Lateral Epicondylitis

1. DIET

• Begin with clear liquids and light foods (Jell-O, soups, etc.)
• Progress to your normal diet if you are not nauseated

2. WOUND CARE

• Maintain your operative dressing, loosen bandage if swelling of the elbow, wrist, or hand occurs
• It is normal for the elbow to bleed and swell following surgery – if blood soaks through the bandage, do not become alarmed – reinforce with additional dressing
• Remove surgical dressing on the 2nd post-operative day – if minimal drainage is present, apply waterproof band-aids over incisions and change daily
• To avoid infection, keep surgical incisions clean and dry – you may shower by placing a large garbage bag over your sling starting the day after surgery
• Once surgical dressing has been removed (2nd day) you may shower with waterproof Band-Aids in place. Bandages should be changed daily.

3. MEDICATIONS

• Pain medication is injected into the wound during surgery – this will wear off within 8-12 hours
• Most patients will require some narcotic pain medication for a short period of time – this can be taken as per directions on the bottle
• Primary Medication = Oxycodone
• Take 1 tablet every 4 – 6 hours as needed
• Max of 12 pills per day
• Plan on using it for 2 to 5 days, depending on level of pain
• Common side effects of the pain medication are nausea, drowsiness, and constipation – to decrease the side effects, take medication with food.
• If constipation occurs, consider taking an over-the-counter laxative
• If you are having problems with nausea and vomiting, contact the office to possibly have your medication changed
• Do not drive a car or operate machinery while taking the narcotic medication
• Ibuprofen 400-600mg (i.e. Advil) may be taken in between the narcotic pain medication to help smooth out the post-operative ‘peaks and valleys’, reduce overall amount of pain medication required, and increase the time intervals between narcotic pain medication usage.

4. ACTIVITY

• When sleeping or resting, inclined positions (i.e. reclining chair) and a pillow under the forearm for support may provide better comfort
• Do not engage in activities which increase pain/swelling (lifting or any repetitive above shoulder level activities) over the first 7-10 days following surgery
• Avoid long periods of sitting (without arm supported) or long distance traveling for 2 weeks
• NO driving until instructed otherwise by physician
• May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable
• Formal physical therapy typically begins 7-10 days postoperatively. Please contact your therapy location of choice within 2-3 days after surgery to schedule appointments.

5. IMMOBILIZER

• Your immobilizer should be worn at all times except for hygiene and exercise

6. ICE THERAPY

• Begin immediately after surgery
• Use icing machine continuously or ice packs (if machine not prescribed) every 2 hours for 20 minutes daily until your first post-operative visit – remember to keep arm supported while icing
• DonJoy device may be used.
• Use unit as frequently as tolerated x 14 days
• If braced* - Loosen brace to avoid added pressure
• If issues with ice machine device, please contact Dr. Waterman’s office

7. EXERCISE

• No exercises or elbow motion until after your first post-operative visit unless otherwise instructed
• You may begin shoulder, wrist, and hand range of motion on the first post- operative day about 2-3 times per day
• Formal physical therapy (PT) will begin 7-10 days postoperatively. Please contact your PT location of choice 2-3 days after surgery to schedule appointments

8. EMERGENCIES

• Contact Dr. Howard or his staff at if any of the following are present:
  • Painful swelling or numbness
  • Unrelenting pain
  • Fever (over 101° - it is normal to have a low grade fever for the first day or two following surgery) or chills
  • Redness around incisions
  • Color change in wrist or hand
  • Continuous drainage or bleeding from incision (a small amount of drainage is expected)
  • Difficulty breathing
  • Excessive nausea/vomiting
  • ** If you have an emergency after office hours or on the weekend, contact the same office number ( and you will be connected to our page service)
  • ** If you have an emergency that requires immediate attention, proceed to the nearest emergency room.

3. FOLLOW UP CARE + QUESTIONS

• Typically the first post-operative appointment following surgery is 10-14 days following surgery
• If you do not already have a postoperative appointment scheduled, please contact the office during normal office hours () and ask for appointment scheduling.
• The first post-operative appointment will be with Dr. Howard where he will assess the wound, go over post-operative protocol, and answer any questions you may have regarding the procedure