Elbow Pain Specialist

Beverly Hills Advanced Pain and Spine

Interventional Pain Medicine Specialist located in Los Angeles, CA

Pain at the elbow joint is often the result of tendon overuse, which causes scaring of the tendon and calcium buildup. This is commonly referred to as either Tennis Elbow or Golfer’s Elbow, depending on which side of the elbow is affected. Medically, these are referred to as lateral or medial epicondylitis. Dr. Enayati offers the latest minimally invasive treatment options for these painful conditions. Dr. Enayati is a Elbow Pain Specialist located in Beverly Hills.

Elbow Pain Q & A

What causes chronic elbow pain?

Although commonly referred to Tennis Elbow and Golfer’s Elbow, epicondylitis can occur as a result of any type of over-use, from typing to sports activities. Importantly, trauma can also cause epicondylitis and chronic elbow pain, including impact injuries or tightly holding on to a steering wheel during a car accident. The high-velocity energy is absorbed by the tissue, causing an inflammatory reaction, which causes scarring, calcification, and even shortening of the tendons.

Can chronic elbow pain be resolved with medications, physical therapy, and stretching?

It depends. Often, acute elbow pain from trauma will resolve with conservative therapy and care (i.e., rest, stretching, and over the counter anti-inflammatory medications). If the symptoms do not resolve with conservative care, it is likely that scar tissue and calcification have occurred over and into the tendon, leading to chronic pain, aching, throbbing, and pain with use of the elbow. As more scar tissue forms, the elbow and grip can become weak, and patients often complain that they cannot open cans and bottles as they used to.

My elbow pain is chronic and has not resolved with after 6-12 months. Do I have to have surgery?

No. Surgical release, which is really cutting of the tendon, is not a guarantee to resolve the symptoms, and there is actually a risk of causing more scar tissue to form. The recovery time from surgery can be extensive, the elbow may never feel as strong again afterward, and the change in the balance of tendons may place extra stress and strain of the other tendons that have to compensate. Instead of surgery, Dr. Enayati offers minimally invasive treatment with less risk and a great likelihood of success.

How can Dr. Enayati treat my chronic elbow pain?

Dr. Enayati offers the most cutting-edge treatment for chronic elbow pain, called a percutaneous tenotomy. This procedure is much less invasive than a traditional tenotomy and allows you to use your elbow immediately afterward! The procedure is performed in the office, under local anesthesia, and there is virtually no recovery time! In this procedure, Dr. Enayati views the inside of the elbow using live ultrasound imaging as he uses a special needle to break up scar tissue and calcium deposits in and around the tendon. Afterward, he can inject corticosteroids to reduce inflammation as the elbow heals. But as an alternative to steroids, Dr. Enayati prefers injecting Platelet Rich Plasma (PRP), and sometimes amnion stem cell allograft, into the tendon to promote cellular healing and tendon and tissue regeneration. There is no downtime after the procedure --in fact, Dr. Enayati will encourage you to be diligent with stretching and physical therapy exercises to promote recovery – we do not want the elbow immobilized.

Is there data to support this advanced medical procedure?

Yes. This procedure is well understood and has demonstrated excellent long-term success. Below is a recent example of a major study showing how effective the procedure is.

“Minimally invasive percutaneous ultrasonic tenotomy provided sustained pain relief and functional improvement for recalcitrant tennis elbow at 3-year follow-up. It is one of the few procedures to demonstrate positive sonographic evidence of tissue-healing response and is an attractive alternative to surgical intervention for definitive treatment of recalcitrant elbow tendinopathy.”

Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Sustainability and Sonographic Progression at 3 Year 
American Journal of Sports Medicine 
2016 Feb; 44(2): pages 504-10

 

Most PPO Insurance Plans Accepted

Beverly Hills Advanced Pain and Spine accepts most PPO insurance plans.  We also are pleased to accept most Aetna POS plans, most Cigna OAP plans, and most international insurance and “expat" insurance.  We do not accept Covered California, Kaiser, HMO plans, EPO plans, Medicare, or MediCal, but we welcome all of those patients on a self-pay basis.  Please note that some of our advanced treatments are self-pay only. 

Aetna
Anthem Blue Cross
Cigna
United Healthcare