Epicondylitis

Epicondylitis – General Information

Epicondylitis – Symptoms

It has been discovered that x-rays are usually normal for affected elbows, so the diagnosis of the condition is made by symptoms and other clinical signs. The tendon will present pain when it is gently pressed in the region near where it attaches to the bone of the upper arm, both over and outside of the elbow. Exposure to unaccustomed strenuous activity later in life, like starting to practice a sport later, or exposing to physically work to which your arms are not used, may trigger the condition. Other actions or elbow stresses like decreasing the reaction times, or speeding repetitive muscle contractions put pressure on the region, thus becoming a threat.

Epicondylitis – Treatment

Initial measures for dealing with pain of the elbow are rest and cold water/ice compression. Cold therapy products for such problems are widely found in shops and pharmacies. There are also a wide range of nonsteroidal anti-inflammatory drugs, also called NSAIDs, like ibuprofen, effective in reducing the pain and the inflammation. After healing, preventing the injury from happening again may be accomplished by wearing a splint during aggravating activities, or a brace. Keeping an ergonomic work medium is a good way to avoid the appearance of the condition. Certain stressful activities may need to be limited. If the pain in the elbow region persists, surgery may be needed.

The intra-articular glucocorticoid steroid injections may be effective for several months, but present a high risk of side effects, local infection or tendon rupture. Therefore, most doctors are restrictive towards giving further courses after two injections. The effectiveness of the injections reduces each time, so the method it is rather short-termed. Other methods for dealing with tennis elbow are physiotherapy, exercises and stretches and alternative treatments like laser therapy.

Stretches, progressive strengthening exercises and progressive physically activities are essential for preventing the re-irritation of the elbow tendon. Weights or elastic therabands are involved in these exercises and increase a pain free grip of the wrist, wrist strength and forearm strength. In general, increasing the strength of the parts and muscles of the whole arm prevents tennis elbow and also treats it. So, racquet sport players often work their shoulder rotator cuff, abdominal and scapulothoracic muscles. Other methods like massaging of the arms or soft tissue release help reduce muscular tightness and tension. Another way of realigning the muscle fibers and redistribute the tension is by strapping the forearm.

Physiotherapy or ultrasound can be used to reduce inflammation in the elbow region and to promote collagen production. Manual therapy works the elbow joint’s movement, or mobilizes the muscle tissues, thus being an important part of the therapy. Nerve mobilization generally offers information about the condition. The radial nerve is the most common upper limb nerve that is sensitive to nerve mobilization. Clasping the elbow is also a method to temporary relief the pain symptoms.

In our days, Low Power or Low Intensity Laser Therapy may be used for treating Epicondylitis. The concept behind this method is that light affects cells, and it stimulates and accelerates the normal healing. The most important thing in this method of therapy is the dosage, the intensity and the frequency of the laser. Therefore, only experienced clinicians apply the therapy. The method was used by professional athletes and it has attracted attention among the media, but studies that evaluated the laser therapy method in the case of patients with Epicondylitis show contradictory results.