Son has a large bone spur on elbow as a result of playing baseball. Has gotten bigger in past few years. At this point the pain is so bad when he throws that he can no longer play. The orthepedic surgeon recommend rehab. Prior to going to doc we had already rested for 4 weeks and tried to throw and the pain was even worse. If we go to rehab the bone spur will still be there to cause the pain. what are your thoughts?
ultra sound, heat, ice, rest
Hi there. I am happy to help answer your question.
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I am an Orthopedic Surgeon and would like to help answer your questions. Please understand that the information that I provide is for educational and informational purposes and is not treatment or meant to substitute for being treated by a live physician. I get online once a day and therefore please bear with me if you post and I haven't responded yet. I will in do time. Please do not accept until you have had your question answered in a satisfactory fashion.
Is the bone spur a loose body? Is it palpable under the skin?
For some reason my responses are being repeated. Since you are not online, let me go ahead and answer. You can follow up afterwards with me.
If the bone spur is large or sharp and it is pushing into the triceps tendon then it probably should be removed or shaved down. How old is your son? If your son is under 16 then that is probably somewhat aggressive treatment because really it is only throwing that causes the problem.
Is he a good baseball player with advanced prospects such as college or MLB? One reason that I ask is that sometimes players who rise to the highest level tend to have surgery for smaller things such as bone spurs.
There is the potential if he goes to the MLB tryout that they could see in his history that he had previous elbow surgery and they would of course MRI his elbow and also look into the operation. So in some sense it could be an issue if he is that good.
If on the other hand this is just recreation or college level then it is not a problem to go ahead in surgery.
I will tell you that the American Academy of Orthopedic Surgeons does not have clear recommendations on the removal of bone spurs at the elbow for throwers. If it is a loose piece that is broken off then that would be a clear reason to remove the piece because it could cause damage to the joint if left floating around.
I think your Ortho Surgeon has a good opinion and it is the conservative approach. You can always have surgery down the road if it does not resolve. However, even though I would probably end up removing it I would still put the patient through the motions of trying rehab because then the surgery is really justified - the patient has failed nonoperative treatment (rehab) and continues to have pain.
I hope I have answered your question in a satisfactory fashion. If I haven't please let me know what else you would like answered.
If you would like me to look at the xrays or MRI I would be willing to take a look. Please ask as a separate question and post the films and put in the subject "For OrthoSportsDoc Only" and it will get routed to me. Thanks.