Epicondylitis

EpicondylitisEpicondylitisDescription, Causes and Risk Factors:Epicondylitis is an uncommon disorder, with the overall prevalence in the general population reported to be from 1-5%. There are fewer epidemiologic studies addressing workplace risk factors for elbow MSDs than for other MSDs. Most of these studies compare the prevalence of epicondylitis in workers in jobs known to have highly repetitive, forceful tasks (such as meat processing) to workers in less repetitive, forceful work (such as office jobs); the majority of these studies were not designed to identify individual workplace risk factors.Lateral epicondylitis, is one of the most common elbow problems seen by an Orthopedic surgeon. It is actually a tendinitis of the muscle called the extensor carpi radialis brevis which attaches to the lateral epicondyle of the humerus. It may be caused by a sudden injury or by repetitive use of the arm.The cause is repeated contraction of the forearm muscles that you use to straighten and raise your hand and wrist. The repeated motions and stress to the tissue may result in inflammation or a series of tiny tears in the tendons that attach the forearm muscles to the bony prominence at the outside of your elbow (lateral epicondyle).Playing tennis — especially repeated use of the backhand stroke with poor technique — is one possible cause of epicondylitis. However, many other common arm motions can cause epicondylitis, including:Using plumbing tools.
  • Painting.
  • Driving screws.
  • Cutting up cooking ingredients.
  • Excessive computer mouse use.
Factors that may increase your risk of epicondylitis include:Age. While epicondylitis affects people of all ages, it is most common in adults between the ages of 30 and 50.
  • Occupation. People who have jobs that involve repetitive motions of the wrist and arm are more likely to develop tennis elbow. Examples include plumbers, painters, carpenters, butchers and cooks.
  • Certain sports. Participating in racket sports increases your risk of epicondylitis, especially if you employ poor stroke technique.
If you experience repeated or continuous pain in your elbow or forearm, you should see a medical professional so that a proper diagnosis can be made.Symptoms:The symptoms of epicondylitisinclude pain that is apparent near the outside area of the elbow. The pain usually radiates along the forearm, and may also be felt through the wrist and in the back of the hand. The pain typically develops over time, increasing in severity, although it can come on more suddenly if an abrupt injury occurs rather than a repetitive use injury. Symptoms are often felt in a person's dominant arm, since that is the arm that is most often used for most movements, although it can occur in both arms. The pain associated with tennis elbow will typically be worse when moving the wrist quickly or twisting it, when squeezing objects, or even with actions such as shaking hands or grasping an object.Diagnosis:In many cases, your medical history and the physical exam provides enough information for your doctor to make a diagnosis of epicondylitis. But if your doctor suspects that something else may be causing your symptoms, he or she may suggest:X-rays. An X-ray can help your doctor rule out other possible causes of elbow pain, such as a fracture or arthritis.
  • Magnetic resonance imaging (MRI). Problems in your neck can sometimes cause symptoms similar to tennis elbow. MRI machines use radio waves and a strong magnetic field to produce detailed images of bones and soft tissues.
  • Electromyography (EMG). This type of test can check to see if your symptoms are linked to a pinched nerve. During an EMG, fine wires are inserted into a muscle to assess electrical changes that occur when the muscle moves.
Treatment:Treatment options:Conservative treatment is in two phases and after Phase I (Pain relief) has been successful, Phase II (Prevention of recurrence) is equally as important and involves stretching and then later strengthening exercises, so the micro tears will not occur in the future.When conservative treatment does not work, then surgery is indicated. Many procedures have been described. Procedures as simple as percutaneous release of the tendon off of the bone have been described and more recently arthroscopic procedures or other procedures involving the joint and resection of a ligament as well have been described.The most popular procedure today is a simple excision of diseased tissue from within the tendon, shaving down the bone and re-attachment of the tendon. This can be performed as an outpatient procedure with regional anesthesia (where only the arm goes to sleep) and through a relatively small incision of approximately 3” long. 85-90% of patients with this technique are typically able to perform full activities without pain after a recuperation of two to three months. Approximately 10-12% of patients have improvement but with some pain during aggressive activities and only 2-3% of patients have no improvement.NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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