This page gives some outline treatment and referral advice for common elbow conditions.

Tennis and Golfer’s Elbow

90% resolve < 1yea

Initial treatment

  • Physio + Activity modification + (splints)

Eccentric exercise programme for at least 6 weeks

  • Steroid

40mg kenalog (1ml) + <5ml chirocaine (0.5%)

Symptoms return in 2/3 within 3 months

When to refer

Traumatic onset
Failed steroid
Severe symptoms
Greater than 1 year

Cubital Tunnel Syndrome (Ulna Nerve compression at the elbow)

2nd Most common compression neuropathy

  • Management

Severity dependant
Conservative – activity modification

When to refer

Severity or deterioration
Motor symptoms

  • Surgery = Decompression

Pops, Clicks and Instability

  • Symptoms

Catching / Snapping / Locking
Can’t push out of chair
Can’t do press up

  • Ask – History of dislocation
    Think instability
  • Xray reasonable 1st line
  • Locking but no dislocation
    Loose body
    Osteo Chondritis Desicans (typically young girls / gymnasts)

When to Refer

Any troublesome symptoms

Arthritis

  • Osteoarthritis
    Starts at radiocapitellar joint
  • 2 main types

Type 1 – younger patients (40-60 ish)
Hypertrophic – ostephytes

Type 2 – Older
Pain from joint itself

When to refer

Based on symptoms

Type 1 – Respond well to debridement = OK procedure or arthroscopy.

Type 2 – Injections / Interposition / Total Elbow Replacement