Epicondylitis is defined as a painful syndrome affecting theelbow area. This condition is also nicknamed “tennis elbow” because it is common among tennis players.
This is aninflammation of the tendons and extensor muscles of the forearm near their insertion on the lateral epicondyle. This is a bony protuberance of the humerus in its lower portion where, together with the radius and ulna, it forms the elbow joint.
Causes of epicondylitis
It is usually caused by a functional overload of the forearm muscles as precisely occurs when playing certain sports such as tennis but also golf, squash, baseball, and javelin.
People who work in specific fields where the elbow joint is affected more than others can also suffer from it: plumber, bricklayer, gardener, tailor, musician, dentist, etc…
It usually occurs in ages 30 to 50 although anyone can be affected by tennis elbow if jobs involving repetitive wrist and elbow movements are performed.
Symptoms of tennis elbow
The symptoms of epicondylitis develop gradually.
- Pain: at first mild, typically punctal, when making wrist extension movements against resistance. Painful symptomatology at first localized in the region of the outer elbow, may radiate down the forearm and persist even at rest;
- Swelling: usually mild;
- Morning stiffness: a sense of difficulty in performing flexion and extension movements of the forearm and wrist may appear in the morning. The movements seem “mellow” and still not as fluid and free as in the contralateral limb;
- Decreased strength: Grip becomes weak and painful, even while holding small, relatively heavy objects in the hands.
Diagnosis of epicondylitis
It is not difficult to diagnose epicondylitis. The onset of painful symptomatology at the outer elbow after functional forearm overload is, in itself, significant for tendinopathy. However, a visit to the orthopedist is necessary to rule out concomitant diseases and set up proper therapy by correctly identifying the extent of the disorder. Medical diagnosis can be made by:
- Ultrasound: can provide little information on the degree of inflammation of inflamed tendons;
- Radiography: mainly used to rule out degenerative diseases that may concomitant such as osteoarthritis and arthritis. X-rays of the elbow may show the presence of calcifications that can fuel tendon suffering;
- MRI: to the cervical spine district, again to rule out radial nerve compression symptomatology due to herniated disc.
How to treat tennis elbow
Tennis elbow is classically a self-limiting condition that tends to heal provided the following steps are implemented early:
- Rest: it is the first measure to be implemented. Limiting the activity of inflamed tendons as much as possible is a top priority. In severe cases, immobilizing braces or a cast must be used;
- Anti-inflammatory drug therapy: recommended the use of F.A.N.S. such as ibuprofen or ketoprofen also in creams or gels to be applied topically. In more severe forms, corticosteroid infiltrations directly into the painful area of the elbow may be effective;
- Laser Therapy: aimed at reducing inflammation of the tendons involved;
- Shock wave: to fragment tendon calcifications often present in chronic epicondylitis.
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