Elbow Embolization

Elbow Pain Embolization Q&A

What causes chronic elbow pain?

Elbow pain can have many causes, but two of the most common overuse conditions involve inflammation and degeneration of the tendons that attach the forearm muscles to the elbow.

These include:

Lateral epicondylitis

Lateral epicondylitis affects the tendons on the outside of the elbow. It is commonly called:

• Tennis elbow
• Pickleball elbow

Despite the names, you do not have to play either sport to develop the condition. Repetitive gripping, lifting, wrist extension, or repeated use of the forearm can place stress on these tendons.

Medial epicondylitis

Medial epicondylitis affects the tendons on the inside of the elbow. It is commonly called:

• Golfer’s elbow
• Climber’s elbow

It can result from repetitive gripping, pulling, throwing, climbing, weightlifting, or other activities that place repeated stress on the muscles and tendons of the forearm.

Both conditions can cause persistent pain and weakness that make everyday activities difficult.

What are the symptoms of tennis elbow or golfer’s elbow?

Symptoms depend on which tendons are affected.

With tennis or pickleball elbow, pain is usually concentrated on the outside of the elbow.

With golfer’s or climber’s elbow, pain typically occurs along the inside of the elbow.

Other symptoms may include:

• Elbow tenderness
• Pain when gripping or carrying objects
• Pain when lifting
• Reduced grip strength
• Discomfort during exercise or sports
• Pain extending into the forearm
• Difficulty performing repetitive hand or wrist movements
• Pain that persists despite rest or conservative treatment

Many cases improve with nonsurgical treatment. However, some patients continue to experience symptoms for months or longer.

What is elbow embolization?

Elbow embolization is a minimally invasive, image-guided procedure used to treat certain types of persistent elbow pain, including chronic medial and lateral epicondylitis.

It may also be referred to as elbow artery embolization or transcatheter arterial embolization.

Chronic tendon injuries can be associated with the development of tiny abnormal blood vessels, known as neovessels, around the painful and inflamed tissue. These vessels may contribute to an ongoing cycle of inflammation and pain.

During elbow embolization, a vascular specialist guides a very small catheter through the arteries supplying the elbow.

Using advanced imaging, the physician identifies abnormal blood vessels around the painful tendon and delivers a small amount of embolic material to selectively reduce blood flow to those vessels.

The goal is to interrupt the cycle of abnormal blood flow and chronic inflammation while preserving normal circulation to the surrounding elbow.

Can embolization treat both tennis elbow and golfer’s elbow?

Yes. The underlying embolization technique can be used to address abnormal blood vessels associated with chronic tendon pain on either side of the elbow.

This means elbow embolization may be considered for patients with:

• Tennis elbow
• Pickleball elbow
• Lateral epicondylitis
• Golfer’s elbow
• Climber’s elbow
• Medial epicondylitis

The specific arteries treated depend on the location of the patient’s pain and the abnormal blood vessels identified during the procedure.

Your Vascular Surgery Associates specialist evaluates the exact source of your symptoms before determining whether embolization is appropriate.

Why consider embolization for chronic elbow pain?

Most patients with tennis elbow, golfer’s elbow, or other overuse-related elbow pain should begin with conservative treatment.

When symptoms persist despite appropriate treatment, elbow embolization may provide another option.

Potential benefits include:

Minimally invasive treatment
The procedure is performed through a small arterial access point rather than an open surgical incision.

Targets the source of chronic inflammation
Advanced imaging allows the vascular specialist to identify abnormal blood vessels associated with the painful tendon.

No incision over the elbow tendon
The tendon itself does not need to be surgically opened or repaired during embolization.

Treats multiple forms of epicondylitis
The same underlying technique may be used for chronic lateral or medial elbow pain, depending on where abnormal vessels are identified.

Typically performed on an outpatient basis
Most patients can return home following post-procedure monitoring.

Potential alternative to elbow surgery
For appropriately selected patients, embolization may provide another option before considering a more invasive surgical procedure.

Who is a candidate for elbow pain embolization?

You may be a candidate if you have persistent elbow pain caused by medial or lateral epicondylitis and conservative treatment has not provided adequate relief.

Candidates may have:

• Chronic pain on the inside or outside of the elbow
• Tennis elbow or pickleball elbow
• Golfer’s elbow or climber’s elbow
• Symptoms lasting several months or longer
• Pain when gripping, lifting, exercising, or working
• Reduced grip strength
• Difficulty participating in sports or everyday activities
• Persistent symptoms despite nonsurgical treatment

Treatments attempted before embolization may include:

• Rest
• Activity modification
• Physical or occupational therapy
• Stretching and strengthening exercises
• Anti-inflammatory medication
• Elbow or forearm bracing
• Corticosteroid or other injections

Elbow pain can also result from arthritis, nerve compression, ligament injuries, fractures, and other conditions. For this reason, determining the cause of the pain is an important part of deciding whether embolization may help.

Your Vascular Surgery Associates specialist reviews your symptoms, medical history, previous treatments, and imaging before recommending the procedure.

What happens during elbow embolization?

Before the procedure, your care team reviews your medical history and medications and provides instructions for preparing for treatment.

During elbow embolization, your vascular specialist creates a tiny arterial access point and inserts a small catheter.

Using real-time X-ray imaging and contrast dye, the physician carefully guides the catheter through the arteries supplying the painful area of the elbow.

Once abnormal blood vessels associated with the inflamed tendon are identified, a small amount of embolic material is delivered to selectively reduce blood flow to them.

Because the procedure is performed from inside the arteries, there is no surgical incision directly over the elbow tendon.

Following treatment, your care team monitors you during recovery. Elbow embolization is generally performed as an outpatient procedure, allowing most patients to return home the same day.

What is recovery like after elbow artery embolization?

Recovery is typically less extensive than recovery following open elbow surgery.

Your specialist provides instructions regarding:

• Care of the catheter access site
• Medications
• Use of the treated arm
• Exercise
• Return to work
• Return to sports and other activities

You may temporarily need to limit strenuous activity involving the treated arm.

Improvement is generally expected to occur gradually as inflammation decreases rather than immediately after the procedure.

How soon can elbow pain improve?

The goal of elbow embolization is to reduce chronic pain, improve function, and make activities such as gripping, lifting, working, and exercising more comfortable.

Some patients experience improvement within the weeks following treatment, while others may improve more gradually.

Early clinical research on arterial embolization for chronic epicondylitis has shown encouraging improvements in pain, function, and grip strength.

However, elbow embolization remains a relatively new treatment, and the amount of published research is smaller than for many established orthopedic treatments.

Results vary from patient to patient, and no procedure can guarantee complete pain relief.

Why choose Vascular Surgery Associates for elbow embolization?

Elbow embolization requires expertise in vascular anatomy, image-guided catheter procedures, and highly selective embolization techniques.

Patients choose Vascular Surgery Associates, LLC because our practice offers:

Experienced vascular specialists
Our board-certified vascular surgeons are experienced in advanced catheter-based and endovascular procedures.