Newspaper article St Louis Post-Dispatch (MO)

Surgery One Option for Tennis Elbow

Newspaper article St Louis Post-Dispatch (MO)

Surgery One Option for Tennis Elbow

Article excerpt

Dear Dr. Donohue: My problem is lateral epicondylitis, for which I have been treated with periodic steroid shots. It's been a year and a half. The pain goes away for a while, then comes back worse than ever. I have tried resting the arm and putting on hot packs, which help some, but I still get pain, even just shifting the car. It's in my dominant arm. The doctor now says surgery. I don't want that. Does this problem ever last this long?

Lateral epicondylitis - tennis elbow - is a common injury. It happens to carpenters, mechanics and anyone whose activity demands a twisting of the arm. Overuse and misuse play obvious roles.

I have heard of cases that just will not go away. A year and a half is a long time, but I'd want a second opinion about surgery. About five cases in a hundred require surgery.

The source of pain is a small tearing of ligament attachments from forearm muscles to the elbow. Rest becomes important. The patient needs to stop further tendon irritation.

Anti-inflammatory drugs such as aspirin, ibuprofen or indomethacin should help. Steroid shots are pretty strong medicine, steroids being the most potent anti-inflammatories of all. The shots bring temporary relief, but there are stringent limits to their use.

Most patients eventually get rid of pain sufficiently to begin muscle restrengthening exercises. But 18 months of unrelenting pain does not bode well.

At the very least you need another examination and some comprehensive emphasis on tendon healing. If surgery then remains the only option, I'd go along with it.

How did you develop your tennis elbow?

Dear Dr. Donohue: I am a woman, 71, diagnosed as having interstitial cystitis, for which there is no cure. I'm in a great deal of pain. I have no idea what I can eat or what I can do to help myself. Is there no help for me?

"Cystitis" means urinary bladder inflammation. "Interstitial" refers to the bladder wall, specifically its framework tissue, the interstitium. …

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