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Treatment options for golfer's elbow

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Posted 10/16/2013 7:42 AM (GMT 0)
Hi, all,

You have been so kind and helpful in the past that this was the first place I wanted to come with my medical news.

I'm a 26 year old full time author and because of my constant typing on a computer, I developed golfer's elbow seven years ago. It has only gotten worse and now prevents me from working. (Yes, I did try dictation and unfortunately, my brain doesn't function that way!)

I have been on various medications from Vicodin to dilaudid. I just had an MRI which showed no damage. about a month ago, my new doctor started me on 150 mgs of Nucynta 2x a day (ER) and up to 4 fifty mg Nucynta IR per day plus 50 mgs of Lyrica 2x a day.

Each Nucynta prescription costs me almost $400 WITH my insurance. (BlueCross/Blueshield PPO through Freelancers Union.) Plus, the prescribed dosage is not covering my pain. That's not my point, however.

I am having a surgery consult on 10/30 about a spinal cord stimulator trial. I am wondering if anyone has had this done, what it was for and what your thoughts are on it.

I will be asking the question of "Why not perform surgery that an orthopedic doctor would on the tendon?" And why can't both surgeries be performed at the same time in case the spinal cord simulator doesn't work?

Has anyone had surgery for golfer's elbow? If so, I would very much appreciate hearing about it.

Thanks so much, guys!

Jess
Posted 10/16/2013 6:01 PM (GMT 0)
Hi Jess, so sorry to read what all is taking place with you. We have mixed reviews on the SCS units. Each person is so different with those. I have seen them to be of no help to helping. Just remember it is not a cure for your pain. If you will use the search feature here at the forum & type in SCS units you will pull up a lot of posts about these. It is just a real mixed bag as to whether they help or not. Some people have had them implanted and not work at all after being implanted, so its really hard to say.

Before agreeing to having a permanent one put in, do your homework before agreeing to the surgery. One of the things that bothered me the most about them is, we see people get some relief but after a couple of years they stop helping. Once the leads are put in those cannot be removed because of scar tissue. Good luck & keep us posted.....Susie
Posted 10/20/2013 6:25 AM (GMT 0)
Straydog,

I wanted to thank you SO very much for your advice here. I combed through all of the posts about the SCS and cancelled my consultation. I was quite taken aback with how it is really a major surgery. The way my PM doctor described it was so easy, outpatient and like it was a no brainier not to try it.

I am so grateful for your help and, what I belive, from preventing me from making a giant mistake.

Thank you!

Jess
Posted 10/20/2013 2:04 PM (GMT 0)
I have a SCS and am fairly happy with it. Mine is for the lumbar so placement is a bit different. The trial surgery is very simple, the leads are put in subcutaneously (under the skin, near where a permanent lead would be put, but not nearly as invasive), then they are pulled right out in the office a week later. My permanent paddle leads required a laminectomy to get them where they needed to go. You dont hear much about SCS for the neck/arms, you will find it but not nearly like the lumbars.

I had cubital tunnel syndrom, tennis elbow, which is very similiar to golfers elbow. I ended up needing surgery, ulnar nerve transposition is what the surgery is called. I am assuming you have had an EMG, corticosteroid injections, bracing, therapy and ultrasound already. Has anything helped?
Posted 10/20/2013 2:29 PM (GMT 0)
Thank you for sharing! I am so glad to hear SCS works well for you.

I have not tried steroids for two reason--one being that I faint at the sight of needles and I imagine this injection is really painful. The second reason is that my dr says steroids could weaken the tendon and that would be bad if I had surgery.

I've never heard of EMG. Will Google it. I have had an ultrasound and an MRI. I'm on Lyrica and Nucynta.

Did your surgery--the ulnar nerve transposition--help your tennis elbow?

Thanks again! :)

Jess
Posted 10/20/2013 3:47 PM (GMT 0)
An EMG measures if the nerves are being affected from the inflammation, not sure if thst is applicable in your case.

The steroid injections are painful but they can do wonders to calm things down. In my case they worked for a few weeks and then my pain came back. The surgery I had hasnt helped to much, some days are alot better than others but I still flare up when I do repetative things.

Honestly, I am surprised that a dr recommended SCS allready. Usually, it is the absolute last resort after nothing else had worked. I can only speak for myself in regards to my experience of course. Has an orthopedic dr talked about surgery at all?

Since you cancelled your SCS consultation its probably a mute point, but just wanted to let you know that once a person has a SCS you can never have an MRI or therapeutic ultrasound while it is implanted.
Posted 10/22/2013 1:16 AM (GMT 0)
Angeleyes13,

I met with one orthopedic doctor before I started with this pain management doctor. This doctor did suggest surgery--but not SCS. My PM doctor hasn't brought up me seeking ortho treatment which is a little odd to me. I am going to bring it up myself at my next appointment. She seemed very focused on the fact that very little inflammation showed in tests so she seems to think this problem can be completely corrected with Lyrica and Nucynta.

However, I am still having daily pain spikes up to a 7-8 after being on these meds for 2 months and I am not working. I took two months off to try to give my arm a break from the computer. I start back on 11-1--full force--and I am so scared that I will be in a lot of pain that will keep me from meeting deadlines. I voiced this to her and she said not worry--my pain would be under control by 11/1. Little more than concerned . . . My editors were wonderful with my taking time off but I can't do it again any time soon. It would then delay release dates of my upcoming books.

So, thank you for bring up the concern that SCS seemed a little early. I'll keep that in mind and make sure I don't just blindly follow all of her suggestions. Especially when it comes to seeing an ortho dr. If I bring it up and she says it isn't necessary, I am going to go anyway.
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