. Use of a wrist splint also provides significant relief in some patients.
Steroid injections are possible in patients with the condition. Dr. Rueda uses ultrasound guidance to place the steroid injection into the affected tendon origin. This medication helps reduce inflammation and therefore symptoms of pain. It is of critical importance to do this injection under ultrasound guidance to avoid damage to the ulnar nerve.
Dr. Rueda performs surgery for medial epicondylitis only in cases that have failed conservative treatment for at least 6 months.
Golfers Elbow Procedure
It is very rare to need surgery as most of tennis elbow symptoms improve with conservative treatment. The procedure removes the diseased tendon origin that is causing the symptoms thereby relieving pain.
A single incision centered on the inner elbow is used; this is Usually 5-6cms in length
RECOVERY AND DOWNTIME
Outpatient procedure. There is tightness, swelling and bruising for first few days after surgery. A splint is applied and removed in 5 days. Pain from tennis elbow improves about 2-3 weeks after surgery. Use of a removable wrist splint during laborious activity is encouraged for 3 weeks after surgery. Elbow and wrist range of motion are initiated immediately after surgery.
Most patients generally return to work in 1 week. Exercise is not allowed until 3 weeks after the surgery.
Why Choose Precision Hand Center for your Golfers Elbow Procedure?
Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for golfers elbow treatment. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in expert peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best golfers elbow treatment Palm Beach can offer.
FREQUENTLY ASKED QUESTIONS (FAQ)
Patients with classic history, symptoms, and exam who have failed conservative treatment are good candidates for the procedure. It is very rare to need surgery for this procedure. Dr. Rueda likes to wait at least 6-9 months prior to discussing any surgical treatment.
Complications are very rare in golfers elbow surgery; it is a very safe procedure. Some of the uncommon risks include infection and bleeding. There are also other major complications that are very unlikely including persistent pain and ulnar nerve injury.