Tennis Elbow Embolization Consultation Guide

Quick Answer

At an elbow embolization consultation, Dr. Fox reviews your history and imaging, examines the elbow to confirm the tendon is the pain source, and discusses whether embolization or another option makes sense. Bring a symptom timeline, a list of past treatments, imaging reports, your medications and allergies, and insurance information.

A consultation for elbow embolization is a conversation, not a commitment. Its purpose is to answer three questions: is your pain really coming from the tendon, is embolization a sensible option for you right now, and if so, what would the plan look like? This guide explains how to prepare, what usually happens during the visit, and the questions that will help you make a confident decision.

Before your visit: what to gather

The more history you bring, the more useful the visit will be. Try to collect:

A symptom timeline. When the pain started, whether it began after a specific activity, and how it has changed.
A treatment list. Physical or occupational therapy (dates and number of visits), home exercise programs, braces or straps, medications, and injections with dates and how long any relief lasted.
Imaging. Reports and, if possible, the images from any X-ray, ultrasound or MRI of the elbow, and of the neck if one was done.
Other specialist notes, such as orthopedic, sports medicine or nerve testing results.
A medication and allergy list, including blood thinners, diabetes medicines, and any reaction to contrast dye, iodine or antibiotics.
Relevant health history, such as kidney disease, bleeding problems, circulation problems in the arms, or prior elbow surgery.
Insurance information, so the office can begin checking benefits.

It also helps to write down how the pain affects your life: tasks you avoid, time missed from work, sports you have stopped, and sleep disruption.

What typically happens during the consultation

Your history

Dr. Fox will ask about your symptoms, work, sports, and everything you have tried. He will want to know what has helped, even briefly, and what has not.

Examination

Expect a hands-on exam of the elbow, forearm and wrist. This usually includes pressing over the bony bumps on the outside and inside of the elbow and testing wrist and finger movements against resistance, which help confirm tendon involvement. The exam also looks for signs of other problems, such as nerve irritation, arthritis or ligament injury, that would point to a different treatment. Checking circulation in the hand and wrist is part of planning any procedure that uses an artery in the arm.

Reviewing imaging

Your existing imaging will be reviewed. If you have none, or if it is old, additional imaging may be suggested. In a small 2018 study, patients whose X-ray dye images showed an obvious blush of abnormal vessels around the tendon improved more often after embolization, which is one reason careful evaluation matters.

Discussing options

You should leave with a clear picture of all reasonable options, not just embolization. For many people, especially those whose symptoms are relatively recent or who have not yet tried a structured exercise program, continuing conservative care is the right next step. Tennis elbow often improves with time: in a 2022 analysis of untreated and placebo groups across 24 trials, about 89% of people were much better or recovered at one year.

Questions to ask about embolization

Consider bringing this list:

Do you think my pain is coming from the tendon, and how sure are you?
Am I a reasonable candidate, and why or why not?
What does the research show, and how strong is it? (Our summary: small studies, promising results, no randomized trials yet.)
How do you perform the procedure: which artery, what anesthesia or sedation, which particle, and how long does it take?
What results do you expect for someone like me, and over what time frame?
What are the most common side effects, and what are the rare but serious ones?
How likely is it that I would need a second treatment? In the main 2017 study, about 36% of patients had one.
What will my first week look like, and when can I return to work or sport?
What follow-up visits do you schedule?
What are my other options if I decide not to have embolization, or if it does not help?
Will my insurance cover it, and what are the self-pay costs if not?

A good answer to question 3 should be honest about uncertainty. Our article on research and success rates can help you follow the discussion.

Questions about your treatment options? Dr. Fox can help.

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This article is part of our Embolization Guide.

Questions to ask yourself

How much is the pain costing me in work, sport, sleep or mood?
Have I given exercise therapy a consistent, progressive try?
How do I feel about a newer procedure with encouraging but limited evidence?
Is the timing right given my work, travel and family commitments?
Am I comfortable with the cost if insurance does not cover it?

There is no wrong answer. Some people decide to proceed; others decide to give conservative care more time. Our candidate guide may help you sort through these questions before you come in.

Insurance and costs

Coverage for elbow embolization is uncertain, and some major insurers list even knee embolization as experimental. If you are considering treatment, the office verifies your benefits and explains any expected out-of-pocket costs before scheduling, so there are no surprises. Read more in is tennis elbow embolization covered by insurance?

After the consultation

If embolization is recommended and you decide to go ahead, the next steps usually include:

Any needed blood tests, such as kidney function.
Instructions about medications, including whether to adjust blood thinners in coordination with your prescribing doctor.
Benefits verification and scheduling.
Written instructions about eating before the procedure, transportation, and what to wear.

If embolization is not recommended, you should still leave with a plan, whether that is a referral to physical therapy, an orthopedic opinion, nerve testing, or simply a timeline for reassessment.

It is also completely reasonable to take time to think, talk it over with family, or get a second opinion from an orthopedic or sports medicine specialist before deciding. A good plan should still make sense after a few days of reflection. If new questions come up after you get home, write them down and call the office; you do not need to decide everything in one visit.

Many people find it helpful to bring a family member or friend to the consultation. A second set of ears can help you remember details, and they can help you weigh the decision afterward.

About Dr. Fox

David Fox, MD, FACS, RPVI, is a board-certified vascular surgeon who performs image-guided embolization procedures, including for the knee, heel, shoulder, hip and elbow, at Fox Vein & Vascular, 1041 Third Avenue in Manhattan. You can learn more on Dr. Fox's profile page, read the main tennis elbow embolization guide, or see how embolization is used for other joints in our embolization guide.

Do not wait for a consultation if you have a hot, red, swollen elbow with fever, new hand weakness or numbness, or pain after a fall or a pop. Those need prompt medical care.

Frequently Asked Questions

Do I need a referral for an elbow embolization consultation?

It depends on your insurance plan. Some plans require a referral for specialist visits. The office can help you check.

Will I have the procedure on the same day as my consultation?

Usually not. The consultation is for evaluation and planning. If you decide to proceed, the procedure is scheduled after any needed tests and benefits verification.

What should I bring to my consultation?

Bring a symptom timeline, a list of treatments you have tried with dates, any imaging reports or discs, your medication and allergy list, and your insurance information.

What if Dr. Fox says I am not a candidate?

You should still leave with a plan, such as continued physical therapy, further testing, or a referral to another specialist.

Keep Reading

Sources

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with joint or tendon pain that hasn’t improved? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether embolization is right for you. Call (212) 362-3470 or request an appointment online.

Your Tennis Elbow Embolization Consultation: What to Bring and Ask