Nearly everyone will experience elbow pain at some point in their lives. Tennis and golf enthusiasts are especially prone to such injuries. Baseball players, both professionals and little leaguers, often develop pain through over use of their arms.

But you don’t have to play sports to get elbow pain. Even office workers can cause damage to their elbow joints just by frequently resting their arms on the hard surface of a desk.

Given the number of bones, nerves, tendons, and ligaments that comprise the elbow joint, it’s easy to understand why your elbow can be prone to injury.

In this Q&A, Dave Shukla, MD, an orthopedic surgeon at Mount Sinai Brooklyn, explains some of the most common causes of elbow pain and non-surgical and surgical treatment options, including recent advances in implant design and surgical techniquethat have improved the success rate of elbow replacements.

Why is the elbow such a complex joint?

The elbow is composed of the ulna and radius (bones of the forearm), the humorous (the bone in your upper arm); cartilage; and ligaments and muscles that surround the joint and keep the elbow stable. The elbow has two main nerves that signal pain: the ulnar nerve, which wraps around the exterior corner of the elbow, and the radial nerve, which runs on the front outside of the forearm.

What are the most common causes of elbow pain?

Many different issues can lead to pain in your elbow, ranging from repetitive conditions and overuse to injuries. This includes arthritis-related conditions, sprains and strains, and fractures. However, sports-related activities, notably tennis, golf, and baseball, are among the most common causes.

The pain from these sports activities can come on suddenly or gradually and may worsen with certain movements.

• Tennis Elbow (lateral epicondylitis)

Tennis elbow results from overuse or injury. However, you do not need to be a tennis player to wind up with tennis elbow.  Any repetitive gripping or grasping activity can cause this problem including using a kitchen knife to cut meat; using hand-held tools (screwdriver or hammer); painting or drawing; and knitting or crocheting. Plumbers, carpenters, butchers, and painters are among those whose jobs require the types of motion that can lead to tennis elbow. Tennis elbow pain mostly occurs where the tendons of your forearm muscles attach to the bony bump on the outside of your elbow and possibly spreading into your forearm and wrist.

• Golfer’s Elbow and Baseball Player’s Elbow (medial epicondylitis)

Any repetitive or forceful activities involving the wrist or fingers can result in this condition. The cause of golfer’s elbow is primarily damage to the muscles and tendons that control your wrist and fingers. The symptoms of golfer’s or baseball player’s elbow include pain on the inside of your elbow, or the “funny bone,” when you clench your hand into a fist.  Symptoms can also include weakness, stiffness, numbness, and tingling in the hand and wrist.

What treatments are available for tennis elbow, golfer’s elbow and baseball player’s elbow ?

Rest and physical therapy exercises are common treatments. Consult your health care provider before using any form of treatment. Simple stretches of the hand, wrist and arm, as well as grip strengthening, can often help repair the damage. Non-surgical treatments might include over-the-counter pain and anti-inflammatory medications.

How can I prevent elbow overuse injuries?

There are a number of simple things you can do.

• For playing sports, ensure you have done the proper conditions and use warm-up exercises
• Minimize the repeated impact on your elbow, such as avoiding resting your elbow on hard surfaces, especially at your desk.
• Always use proper form and gear, pace yourself, gradually increase activity levels and mix up routines with other physical activities.

When should someone experiencing elbow pain see an orthopedic surgeon?

You should follow a simple rule that if conservative measures fail after six weeks, it’s time to see an orthopedic surgeon for further evaluation. Before seeking medical help, using home remedies can help. This includes basic things like:

• Wrapping a towel around your elbow so that you don’t sleep with your elbow bent up all night.
• Wear a baseball elbow pad and place it in the front of your elbow so that you don’t bend it.

If the pain does not subside after you have taken anti-inflammatory medications and used heat or ice or any other home remedy, you should see an orthopedic surgeon.

How is elbow pain diagnosed?

First an orthopedic surgeon will conduct a physical examination and take a medical history. The surgeon will also use radiological exams to determine best courses of treatment. At Mount Sinai Brooklyn, we commonly rely on a magnetic resonance imaging (MRI), a non-invasive test, because it  provides the most information.

Will my elbow pain resolve on its own?

Sometimes, elbow pain can go away on its own, especially if it’s due to a strain or sprain. These issues are usually minor, and with home care they can subside within a few weeks. However, many of the other more serious causes usually require some kind of treatment, especially if they don’t get better after a six weeks of conservative care at home.  

What non-surgical treatment options are available?

In most cases, mild elbow soreness can be treated by icing the area, refraining from pain-causing activities, and taking over-the-counter medications.  Persistent, worsening, or severe pain may need more formal treatment and should be evaluated by an orthopedic surgeon. In the case of sprains, strains, golf or tennis elbow, therapy is often used. Physical therapy will lead to a reduction in pain and add stability to the affected joints especially in people with osteoarthritis and rheumatoid arthritis. Oral anti-inflammatory medications can help alleviate pain and swelling. If needed, a cortisone injection maybe given to provide short-term pain relief for conditions such as osteoarthritis and tennis elbow.

What are the surgical options available for elbow pain?

Surgery may be needed if symptoms don’t improve after a few months of non-surgical, conservative therapies. At Mount Sinai Brooklyn, we use minimally invasive and/or arthroscopic surgery with most procedures performed as same day outpatient surgery. This approach allows patients to immediately begin their recovery at home. Surgical options include:

• Arthroscopy—a minimally invasive procedure that uses small instruments to remove bone fragments, damaged cartilage, and bone spurs from the joint
• Arthroplasty—a minimally invasive procedure used to replace damaged joints with an artificial one
• Osteotomy—a procedure involving the removal of sections of the bone to ease symptoms and reduce any bone-on-bone contact
• Synovectomy—a procedure involving the removal of the synovium, which is a thin layer of tissue surrounding each joint

Can my elbow joint be replaced like my knee or hip?

Orthopedic surgeons can replace the elbow joint just as they do with knee and hip joints. This surgery is called elbow arthroplasty. The surgery involves replacing one or more bones that meet in the elbow with parts made of metal and plastic (implants). In the past, elbow replacement surgery had a higher rate of complications than hip or knee joint replacement surgeries. However, recent advances in implant design and surgical techniques have improved the success rate of elbow replacements. 

How long will it take to recover from surgery?

After elbow surgery, most patients usually recover within two weeks, even patients undergoing elbow replacement surgery. A complete recovery that restores full range of motion might take up to three months.

Selecting new eyeglasses can be a challenge. But with assistance from a trusted resource and an experienced optometrist or optician, you can find the perfect eyeglasses to complement your style and budget.

In this Q&A, Niki Mirzaei, OD, a board certified optometrist, offers some helpful tips when you are preparing to get new glasses, including when you need an eye exam, how to find the right frame, and the suggestions about prescription sunglasses.

Should I have an eye exam before buying new glasses?

It all starts with an eye exam and a current prescription. Adults under 40 years old whose eyes are healthy and whose vision is good should have a complete exam by an eye care professional every two to three years, or an annual exam if you wear contact lenses.  If you are experiencing vision changes, eye pain, seeing spots or blurry vision, you should have your eyes checked.

After age 40 (or for people with a family history of glaucoma), eye exams should be scheduled at least once a year to test for glaucoma. Anyone with diabetes should have an eye exam at least once a year or as recommended by their health care provider.

A vision test (also known as a refraction test) can be done as part of a routine eye exam. This test determines whether you have a refractive error (a need for glasses or contact lenses) or your prescription needs to change in order maintain clear vision. Your provider will give you a copy of your updated prescription so you can adjust your eyeglasses as needed.

How do I find the best frame to suit the shape of my face?

It’s important to choose a frame to complement your facial features. Typically, an oval face can accommodate a wide range of frame styles. Round faces are best suited to angular shapes, such as a square or rectangular. Those with faces that more square typically opt for softer round or oval-shaped frames. Oblong faces are suited to a frame that adds width or is a bold, oversized frame. It’s best to spend time trying on several styles to determine which frame will provide the best fit and flatters your face shape.

Is there a difference between plastic and metal frame options?

What material you pick is based on your personal preference and style. Metal frames are more durable, especially if made of stainless steel or titanium, and many wearers favor the nose pad as it can be adjusted to fit their face. However thin metal frames may not be able to accommodate thicker lenses.

Plastic frames are resilient, are available in a wide range of prices, and offer many colors, designs, and shapes. Also, they can accommodate a thicker lens better than a metal frame. It is best to try on several styles of each material type and see what works best for you.

How do I choose a frame that is best for my prescription?

If you have a thicker lens prescription, consider a small, full-rimmed frame that is round, cat-eye, or oval shaped as they can best hide the thickness of the lenses. You may want to avoid frames with little to no rim as they make thicker lenses more noticeable. An optician can help guide you to a selection of frames that best suit your needs.

What is the best lens coating?

When you purchase new eyeglass lenses, certain coatings are included in the price, such as a coating to reduce reflections or bolster scratch resistance. Ask your provider or optician to review what coatings are included in the price and what other options are available. Four common lens coatings are UV-protective, scratch-resistant, anti-glare, and tinted lenses. Your optometrist or optician can explain the benefits of each coating and help you choose which ones are best for you.

Are there any special considerations when buying prescription sunglasses?

The same considerations would apply to selecting sunglass frames, however larger frames provide additional eye protection. Sunglasses use the same prescription as your eyeglasses and are essential for protecting your eyes from harmful UV rays and ensuring optimal vision while driving or being outside.  The color of your lenses filter light in different ways. Some enhance colors and some are better at blocking light. Your optometrist or optician can help you choose the right one. Instead of sunglasses, you may want to consider getting “transition” lenses. These lenses darken automatically when exposed to sunlight and return to clear indoors so there is no need to switch to sunglasses when you go outdoors.

What services does the NYEE Optical Shop at East 14th Street offer?

Our Optical Shop has an experienced team of eye care experts and a wide array of quality frames, offering you value and convenience.  Make an appointment with our optometrist for a comprehensive eye exam then have your prescription filled from a trusted source. Receive personalized service, complimentary repairs, and the highest level of care.

Eggs are a great source of protein and other nutrients. But with egg prices soaring and questions around potential health risks—from bird flu to cholesterol—you may be considering alternatives.

In this Q&A, Taylor Stein, MS, RD, CDN, Associate Researcher and Registered Dietitian at The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, discusses the health benefits of eggs and egg substitutes for breakfast and baking.

What are the health risks and benefits of eating eggs?

Eggs are a good source of protein and micronutrients, including choline, B vitamins, and antioxidants, and are one of the few dietary sources of vitamin D. In terms of potential health risks, they are high in cholesterol. However, recent research indicates that eating foods high in cholesterol does not necessarily lead to high blood cholesterol in healthy people, as was once thought. Additionally, egg yolks are high in fat, but most of this fat is unsaturated “healthy fat,” similar to the fat in olive oil, nuts, and seeds.

How many eggs a day are okay?

In general, eating two eggs a day is good for most healthy people and won’t raise your cholesterol. If you have heart disease or diabetes, we recommend eating one egg and two egg whites, so you get most of the health benefits without much of the saturated fat.

With the current bird flu outbreak, are eggs safe to eat?

As with any raw animal proteins, eggs included, there is always some risk of bacteria and other pathogens. Individuals at the highest risk include those with weakened immune systems, adults aged 65 and older, children under five, and pregnant people. As long as your eggs are well cooked (at least 160°F), they should be safe. If you prefer undercooked eggs, pasteurized eggs are preheated and should be safe to eat but are generally more expensive.

Where can I find affordable eggs?

Eggs sold at local farmers’ markets or through Community Supported Agriculture (CSAs) programs may be more affordable than what you will currently find at the grocery store. Unlike commercially sold eggs, they do not go through complex supply chains, and are therefore less subject to price fluctuations.

What are some breakfast alternatives to eggs that are high in protein?

If you want something similar to eggs, or a vegan option, a tofu scramble is an easy swap. Tofu is high in protein and can be sautéed in a pan. You can even make it look like eggs by adding turmeric or nutritional yeast, and for additional flavor. There are also commercial egg replacement options—for example, Just Egg—which cook similarly to eggs and have little to no saturated fat. Keep in mind that commercial substitutes tend to be ultra-processed, so we don’t recommend eating them every day. Commercial substitutes include gums, stabilizers, and preservatives, which we just don’t know the long-term effects of high intakes of these components, which is why we suggest limiting how much you eat. Additionally, tofu and commercial egg substitutes do not have the same nutrition as eggs, so it’s important to be mindful of any nutrients that eggs are high in, such as B12 and choline, and incorporate other foods in your diet if you are not eating eggs.

Yogurt and cottage cheese are also great options, and are nutritionally similar to eggs, but be sure to check the packaging. For example, milk products may or may not be fortified with vitamin D. If you cannot consume conventional dairy products, consider ultra-filtered milk options—milk products that have been through an extra filtration process.

What are some egg substitutes for baking?

It depends on the purpose and the recipe. Eggs are used in baking for a multitude of purposes—for binding ingredients together and for leavening, as well as moisture, flavor, and browning. Depending on the purpose, you might choose from among these options:

• Unsweetened applesauce or mashed banana, ground flax seeds or chia seeds, which can create a binding effect and help retain moisture and promote browning
• Commercial egg replacers, which are usually made of starches to create a thickening or potentially binding effect
• Silken tofu, due to its protein content and structure, can mimic the texture of eggs, mostly in chilled dessert items and sauces
• Yogurt or buttermilk can help with moisture and texture
• Aquafaba, the starchy liquid left over from cooking beans (be sure to use low or no sodium), can help make things fluffy by replicating what egg whites do
• Gelatin (used as a thickener to give baked goods their structure)
• Vegan egg substitutes, which are made from mung bean protein, can be sautéed to resemble an egg omelet or scramble, and flavoring to make it taste similar to eggs

If you want the healthiest option, we recommend choosing whole food substitutes over commercial options.

For those planning to become pregnant, there is an often overlooked yet vital factor: the connection between heart health and fertility.

The growing recognition of the intersection between these two specialties has paved the way for increasingly collaborative care models and shown how fertility and cardiovascular health cannot be treated in isolation. In fact, early referrals, shared decision-making, and team-based care can significantly improve outcomes, particularly for high-risk patients.

In this Q&A, Tia Jackson-Bey, MD, a reproductive endocrinologist and infertility specialist at RMA of New York and Assistant Clinical Professor, Obstetrics, Gynecology and Reproductive Science, at the Icahn School of Medicine at Mount Sinai, and Ruwanthi Wijesinghe, MD, a cardiologist at Mount Sinai and Assistant Professor of Medicine (Cardiology), explain why maintaining a healthy heart is crucial for reproductive success, how multidisciplinary care can enhance patient outcomes, and steps you can take before, during, and after pregnancy to improve your overall heart health.

What are some common cardiovascular risk factors, and what is their connection to fertility success?

Many of the chronic conditions that affect cardiovascular health also affect fertility. This includes high blood pressure (hypertension), obesity, diabetes, and dyslipidemia. For example, diabetes can cause hormonal imbalances, and dyslipidemia—a condition in which fats in the blood are too high or too low— can affect your cardiovascular health, which in turn can affect ovarian function, hinder implantation, and even prevent the proper development of the placenta.

One critical area that has often been overlooked is a condition called endothelial dysfunction. The endothelium, a thin layer of cells lining blood vessels, plays a pivotal role in vascular health. Disruptions to endothelial function can impair blood flow to the uterus, disrupting implantation and placental development. For women looking to conceive, managing these risk factors before conception is vital for both heart health and reproductive success.

What are some ways to improve overall heart health, both before and during pregnancy?

The same general risk factors that affect your health overall affect your pregnancy and overall wellbeing. It is important to maintain a healthy diet, physical fitness, good weight, and proper levels for blood pressure and cholesterol, as well as control your blood sugar levels and reduce smoking (ideally, to quit). Sleep quality and duration has been linked as a factor in cardiovascular health; it also has a huge effect on hormonal function, which is critical to fertility. Creating a well-balanced, healthy lifestyle is an important first step.

What are some tips you would give to women who are trying to get pregnant now?

The best thing you can do to make a baby healthy is make sure you are healthy before pregnancy. Everything you do in pregnancy helps not just you, but also the baby. If you have high blood pressure, weight issues or high blood sugar levels (hyperglycemia), it can be worth pausing and getting things more under control. Optimizing your medical health prior to pregnancy can not only increase your chances of success, but also help you and your baby maintain good health for the long-term.

What occurs during a cardiovascular checkup, after a referral from a reproductive, endocrinology, or infertility specialist has been made?

We review a variety of metrics and see where we can make targeted changes before trying to conceive, as well as during and after pregnancy. We look at whether a patient is presenting a healthy weight and check blood pressure, as well as review sugar and cholesterol levels. We discuss cardiologic risk factors during pregnancy, like preeclampsia—high blood pressure that occurs generally later in pregnancy—and cardiomyopathy, a weakening of the heart muscle. We also talk about family history of pregnancy and look at congenital heart disease to see if that runs in the family; it is something we can screen for prior to patients getting pregnant.

What can be done during the process of in vitro fertilization (IVF) to help prevent the continuation of cardiovascular conditions?

We can try to prevent genetic forms of heart conditions in the next generation with testing done prior to pregnancy. If there is a condition caused by a gene mutation there is a way to test embryos prior to pregnancy with preimplantation genetic testing. Making sure patients have a thorough evaluation is important because if this gene mutation is identified, we can prevent passing it to the next generation by doing IVF and screening the embryos for that genetic mutation. Genetic counseling also plays a vital role, enabling both fertility specialists and cardiologists to assess and discuss potential outcomes.