Epicondylitis or tennis elbow: how to treat it

Inflammation due to repeated movement affects the elbow area and can cause a lot of pain.

Often called tennis elbow, epicondylitis is an inflammation of the joint between the bone and tendon of the elbow that can affect people who play other sports and work in various professions. As it is a very uncomfortable pain that affects the strength and dexterity of the upper limb, its treatment must be effective.

What is epicondylitis?

The name epicondylitis is related to the condyles. In this case, the condyles of the humerus, the bone in the arm that connects the shoulder to the elbow. In the elbow region, the humerus ends in two condyles, which are bony protuberances, one internal and one external. It is the external condyle, or epicondyle, that is associated with epicondylitis.

Several muscles in the forearm are connected to the epicondyle by tendons. Epicondylitis is an inflammation of the region that connects these tendons to the epicondyle, that is, to the bone. These tendons play a major role in extending the wrist and fingers, which means that professional or sporting activities that involve this movement repeatedly can lead to inflammation at the insertion of the tendons.

The dominant arm is usually the most affected. Despite this, epicondylitis can occur in both arms, but the intensity of the inflammation is never the same in both.

Risky activities

The disease is closely associated with tennis due to the type of arm movement that this sport requires. The rotational movement of the forearm in extension of the wrist, which is under muscular tension, leads to inflammation of the tendons. However, several sports can cause this common pathology, such as squash , table tennis and tennis. badminton are some of them.

On the other hand, professional activities that involve gestures similar to the sporting gesture previously described can give rise to the same pathology. Carpenters, plumbers, painters, cooks and butchers are more likely to develop this disease than the rest of the population.

Symptoms and diagnosis

The most important symptom caused by epicondylitis is pain caused by inflammation “on the outer side of the elbow,” says the doctor, specifying that this pain is inserted over the epicondyle and radiates to the end of the radius bone next to the elbow (the radius is one of the two bones in the forearm, the other is the ulna). The tendons are affected together, and the pain can vary in intensity.

In addition to pain, a burning sensation may occur and, depending on the severity of the inflammation, the affected area may become red, hot and swollen. The patient may feel a lack of strength in that arm. Activities that involve the use of the arm with epicondylitis aggravate the episode.

Based on these complaints, the diagnosis is made at a clinical level. The doctor may use ultrasound and, in certain cases, magnetic resonance imaging.

Treatments

Treatment for epicondylitis involves resting the arm in the first instance. The person must stop doing the regular activity that caused the problem. Applying ice to the elbow, taking anti-inflammatory medication and physiotherapy are some of the methods to combat inflammation.

There are two effective treatments, one of which involves peritendinous infiltration of a corticosteroid. This infiltration is an injection of this substance directly into the joint and treats the inflammation.

In addition to corticosteroids, doctors have recently been using collagen and platelet-rich plasma. Collagen is a natural product applied by infiltration with tissue remodeling properties in collagen-rich tissues such as tendons, muscles and fascia.

Platelet-rich plasma is a regenerative treatment still under study, in which the patient's blood is taken and, from it, this plasma is produced, which has anti-inflammatory, reconstruction and tissue renewal properties.

Another effective treatment is shock waves produced by a radial and focal wave device, which has been very useful in treating this pathology.
As a rule, these treatments lead to a cure in 95% of cases. In the rare cases where there is no cure, doctors resort to surgery.

When surgical treatment is required, the technique may consist of a minimally invasive intervention using radiofrequency or even a small tendon detachment, with release of the tendons. By removing the tendon tissue that has already undergone a fibrosis process, the surgery aims to alleviate tendon retraction.

Once cured, the patient may experience another episode of epicondylitis, requiring new treatment. There are also cases in which the disease can evolve into a chronic condition.

In short

Epicondylitis is an inflammation that affects the connection between the tendons and the external condyle of the humerus, usually developed by repetitive rotational movements of the forearm, common in certain sports and professions. However, there are effective treatments that cure this inflammation. As a last resort, patients may need to undergo surgery.

Original article at lusíadas.pt