Has anyone had Elbow Surgery?

[bendyone]

Hi everyone

I am currently typing with a limp cos my tennis elbow has flared up yet again!

I am going back to the Ortho tomorrow and it is looking like I will need to get my 3rd cortisone injection in 3 months.
When I so the Ortho last week, he said I may need to have surgery and explained what the surgery entails i.e. slicing through the muscle to encourage the blood supply to the muscle to heal the micro-tears

He then said that the surgery isn't always successful and tennis elbow is something that takes time to heal

Since we HMS sufferers are predisposed to this kind of complaint (tendonitis, bursitis etc.) I can't help thinking that an operation would not be the best thing for me as the problem could re-occur. I would like to hear from anyone who has had surgery for tennis elbow and if it has been successful.

[Mods - I searched and couldn't find any previous threads with this specific question - please feel free to move it if necessary.]

[Sandy L]

Tennis elbow is usually caused by rapid, forceful, or repeated pronation and supination of the hand (turningitpalmsup and palms down or any movement that requires the same rotation of the forearm) or by carrying things in the hands. The forehand and backhand strokes in tennis are what gave it its name. Is there anything in your daily life that requires either or both? If carrying or lifting is involved, try to carry the load close to the elbow; it takes less force.

[bendyone]

Hi Sandy

I work on a computer all day and my tennis elbow is considered to be a Repetitive Strain Injury. Everything at my workstation has been changed by an OT since I had my first cortisone injection back in November but the condition was, by that time, already "extremely acute" and my consultant thinks it will continue to persist even with injections.

I will be allowed one more injection and if the pain returns then he has told me surgery will then be my only option which is why I am asking for info from anyone who has had the surgery.

[Sandy L]

Ok, a few last-ditch questions:
1. Do you have a wrist support with your keyboard?
2. Have you used a tennis elbow strap?
3. Is there any thing you do that requires turning over stacks of papers, reaching for reference works, frequently picking up a telephone hand set, or getting things out of drawers?

I am inclined to assume all these were considered, but every now and then, it pays to check.

[bendyone]

Hi Sandy

Thanks for responding. Here's my answers to your questions:

1. I have a gel support for my keyboard. I now have a split keyboard and a touchpad mouse. I was finding I was using a "pincer" action with a conventional mouse - I basically was gripping it like my life depended on it (just like most of us do day-to-day with everthing!!)

My workstation could not really be improved much more. I guess voice activated software would be the next step at work if the adjustments don't work. But this wouldn't necessarily solve all my problems.

2. I have had a tennis elbow clasp for sometime now. I don't really feel the benefit of it although I do wear it when I'm suffering symptons. I have had ultrasound treatment and other exercises advised by the physio but they failed to make any impact. The physio is the one who recommended cortisone injections.

3. Yes to all. My job involves auditting, research (IT based), spreadsheet preparation and typing up reports. Pretty much everything I do involves the computer.

I was at the Ortho yesterday and he has told me that this flare up is not coming from the same place as the tennis elbow. He says that I have trapped the radial nerve(I may have got the name wrong) and this is because the muscle it passes through is torn and swollen and putting pressure on the nerve. The muscle I have weakened is causing problems for my middle finger - the strength is definitely reduced.He has given me another injection directly into the muscle with anaesthetic to paralyze the nerve initally until the cortisone kicked in the reduce the swelling.

I am suffering the aftermath at the moment, feels like I have had a terrific cramp because the muscle was contracted for a number of hours. I have to see how it goes and maybe need to get sensory tests.

There you go Sandy........you did ask! Any words of advice?

[Sandy L]

The radial nerve comes around the back of the elbow, near the lateral epicondyle. It could be affected by inflammation in the jointbetween the radial head and the humerus, but it could also be injured by stretching if your elbow spends much time in a sharply flexed position (which often happens during sleep) and couldbe harmed if there is pressure from the arm of a chair or something else you lean against (though that usually gets the ulnar nerve, on the inside of the elbow). Using an athletic elbow guard--as basketballers sometimes use--will discourage bending the elbow at night and, if you are somehow pressing or leaning on it during the day, would spread the pressure out more.

[bendyone]

Thanks Sandy.

I may get one of the guards you are speaking of.I did have a tame version of one (tubigrip type) but it was pretty useless. I I have seen the higher spec ones though and wondered if they might help.

I play netball (don't know if you have it in the States - it's a bit like basketball but for us girls!). Could this exacerbate the problem? I already have to wear a hefty support for my unstable knee - I could end up looking like Robocop! The girls I play with are very understanding though so I'm not worried about my image.

[Sandy L]

My guess would be that the netball would not be too much of a problem. Do you feel worse after a game?

[bendyone]

No problems at all with my arm when playing or after playing. I didn't think it would be a problem.

[vickers]

Hi Bendyone,

I had recurring tennis elbow for over a year and tried all a sorts of things. Mine was caused by using a keyboard and mouse all day too and was told by my ortho that moving my fingers/hand up and down was the cause. I had several cortisone injections to no effect. I had a plaster cast on my wrist to prevent the movements that cause pain and to enable the muscle to heal, which worked really well for about a week after I had the cast removed. I finally had a tennis elbow op to remove the inflamed part of the muscle as it just would not heal. After recovery from the op and much physio I wore a wrist splint permenantly for work and never had the problem back. I now work from home and spend a lot less time on the computer so rarely need to wear the splint anymore.
Obviously we are all different and I didn't have the complications with my radial nerve but thought you might like to know you are not alone and there is hope for you.

[StandFree1903]

I have HMS in my elbows and the past 2 years my left one has been in alot of pain.

Am I able to ask my gp about surgery on it to see if it helps or would i have to wait to see rheumatologist?

[gila]

hi standfree
do you know what exactly is causing the pain in the elbows?
there are many poss reasons, causes- and only for some of them would surgery make any sense
if you describe where exactly/when/how the pain is we might be able to give some pointers what it might be due to BUT only a med bod who can examine you in the flesh can really tell what it might be

and in HMSers... pity enough even some poss surgeries that would bring good results in normals, might not do so in us-
so usually it is advised to consider surgery only after 'everything else' has been tried

pity enough for most pain giving probs we have there is no 'quick cure/fix' - many long term effective 'treatment/management' options do involve us learning about and understanding our bodies and brains better (for example when/how we overextend,unhelpful postures etc), involve a lot of time and effort by us (physiotherapy for example)
hope this helps a bit, even though it probably wasnt what you wanted to hear
xxg
P.S.: did you actually get an "HMS' rather than "just HM" diagnosis by a doc in the mean time? if not yet, and you think you fit the diagnostic criteria (see http://www.hypermobility.org/beighton.php and http://www.hypermobility.org/diagnosis.php) it might be an idea to get referred to first a local rheumy and then the glasgow hypermobility clinic ( as per http://www.hypermobility.org/clinics.php )