tennis elbow

Epicondylitis is a painful inflammation of the base of the tendons of the muscles of the forearm, which originate in both epicondyles (epicondylus) of the lower part of the humerus.

There are two forms of epicondylitis:

Lateral epicondylitis (also known as "tennis elbow"): inflammation of the base of the tendons in the external epicondylus of the humerus (extensor of the wrist and fingers).

Medial epicondylitis (also known as "golfer's elbow"): inflammation of the tendon bases in the medial epicondylus of the humerus (flexor of the wrist and fingers).

Causes

Epicondylitis occurs due to overload of the muscles of the forearm, that is, due to strong or long-term repetitive movements.
Epicondylitis occurs due to the overuse of the forearm muscles, which is often caused by repetitive or forceful movements. Bone deposition during the optimization of the muscle base angle may stretch the periosteum, which is supplied with sensory nerves.

Possible contributing factors include:

• One-sided tension (e.g., using a keyboard, mouse, or sport climbing).
• Incorrect posture during work, housework, gardening, or leisure activities.
• Incorrect sports technique involving the active use of the hand (e.g., tennis, badminton, golf).
• Incorrect sleeping position, especially sleeping on the side with a strongly bent arm as a pillow.

It is generally accepted that too much or too little finger grip can also lead to epicondylitis. However, according to a recent study (2006), this factor does not play any role: according to the researchers, the erroneous grip force of the hand has no effect on the affected muscles of the forearm and therefore also does not play any role in the occurrence of tendinitis (inflammation of the tendons).

Prevention

Preventive measures include organizing the workplace ergonomically and avoiding excessive strain.

Symptoms

Common symptoms include pain upon pressure in the affected muscles, shooting or drawing pain throughout the forearm. Initially, the pain may occur only during exertion, but in the middle stage, it may persist even without activity, accompanied by weakened muscle strength.

Diagnostics

An orthopedic clinical examination is used for diagnosis.

Treatment

Various treatment options are available, including cooling, ultrasound, laser therapy, interference therapy, high voltage therapy, electrical stimulation therapy, muscle-strengthening exercises, bandages, dressings, shock wave therapy (ESWT and lithotripsy), topical creams and gels (e.g., Voltaren, Diclac, Dolobene), manual therapy, exercise therapy, acupuncture, neurotherapy, homeopathy, local massages, and cortisone administration. Physiotherapy has been found to be significantly more effective against epicondylitis than cortisone or waiting for improvement. Reducing the load on the affected area is crucial. It's worth noting that epicondylitis is typically a self-limiting condition, with about 90-95% of patients experiencing relief from symptoms approximately one year after therapy.

There are indications that physiotherapy helps against epicondylitis complaints by an order of magnitude better than cortisone or dormant waiting for improvement. It is important to limit the load. It is also important to know that epicondylitis is, in most cases, a self-limiting disease. Approximately one year after therapy, complaints stop coming in 90-95% patients.