I've had the pain you speak of. Actually I've had shoulder and elbow surgery, along with the knees. I was to the point that I had to switch picking up my cup to the other hand to have a drink because of the pain.
I got the xbow permit and used it one year. Not my cup of tea but I couldn't pull a bow back. Compound bows aren't the way to go. Actually they are worst than the trad bows.
With the compound you still have to pull all the weight, then a sudden let off, not good. With a trad bow you can just pull nice and smoothly till the pain says no more, and letting it down doesn't bother you like it does on a compound.
Do all the therapy and exercises without too much weight. Don't push it. The elbow wraps with the little air pillow on them will really help, but if surgery is needed do it.
I ended up dropping my draw weight to about 30# then slowly went a little heavier. It took me at least a full year to reach 50+#. Now I shoot 55-60# most all the time.
I still have to pay attention to the pain, but now I have pain in all my joints due to Arthritis, Fibromyalga and Neuropathy. I still can shoot my bows though, most of the time anyway.
So if ya need surgery, do it as soon as ya can. The sooner it's done, the sooner ya can start healin'. Therapy, exercise, and rest, oh yeah don't forget the ice, will get ya back to shootin' and enjoyin' it. Good luck, have faith, and just forget about them compounds, they won't help ya. Good luck...