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Tennis elbow pain returns even after surgery! Help!!


Sent to Health Experts October 18, 2006 12:32 a.m.

I had tennis elbow surgery (open debridment) almost 5 months ago now. I have followed the treatment plan to the letter, but the pain has still returned. The surgeon gave me another cortisone shot to try and help with the pain and inflammation, but it doesn't seem to be helping. I was about to be discharged from physical therapy, but had to go back due to the pain returning. I'm very frustrated! What else can my surgeon/physical therapist do to help with this pain? More surgery? If so, what kind? What else besides Tylenol and ice can I do to reduce pain and inflammation.

Optional Information:
Female , Age: 30

Already Tried:
Ice, Tylenol, Cortisone shots, Acupuncture, physical therapy, surgery, heat, Ionto patched (24hr release), massage.
Customer (name blocked for privacy)
Status: Closed   Value: $30   
Answer
October 18, 2006 2:41 a.m. (2 hours and 8 minutes later)
ACCEPTED Check Mark

Some patients have persistent symptoms despite surgery, and from what you've written, you're one of these patients. You might benefit from a second surgery with more aggressive debridement of the diseased tissue of your ECRB (extensor carpi radialis brevis) muscle and decortication of the lateral epicondyle. NSAIDs (Motrin or Advil), a counterforce brace/splinting and/or steroid with lidocaine injections are usually helpful to relieve pain. It can take up to 6 months to achieve recovery.

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PictureDr. Hanson  -- Doctor (MD) -- 99% Positive Feedback on 819 Health Accepts
Diplomate, American Board of Quality Assurance & Utilization Review Physicians
Reply to Dr. Hanson
Sent October 18, 2006 7:58 p.m. (17 hours and 17 minutes later)

What does decortication of the lateral epicondyle mean? What does that surgery involve? I also have a question on "counterforce brace/splinting and/or steroid with lidocaine injections." Is the counterforce bracing the same as the braces for tennis elbow that you can buy in the stores (which wrap around the arm tightly just below the epicondyle area)?? And what is the difference between cortisone injections and lidocaine injections? Other than this, your answer was extremely helpful and I will most definately "accept" your answer.
Customer (name blocked for privacy)
Answer
October 18, 2006 9:29 p.m. (1 hour and 31 minutes later)
ACCEPTED Check Mark

1.---"What does decortication of the lateral epicondyle mean? What does that surgery involve?"

Decortication of the lateral epicondyle is usually performed during debridement surgery to improve blood supply. An area of the exposed lateral condyle is decorticated using an osteotome (similar to a chisel) for making three 2 mm drill holes anterior to the lateral epicondyle.

2.---"Is the counterforce bracing the same as the braces for tennis elbow that you can buy in the stores (which wrap around the arm tightly just below the epicondyle area)??"

Yes, it's the same. It wraps around the forearm just below the elbow with two velcro straps. The counterforce tennis-elbow support brace is worn to distribute pressure from muscle-use evenly throughout the area instead of solely on the tendon. Since you are still having significant pain then I recommend wearing the brace whenever you participate in any activity involving using excessive motion of your elbow and forearm until your elbow is fully-healed.

3.---"what is the difference between cortisone injections and lidocaine injections?"

A cortisone injection relieves inflammation without anesthetizing. An injection of lidocaine 1% plus Depo-Medrol is used for short-term relief of inflammation and pain.



__________________
Please click the green "ACCEPT" button.     A "BONUS" and "POSITIVE FEEDBACK" are appreciated!
PictureDr. Hanson  -- Doctor (MD) -- 99% Positive Feedback on 819 Health Accepts
Diplomate, American Board of Quality Assurance & Utilization Review Physicians

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