By Alexander Germanis
Characterized by an achy pain originating on or near the bump on the outside of the elbow, tennis elbow is a common problem among those in their 40’s and 50’s. And, as explained in last month’s article, the ailment’s painful symptoms are not a mystery. But with the complexity of the human anatomy and the relatively youthful science of medicine, many maladies still hold mysteries — including the mystery of which treatments are best.
Dr. Jerome Oakey, a McLean County Orthopedics surgeon specializing in the hand and wrist, backs up this assessment, specifically when it comes to treating tennis elbow. “If you ask ten people, you’ll probably get eleven different procedures that people will recommend,” he admits. “From never operating on it to acupuncture to injections to arthroscopy to percutaneous release to ultrasound to an open release. There are a myriad of operations, and when there are that many operations designed to treat one problem, it basically tells you that we don’t have it figured out.”
Figuring out how to treat tennis elbow becomes even more difficult when there are other problems that can masquerade as tennis elbow; arthritis of the elbow joint can be one such perpetrator. “Also,” Dr. Oakey says, “there’s a nerve that runs behind the arm — the radial nerve — that curves around the front of the elbow and then runs underneath a muscle, and that nerve can be pinched. It’s a very uncommon cause.” Nevertheless, that nerve can easily be another pain generator for people diagnosed with tennis elbow.
Eliminating pain is usually the first thing occupying the mind of a patient, and it is certainly a concern of the treating physician. “If the symptoms are bad enough,” Dr. Oakey says, “we often try a steroid injection.”
The doctor goes on to add, “Everything I can think of in the world has been injected into tennis elbow, and nothing has ever really been proven to be better or worse than anything else.”
This includes platelet rich plasma (PRP). Although a treatment not covered by insurance companies, PRP, a plasma with an increased number of the growth factor proteins present in nor-mal blood, has also been employed to attempt to stem the pains of tennis elbow. Even though Dr. Oakey does not feel the out-of-pocket expenditure is often worth it, there may be unique cases where PRP could possibly be beneficial.
As for surgical solutions to the problem, the old method was to go in and remove the offending tissue. The problem with that was, according to Dr. Oakey, healthy tissue was often removed as well, perhaps causing more of a problem than it was solving. Now, the doctor says, “It’s very rare people go on to require surgery; the vast majority of people get better without surgery.”
“In fact,” he continues, “there’s a growing thought process in the hand surgery community that if you let this go long enough, the body will eventually treat it—the body will eventually heal itself.”
Furthermore, Doctor Oakey says there are some physicians who are recommending no injections of any sort should be used in treating tennis elbow. “Because, if you tell people their body will eventually heal it,” say the doctors, “then that’s good enough. They should adapt and deal with the pain they have.”
Dealing with pain does not always sit well with everyone, however. For them, Dr. Oakey still has some words of optimism. “Tennis elbow can be cured,” he insists. Through a conservative course of steroid injections, the symptom of pain can be treated, “until the body can heal itself.”
For information regarding the prevention of tennis elbow, as well as household methods to curtail the pain, read the third and final article in the ‘Tennis Elbow’ series in next month’s issue of Healthy Cells Magazine.
For more information, you may contact Dr. Oakey at McLean County Orthopedics, 309-663-6461 or www.mcleancountyorthopedics.com. The practice treats all types of orthopedic conditions and offers a comprehensive range of services. Their office is located at 2502 E. Empire in Bloomington.