Elbow

Category

Joint & Soft Tissue Injections

Elbow pain is caused by repetitive minimal trauma to the joint due to repetitive activities or overuse of the hand, wrist, and arm.

Elbow disorder may involve

• Arm and forearm muscle
• Elbow ligaments
• Tendons
• Nerves
• Bones in the elbow
• Bursae

Common causes

 Elbow pain encountered in day-to-day activities are

• Tendinitis– which means damage in the tendons around the elbow from overuse. Based on the arm motion these are the Tennis elbow, Golfer’s elbow, and Triceps tendinitis. Tennis elbow is the more common among the conditions.
• Bursitis– Bursa is a small sac with fluid in them. They are present around the joints to help cushion of bones, tendons, and muscles. They also help the skin to slide over the bone. Sometimes they get swollen and cause pain known as bursitis. Tow bursitis is common around the elbow Olecranon bursitis and Cubital bursitis.
• Trapped nerve-When nerves get squeezed as they run through tissue are called trapped nerves.  Radial tunnel syndrome is one of the main nerves of the radial nerve that squeezes through the radial tunnel near the outside of the elbow. Cubital tunnel syndrome has a similar issue with the ulnar nerve when passes through the cubital tunnel situated in front and middle of the elbow.
• Arthritis– many types of arthritis can affect the elbow, but most ones are Rheumatoid arthritis and Osteoarthritis.
• Osteochondritis dissecans –it is also called panner,s disease. Dislodgement of any piece of bone or cartilage inside the joint.
• Dislocation and bone fracture.
• Other diseases like Gout, Lyme disease, and SLE may cause elbow pain.

Most of the elbow pain is due to strained and inflamed soft tissues.

Signs & symptoms of common elbow disease:

Tennis elbow– is also known as lateral epicondylitis. You may feel a localize pain outside of the elbow joint that worse with active movement of the wrist with an inability to hold a cup and grip strength becomes diminished.

Golfer’s elbow–– is also known as medial epicondylitis. You may feel a localized pain inner side of the elbow joint that worse with active movement of the wrist with an inability to hold a cup and  grip strength become diminish

Olecranon bursitis – it's also called the student’s elbow. pain starts at the back of the elbow with swelling during extension.

Cubital bursitis –  pain at front of the elbow with swelling during flexion.

Cubital tunnel syndrome– you may have pain in front of the elbow with muscle weakness of hand & forearm and muscle wasting & loss of sensation inner aspect of the hand. you may have also burning or numbness in your hand, arm &fingers.

Diagnosis:

Most elbow pain can be diagnosed after a simple examination and clinical features. It is unlikely you will need to have any special tests.

We may suggest an X-ray,  which can show any new bone growth, small pieces of loose bone, or arthritis.

Sometimes a nerve conduction test may be needed if you have been having problems with the nerve.

MINIMALLY INVASIVE TREATMENTS FOR ELBOW PAIN 

• Steroids injection
• Platelet-rich plasma injection

PRP THERAPY

Platelet-rich plasma is a form of regenerative medicine. It uses injections of your own blood platelets to help with healing.

What Is Platelet-Rich Plasma?

Platelets, or thrombocytes, are a type of blood cell. Their main function is clotting blood. They’re produced in your bone marrow. Platelets contain growth factors. These are proteins that may be helpful in healing injuries.

How Does Platelet-Rich Plasma Work?

A healthcare professional will collect a small amount of your blood (approx. 15-20 ml only). They will place your blood into a centrifuge. This spins your blood at different speeds until it separates into different layers. One layer is the platelet-rich plasma. This layer of plasma may have as much as three-four times more platelets than regular blood.‌

The platelet-rich plasma will then be injected into your affected area. We will first numb the area with a local anesthetic. The pain at the site may increase for the first 1-2 days. It could take 1 week before you feel any improvement.‌

After your treatment, we will recommend you to:

Avoid taking non-steroidal anti-inflammatory medications ( NSAIDs) after your treatment as this may block the effect

Avoid activities that put stress on the area of treatment for a few days

Is Platelet-Rich Plasma Treatment Effective?

The effectiveness of platelet-rich plasma treatment depends on several factors, including:

• Your overall health
• Whether your injury is chronic (it developed over time) or acute (sudden and serious)
• Which part of your body needs treatment
• The preparation of the platelet-rich plasma treatment

Many clinical trials have supported its use.

Some studies have found that platelet-rich plasma injections significantly reduced pain compared to placebos. People’s physical function also improved significantly. These benefits continued at 3, 6, and 12-month follow-ups.

There’s no chance of an allergy or immune reaction to platelet-rich plasma treatment because the plasma is taken from your own blood. Side effects and complications are rare.

What does the procedure involve?

The doctor will clean the area over the joint and insert a small needle into the fluid-filled area around the joint bones under imaging guidance. When it is in the correct position, they will inject the PRP into the joint. They will remove the needle and cover the injection site with a small dressing.

Why Not (Contraindication)?

Occasionally it is difficult to inject much medicine into the joint space, especially if the joint is extremely swollen. If this is the case, other medicines may be prescribed to reduce the swelling before the injections are tried again.

What you are to do before the procedure (Preparation)?

1. Book a prior appointment if elective or get admission in causality if the emergency
2. Lab investigation (*PT/INR, CBC), XRAY, CT/MRI scan, and previous records.
3. 2-3 Hours fasting.
4. If you are on a blood thinner like Aspirin, inform us during the appointment.
5. One accompanying person
6. Need to sign a consent form for the procedure

Approx. Stay in the hospital?

We have a very fast and competent working team (Consultant, fellow, clinical assistant, technician, and ward assistant) which provides you with a comfortable atmosphere and eases your nerves. The usual time of stay is around a few hours.

Complications

Every procedure carries a risk, although this is extremely small. The risk of infection with this procedure is extremely small as no incisions are made in the skin.

Resume To Work?

You can resume your work after 1 day if the existing disease allows.