Tennis Elbow (Lateral Epicondylitis)

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Not surprisingly, playing tennis or other racquet sports can cause this condition. However, several other sports and activities besides sports can also put you at risk.  Tennis elbow is inflammation or, in some cases, microtearing of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists and, in some cases, surgeons work together to provide the most effective care.

Anatomy

Your elbow joint is a joint made up of three bones: your upper arm bone (humerus) and the two bones in your forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles, where several muscles of the forearm begin their course. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.

ECRB muscle and tendon

The ECRB muscle and tendon is usually involved in tennis elbow.
Reproduced and modified from The Body Almanac. © American Academy of Orthopaedic Surgeons, 2003.

Muscles, ligaments, and tendons hold the elbow joint together.

Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm that are responsible for the extension of your wrist and fingers. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone.  The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).

Cause

Overuse

Recent studies show that tennis elbow is often due to damage to a specific forearm muscle. The extensor carpi radialis brevis (ECRB) muscle helps stabilize the wrist when the elbow is straight. This occurs during a tennis groundstroke, for example. When the ECRB is weakened from overuse, microscopic tears form in the tendon where it attaches to the lateral epicondyle. This leads to inflammation and pain.

The ECRB may also be at increased risk for damage because of its position. As the elbow bends and straightens, the muscle rubs against bony bumps. This can cause gradual wear and tear of the muscle over time.

Activities

Athletes are not the only people who get tennis elbow. Many people with tennis elbow participate in work or recreational activities that require repetitive and vigorous use of the forearm muscle or repetitive extension of the wrist and hand.

Painters, plumbers, and carpenters are particularly prone to developing tennis elbow. Studies have shown that auto workers, cooks, and even butchers get tennis elbow more often than the rest of the population. It is thought that the repetition and weight lifting required in these occupations leads to injury.

Tennis player

Playing tennis is a possible cause of tennis elbow, but other activities can also put you at risk.

Thinkstock © 2015.

Age

Most people who get tennis elbow are between the ages of 30 and 50, although anyone can get tennis elbow if they have the risk factors. In racquet sports like tennis, improper stroke technique and improper equipment may be risk factors.

Unknown

Lateral epicondylitis can occur without any recognized repetitive injury. This occurrence is called “idiopathic” or of an unknown cause.

Symptoms

The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms.

Common signs and symptoms of tennis elbow include:

  • Pain or burning on the outer part of your elbow
  • Weak grip strength
  • Sometimes, pain at night

The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however, both arms can be affected.

Location of pain in lateral epicondylitis.

Location of pain in lateral epicondylitis.

Doctor Examination

Your doctor will consider many factors in making a diagnosis. These include how your symptoms developed, any occupational risk factors, and recreational sports participation.

Your doctor will talk to you about what activities cause symptoms and where on your arm the symptoms occur. Be sure to tell your doctor if you have ever injured your elbow. If you have a history of rheumatoid arthritis or nerve disease, tell your doctor.

During the examination, your doctor will use a variety of tests to pinpoint the diagnosis. For example, your doctor may ask you to try to straighten your wrist and fingers against resistance with your arm fully straight to see if this causes pain. If the tests are positive, it tells your doctor that those muscles may not be healthy.

doctor pressing lateral epicondyle

During the exam, your doctor will apply gentle pressure to the lateral epicondyle, checking for pain and tenderness.

Tests

Your doctor may recommend additional tests to rule out other causes of your problem.

  • X-rays. These tests provide clear images of dense structures, such as bone. They may be taken to rule out arthritis of the elbow.
  • Magnetic resonance imaging (MRI) scan.  MRI provides images of the body’s soft tissues, including muscles and tendons. An MRI scan may be ordered to determine the extent of damage in the tendon or to rule out other injuries. If your doctor thinks your symptoms might be related to a neck problem, he or she may order an MRI scan of the neck to see if you have a herniated disk or arthritic changes in your neck. Both of these conditions can produce arm pain.
  • Electromyography (EMG). Your doctor may order an EMG to rule out nerve compression. Many nerves travel around the elbow, and the symptoms of nerve compression are similar to those of tennis elbow.

Treatment

Nonsurgical Treatment

Approximately 80% to 95% of patients have success with nonsurgical treatment.

Rest. The first step toward recovery is to give your arm proper rest. This means that you will have to stop or decrease participation in sports, heavy work activities, and other activities that cause painful symptoms for several weeks.

Medications. Acetaminophen or anti-inflammatory medications (such as ibuprofen) may be taken to help reduce pain and swelling

Physical therapy. Specific exercises are helpful for strengthening the muscles of the forearm. Your therapist may also perform ultrasound, ice massage, or muscle-stimulation techniques to improve muscle healing.

Wrist stretching exercise

Wrist stretching exercise with elbow extended.

Brace. Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons.

Counterforce brace

Counterforce brace.

Steroid injections. Steroids, such as cortisone, are very effective anti-inflammatory medicines. Your doctor may decide to inject the painful area around your lateral epicondyle with a steroid to relieve your symptoms.

Platelet-rich plasma. Platelet-rich plasma (PRP) is a biological treatment designed to improve the biologic environment of the tissue. This involves obtaining a small sample of blood from the arm and centrifuging it (spinning it) to obtain platelets from the solution.  Platelets are known for their high concentration of growth factors, which can be injected into the affected area. While some studies about the effectiveness of PRP have been inconclusive, others have shown promising results.

PRP injection

An injection of PRP is used to treat tennis elbow.
Courtesy of Allan K. Mishra, MD, Menlo Park, CA.

Extracorporeal shock wave therapy. Shock wave therapy sends sound waves to the elbow. These sound waves create “microtrauma” that promotes the body’s natural healing processes. Shock wave therapy is considered experimental by many doctors, but some sources show it can be effective.

Equipment check. If you participate in a racquet sport, your doctor may encourage you to have your equipment checked for proper fit. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm, which means that the forearm muscles do not have to work as hard. If you use an oversized racquet, changing to a smaller head may help prevent symptoms from recurring.

Surgical Treatment

If your symptoms do not respond after 6 to 12 months of nonsurgical treatments, your doctor may recommend surgery.

Most surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone.

The right surgical approach for you will depend on a range of factors. These include the scope of your injury, your general health, and your personal needs. Talk with your doctor about the options. Discuss the results your doctor has had, and any risks associated with each procedure.

Open surgery. The most common approach to tennis elbow repair is open surgery. This involves making an incision over the elbow.

Open surgery is usually performed as an outpatient surgery. It rarely requires an overnight stay at the hospital.

Arthroscopic surgery. Tennis elbow can also be repaired using miniature instruments and small incisions. Like open surgery, this is a same-day or outpatient procedure.

Surgical risks. As with any surgery, there are risks with tennis elbow surgery. The most common things to consider include:

  • Infection
  • Nerve and blood vessel damage
  • Possible prolonged rehabilitation
  • Loss of strength
  • Loss of flexibility
  • The need for further surgery

Rehabilitation. Following surgery, your arm may be immobilized temporarily with a splint. About 1 week later, the sutures and splint are removed.

After the splint is removed, exercises are started to stretch the elbow and restore flexibility. Light, gradual strengthening exercises are started about 2 months after surgery.

Your doctor will tell you when you can return to athletic activity. This is usually 4 to 6 months after surgery. Tennis elbow surgery is considered successful in 80% to 90% of patients. However, it is not uncommon to see a loss of strength.

4 COMMON ACL TEAR SYMPTOMS & WHEN TO SEEK TREATMENT

4 COMMON ACL TEAR SYMPTOMS & WHEN TO SEEK TREATMENT

ACL tears are common in physical activities that involve quick stops, changes in direction, or direct contact with the knee. Knowing the symptoms of ACL tears can help you recognize an injury and prevent it from getting worse. Explore our guide to learn how to tell if an ACL is torn and the procedures a knee specialist can perform to help you get back on your feet faster.

 

Signs & Symptoms of ACL Injuries
Individuals who suffer an ACL tear often note an audible “pop” or snapping sound as the injury happens. The onset of symptoms is immediate and usually accompanied by:

  • Decreased range of motion in the knee
  • Rapid swelling
  • Severe pain, soreness, and tenderness along the joint
  • Instability and discomfort while walking

ACL injuries usually occur during sports and fitness activities that can put stress on the knee. This includes movements like:

  • Pivoting with your foot firmly planted
  • Suddenly slowing down and changing direction
  • Stopping suddenly
  • Landing awkwardly from a jump
  • Receiving a direct blow to the knee

There are three levels of ACL injuries, which are classified by the amount of damage to the ligament (partial or complete tear). A grade 1 sprain, for example, is when the ACL is stretched but not ruptured. While a grade 3 sprain means the ACL is torn into two pieces, rendering the joint completely unstable.

 

When To Seek Treatment
If you are experiencing symptoms of an ACL tear, you should schedule an appointment with a knee specialist. They will conduct a physical exam in order to determine the extent of the injury. An X-ray may also be performed to assess if there is damage to the surrounding bone, but MRI will ultimately be the deciding factor in treatment.

Rehabilitation can be the first step in the recovery process with the goal of regaining full range of motion. You may spend several weeks working with a physical therapist who will develop a custom exercise program centered around your unique needs and symptoms.

However, ACL reconstruction surgery is often recommended if the ligament is injured or the injury is causing your knee to buckle during everyday activities. During the procedure, a surgeon will remove the damaged ligament and replace it with a new segment of tendon which recreates the ACL. This replacement tissue — called a graft — can be taken from your own patellar, hamstring, quadricep, or cadaver tendons.

The surgery is typically done using a minimally invasive, arthroscopic approach. Special surgical tools and a video camera are inserted through small incisions in the knee joint. The graft is then secured to the tibia (shin bone) and femur (thighbone) using sutures (special surgical thread) or screws depending on the type of graft. This acts as a bridge for the new ligament to grow on and reconnect the bones.

Recovery time varies based on the severity of the injury. Your doctor will recommend physical therapy in order to regain full range of motion, strength, and stability in the affected knee in the weeks and months that follow. Regular follow-up visits with your knee specialist and physical therapists are necessary to assess progress and readiness to return to your favorite activities.

Understanding the common symptoms of ACL tears can help reduce the risk of injury while playing your favorite sports. If you find yourself with pain or injury, CompOrtho offers top-level care to help you get on the road to recovery quicker. To learn more about injury prevention or make an appointment, contact us today!

EXPLORE WHAT A TFCC TEAR IS AND HOW IT’S TREATED

EXPLORE WHAT A TFCC TEAR IS AND HOW IT’S TREATED

Triangular fibrocartilage complex tears are painful and can affect a person’s ability to use their hand or wrist. But what is a TFCC tear exactly? And how is this injury treated? Understanding what this injury is and how to identify its symptoms can help you resume a pain-free life faster. Explore our guide to TFCC tears and learn how a wrist specialist can help you regain mobility in your wrist.

What Is a TFCC Tear?
The triangular fibrocartilage complex (TFCC) connects the hand and forearm bones to form the wrist. Your TFCC is made up of several ligaments, tendons, and cartilage. It helps your wrist move and stabilizes the forearm when gripping something with your hand or rotating your forearm. A TFCC tear is any injury or damage to this area. There are two types of TFCC tears:

  • Type 1: These tears result from a physical injury. This often occurs when a person overextends their wrist or falls on their hand with it extended.
  • Type 2: These tears occur gradually and can result from damage due to aging or an underlying health condition, gout or rheumatoid arthritis.

TFCC tears commonly cause pain in the wrist. The pain may be constant or only appear when you apply pressure to your wrist or move it. Other symptoms of a TFCC tear can include:

  • Weakness or stiffness in the wrist
  • A limited range of motion in the hand or wrist
  • Wrist swelling
  • Loss of grip strength
  • A clicking or popping sound when you move your wrist

Athletes who regularly put pressure on their wrists — like tennis players or gymnasts — have a higher risk of developing a TFCC tear. You are also at a higher risk of a TFCC tear if you have previously injured your wrist.

TFCC Tear Treatment
If you suspect a TFCC tear, the first thing you should do is temporarily stop doing any activities that cause wrist pain to allow the injury to heal. You might need to wear a cast or splint to prevent your wrist from moving. Your wrist specialist will also likely recommend physical therapy. This involves doing gentle exercises to rebuild strength in your TFCC. If non-surgical treatments don’t provide any relief, you may need surgery to repair the tear.

Surgery to treat a TFCC tear involves a minimally invasive procedure called a wrist arthroscopy. During the surgery, your doctor will make several small incisions on the wrist’s outer edge to repair the damaged portion of the TFCC. Sometimes, they may also shorten the ulna — a long bone in the forearm — to alleviate your symptoms. You must wear a cast for a few weeks after the procedure to allow the area to heal.

Recovery usually takes a few weeks for TFCC tears that don’t require surgery. However, it may take anywhere from a few weeks to several months before you regain full use of your wrist if you do need surgery. Doing physical therapy and avoiding activities that strain your wrist can help speed up your recovery time.

 

How to Tell the Difference Between an Ankle Fracture and an Ankle Sprain

How to Tell the Difference Between an Ankle Fracture and an Ankle Sprain

Do you have an ankle sprain or an ankle fracture? Learn how to spot the signs for each condition.

Considering how much weight our ankles carry and the mobility this hard-working joint provides, it’s not surprising that ankle sprains and fractures are quite common. Sports injuries, car accidents, and bad falls can wrench the ankle joint out of alignment and result in either a fracture or a sprain. But how do you know which one it is?

Severe pain, swelling, and impaired mobility all indicate significant ankle trauma. An orthopedic specialist can determine with an X-Ray or other imaging tests whether your ankle is sprained or broken. But before you book your appointment, here are some clues as to which injury you may have suffered.

Ankle Sprain Vs. Fracture

Both injuries cause similar symptoms — pain, swelling, and an inability to put weight on the joint. At the same time, there are some key differences. It’s important to know these differences and get a quick diagnosis so you can receive the proper treatment.

Ankle Fracture. Your ankle consists of three main bones: the tibia (shinbone), fibula (lower leg), and the ankle bone (talus). All three join together at the ankle to give the joint its wide range of motion. Ankle fractures occur most often due to a car accident or a severe fall that breaks or chips one or all three bones. A swollen, painful ankle is a sign of an ankle fracture, particularly if the area over the ankle bone is tender to the touch. If you’ve fractured your ankle, you may also experience numbness in your toes and notice your ankle appears misshapen. An ankle fracture is usually accompanied by a cracking sound.

Ankle Sprain. Holding the ankle bones together is a network of flexible but strong ligaments. When those ligaments are stretched or twisted beyond their normal range of motion, they can become strained, partially torn, or completely torn. Soreness, tenderness, bruising, swelling, stiffness, and pain when trying to put weight on the ankle are signs of an ankle sprain. Depending on the severity of the sprain, you may hear a popping sound, although in most cases there is no discernable sound. If you feel pain when you touch the soft part of the ankle, it’s most likely a sprain.

How to Treat Ankle Fractures and Sprains

An immediate diagnosis of either a sprain or fracture prevents the injury from worsening and doing more damage to the ligaments or bones. Do not delay treatment if you think you’ve broken your ankle, or your ankle sprain doesn’t improve in a day or two.

Treatment for an ankle sprain begins with the PRICE method: Protecting the ankle from further harm, Rest, Ice, Compression, and Elevation. You may need to wear to a brace to support the ankle and use crutches to take weight off the joint as you heal. Over-the-counter pain medications can alleviate the discomfort. Mild sprains clear up in about two weeks, but it may take longer for more significant sprains to heal. Surgery is not recommended unless there is a severe ligament tear. Physical therapy can also help restore flexibility and range of motion to the joint.

How an ankle fracture is treated depends on whether the bone is stable — meaning it’s broken but not out of alignment — or knocked out of place. A stable fracture can heal in about six weeks immobilized in a cast. If the bones are shattered into small bits and/or out of place, surgery may be necessary to attach the bones together with plates, screws, rods, or wires in a procedure known as reduction. Similar to ankle sprains, treatments for fractures include PRICE, taping around the ankle or a boot to stabilize the joint, crutches while walking to reduce pressure on the ankle, and physical therapy to strengthen and increase flexibility in the joint.

Treat Your Ankle at Comprehensive Orthopaedics

Ankle injuries can be especially debilitating. Fortunately, the physicians at Comprehensive Orthopaedics have years of experience in diagnosing and treating orthopedic injuries like ankle sprains and fractures. We use the latest equipment and techniques to quickly heal your ankle. Contact us today to set up an appointment.

Knee Procedure Done Earlier Might Prevent Knee Replacement Later

Knee Procedure Done Earlier Might Prevent Knee Replacement Later

MONDAY, Feb. 1, 2021 (HealthDay News) — For some patients suffering from knee arthritis, a special procedure may reduce the need for a total knee replacement, Canadian researchers say.

By getting what is known as a ‘high tibial osteotomy,’ younger patients with less severe joint damage who are physically active might be able to delay the need for a knee replacement by 10 years or more, though they may have to search for a doctor who performs the surgery.

“High tibial osteotomy is a knee surgery aimed at treating patients in earlier stages of osteoarthritis by correcting the alignment of bowed legs and shifting load to less diseased parts of the knee,” explained lead researcher Trevor Birmingham, the Canada research chair of musculoskeletal rehabilitation at the University of Western Ontario.

During the procedure, the tibia (shinbone) is cut and then reshaped to relieve pressure on the knee joint.

Beyond improving pain and function, a goal of the procedure is to prevent or delay the need for total knee replacement, Birmingham said.

Although high tibial osteotomy can improve pain and function and is cost-effective, the procedure is underused in North America, Birmingham said. “Rates of high tibial osteotomy continue to decline, while rates of other knee surgeries continue to rise,” he added.

“The low rates of high tibial osteotomy are partially due to the perception that the procedure is only suitable for a very specific subset of patients with knee osteoarthritis, and that the patients will go on to require total joint replacement anyway. So why bother?” Birmingham said.

But the researchers found that among nearly 600 people in the study who had a high tibial osteotomy, 95% did not need a total knee replacement within five years, and 79% did not get a total knee replacement within 10 years.

Even patients not usually considered good candidates for high tibial osteotomy, such as women and those with later-stage disease, 70% did not need a knee replacement within 10 years, the researchers found.

“Knees treated earlier in the disease process had the highest longevity after high tibial osteotomy, with 87% not getting a total knee replacement within 10 years,” Birmingham said.

The findings from this study suggest that high tibial osteotomy has the potential to delay or prevent the need for total knee replacement, bringing the limited use of high tibial osteotomy into question, he said.

Dr. Jeffrey Schildhorn, an orthopedic surgeon at Lenox Hill Hospital in New York City, reviewed the study and said that the goal of this procedure is to realign the knee to help prevent arthritis progression in younger patients.

“The high tibial osteotomy is designed to help patients avoid the knee replacement altogether, or at the very least to get further along in life before it’s necessary,” he said. “The idea behind the operation is solid, and in the right patient, it’s absolutely the right thing to do.”

Schildhorn said the one downside of the procedure is that patients have to keep their weight off the knee for at least a month after a high tibial osteotomy, which is one reason it’s only used for patients strong enough to use crutches.

“When I treat patients, one of the things that limits me in offering certain things is what I think they can tolerate, so if I see someone who I don’t think is going to be able to get through the nuanced rehabilitation that’s going to be required, like not putting weight on it for four to six weeks and the arduous physical therapy that can be involved, I won’t offer them something like this,” Schildhorn said.

He also said that whether a patient is offered a high tibial osteotomy depends on the doctor the patient sees.

“In other words, usually the doctors who do joint replacements don’t do this, and vice versa,” Schildhorn said. “It depends on the philosophy of the surgeon; there are surgeons who are joint replacement surgeons and there are surgeons who are joint-preserving, and some crossover. But for the most part, it depends on your philosophy and how you frame your practice — there’s a lot less doctors who specialize in osteotomy than specialize in joint replacement.”

Patients need to do their homework, he noted.

“Ask your doctor, “Would this be right for me? Would this preserve my knee for longer? And do you think I’m a good candidate?'” Schildhorn said. “You have to arm people with information so they can understand the risks — basically that’s what informed consent really is.”

The report was published Feb. 1 in the Canadian Medical Association Journal.

More information

For more on knee osteoarthritis, see the American Academy of Orthopaedic Surgeons.

SOURCES: Trevor Birmingham, Ph.D., professor and Canada research chair, musculoskeletal rehabilitation, University of Western Ontario, London, Canada; Jeffrey Schildhorn, MD, orthopedic surgeon, Lenox Hill Hospital, New York City; Canadian Medical Association Journal, Feb. 1, 2021

Copyright ©2020 HealthDay. All rights reserved.
A ‘Stunning’ Alternative Rx for Arthritic Joints?

A ‘Stunning’ Alternative Rx for Arthritic Joints?

THURSDAY, Nov. 19, 2020 (HealthDay News) — A procedure that “stuns” pain-sensing nerves might offer relief to people with severe arthritis of the hip or shoulder, a small, preliminary study suggests.

The procedure is a form of radiofrequency ablation, where doctors use needles to send a low-grade electrical current to nerves that are transmitting pain signals from the arthritic joint to the brain. The current heats and damages the nerve fibers, rendering them unable to deliver those pain messages.

In the United States, a number of ablation devices are cleared for treating low back pain and knee osteoarthritis.

At this point, the procedure is slowly becoming a more established treatment, said Dr. Felix Gonzalez, a radiologist at Emory University School of Medicine in Atlanta.

But whether ablation can help patients with severe hip or shoulder arthritis is unclear.

To find out, Gonzalez and his colleagues treated 23 patients whose hip or shoulder pain had become so bad that anti-inflammatory painkillers and cortisone injections — two standard treatments — were no longer helping.

Before undergoing ablation, and again three months later, patients answered standard questionnaires gauging their pain and daily function.

In the end, the study found, patients with shoulder arthritis reported an 85% drop in their pain ratings, on average. Among hip arthritis patients, pain declined by an average of 70%.

Gonzalez called the results “promising” and said, in his experience, there have been no major complications from the procedure, such as bleeding or infections — though those are potential risks.

And before the ablation is done, Gonzalez explained, patients go through what is basically a trial run. They are given an injection of numbing medication near the nerves believed to be generating the pain signals. If the pain abates, that means targeting the same nerves with ablation will likely work, too — longer term.

It’s too soon, however, to judge the effectiveness of the approach for shoulder and hip pain, according to Dr. Rajat Bhatt, a rheumatologist who was not involved in the study.

None of the study patients received a placebo (inactive treatment) to serve as a comparison, said Bhatt, of Prime Rheumatology in Katy, Texas. So it’s possible at least some of the pain relief came from the fact that patients received a novel therapy.

“With pain, there’s generally a large placebo effect,” Bhatt pointed out.

Larger studies, with a comparison group, are still needed, he said.

Gonzalez is scheduled to present the findings at the annual meeting of the Radiological Society of North America, being held online Nov. 29 to Dec. 5. Studies reported at meetings are generally considered preliminary until they are published in a peer-reviewed journal.

Osteoarthritis is exceedingly common, affecting more than 32.5 million Americans, according to the U.S. Centers for Disease Control and Prevention.

The condition arises when the cartilage cushioning the joint breaks down over time, leading to pain, stiffness and decreased range of motion.

People with osteoarthritis often take over-the-counter painkillers, such as ibuprofen (Advil, Motrin) and naproxen (Aleve). But besides being only moderately effective, the drugs are not without risks: Prolonged use is linked to increased risks of heart disease and kidney damage.

Corticosteroid injections, which reduce inflammation, are the next option. But their effectiveness wanes over time, Bhatt said, and there are long-term safety issues, including a risk of cartilage damage.

Beyond that, Gonzalez said, there are essentially two options for more severe pain: joint replacement surgery or opioid painkillers.

“But not everyone is a candidate for surgery, because of health reasons,” Gonzalez said. “And some patients don’t want it.”

Opioids, meanwhile, carry their own well-documented problems, including the potential for addiction.

“So we need something to fill the gap,” Gonzalez said.

Ablation stands as an additional therapy, he said, but it’s not a “cure.” For one, it addresses pain — not the underlying joint damage of arthritis. And the pain is not banished forever: The nerve fibers eventually grow back.

When ablation is used for knee osteoarthritis, Gonzalez said, the pain relief typically lasts 6 months or more — and up to two years in some patients. The procedure can be repeated.

In this early study, patients were only followed for three months. So it’s not clear how long the pain relief will last, Gonzalez said.

And while ablation is coming into wider use for certain pain conditions, people may not be able to find it locally. Gonzalez said some of his patients come from hours away to get the treatment.

More information

The Arthritis Foundation has more on osteoarthritis.

SOURCES: Felix Gonzalez, MD, assistant professor, department of radiology and imaging sciences, Emory University School of Medicine, Atlanta; Rajat Bhatt, MD, Prime Rheumatology, Katy, Texas; presentation, Radiological Society of North America virtual annual meeting, Nov. 29 to Dec. 5, 2020

Copyright ©2020 HealthDay. All rights reserved.

Contact Our Health Professionals

Follow Us

Call Now Button