Epicondylitis of the elbow joint is a very common disease among athletes and representatives of some other professions. The disease is accompanied by inflammatory and degenerative changes in tissues in the area of the elbow joint. If left untreated, pathology can lead to very dangerous and serious complications.
Many people are interested in any additional information about the disease. Why does epicondylitis of the elbow develop? Symptoms and treatment, causes and possible complications, preventive measures - this is very useful information that should not be ignored.
Brief information about the disease
Many people are faced with such a problem as epicondylitis of the elbow joint. ICD-10 refers this disease to the group "Other enthesopathy" (code M77).
This is a very common disease of the musculoskeletal system, which is accompanied by damage to the tendons, periosteum, epicondyle and itsvagina. The main cause of the development of the disease is chronic overstrain of the muscles of the forearm.
According to statistics, in most cases the disease is diagnosed in patients aged 40 to 60 years. On the other hand, if we are talking about professional athletes, then degenerative processes can begin much earlier.
The main causes of the development of the disease
As already mentioned, the inflammatory process is preceded by degenerative changes in the area of the elbow joint. The causes of epicondylitis can be different.
- Such a disease often develops as a result of the peculiarities of the profession, especially if the work is associated with the same type of movements, chronic overload of the joint, regular microtraumas. The risk group includes builders (plasterers, masons, painters), agricultural workers (milkmaids, tractor drivers), athletes (golfers, weightlifters, tennis players, boxers), musicians, doctors (surgeons), etc.
- Causes include direct injury to the elbow.
- Inflammation can develop against the background of impaired local blood circulation and, accordingly, tissue trophism.
- Such a pathology is often associated with some other diseases, in particular, cervical or thoracic osteochondrosis, osteoporosis, humeroscapular periarthritis.
- The list of causes includes congenital weakness of the ligamentous apparatus.
Epicondylitis of the elbow: symptoms and signs
Of course, the clinical picture largely depends on the form of the disease and the stage of its development. However, there are a few common symptoms of epicondylitis of the elbow.
- The disease is accompanied by intense pain in the elbow area. Unpleasant sensations arise spontaneously, for no apparent reason. The pain during the attack is very strong, burning. Gradually, it becomes aching, but becomes constant.
- Pain syndrome intensifies during physical exertion, prolonged muscle tension of the forearm.
- As the disease progresses, the muscles lose strength. Even habitual daily movements cause severe and rapid fatigue.
- In the initial stages, pain disappears at rest. But as the disease develops, discomfort is present almost constantly.
External epicondylitis
Lateral epicondylitis of the elbow joint is a common form of the disease, in which the tissues in the area of attachment of the muscle tendons to the lateral epicondyle become inflamed.
Pain attacks in this case appear against the background of overstrain of the extensor muscles, which are located on the outside of the forearm. This form of the disease is called "tennis elbow", since it is people who are actively involved in this sport that suffer from pain in the elbow. Soreness can appear when turning the hand palm up, as well as during a handshake.
Internal (medial) epicondylitis
Mesial epicondylitis of the elbow joint is accompanied by tissue damage inwhere the tendons of the muscles attach to the medial epicondyle. By the way, this form of the disease also has a special name - “golfer's elbow”. The development of the disease leads to monotonous movements that are performed due to the tension of the flexor muscles of the wrist.
Of course, golfers are not the only "victims" of this disease. Tailors and machinists often face such a problem. Predispose to the development of the disease and sports such as throwing a shot or throws.
As a rule, an attack of pain is associated with pressure on the epicondyle. Unpleasant sensations intensify during flexion of the forearm. The disease often becomes chronic. The ulnar nerve is often involved in the pathological process.
Other forms of the disease
You already know how and why medial and lateral epicondylitis of the elbow develops (treatment will be described below). But there are other forms of the disease.
- Traumatic epicondylitis is said to occur if the disease develops as a result of permanent microtrauma. This is observed, for example, with the constant performance of monotonous movements. In most cases, patients over 40 years of age face a similar problem. In addition, the disease is often associated with cervical osteochondrosis, damage to the ulnar nerve, and deforming arthrosis.
- The post-traumatic form of the disease develops in patients who have previously suffered a dislocation or sprain of the joint. In most cases, the disease is associated with non-compliance with the rules of rehabilitation.
- Chronic epicondylitis of the elbow is usuallyis the result of improper treatment of the acute form of the disease or lack of therapy at all. In this case, episodes of exacerbations are replaced by relatively long periods of relative well-being.
Diagnostic procedures
Diagnosis in this case is rarely difficult. Taking anamnesis and general examination is enough to suspect the presence of epicondylitis in a patient. For example, during a consultation, you may notice that pain occurs only against the background of muscle tension - if the doctor moves the patient's arm, bending it at the elbow, then there are no discomfort.
Of course, some additional procedures are carried out in the future. For example, a blood test helps to identify the inflammatory process. An x-ray is taken to confirm the presence / absence of a fracture, foci of osteoporosis. If carpal tunnel is suspected, the patient may be sent for an MRI.
Drug therapy
The treatment regimen directly depends on the stage of development of the disease and the intensity of the symptoms. If the pain is not too severe, then patients are advised to rest and bed rest. In the event that the pain syndrome is severe, the hand is temporarily immobilized with a plaster cast.
Non-steroidal anti-inflammatory drugs, which are available in the form of tablets and ointments (they are used to treat skin tissues in the elbow joint), help to cope with pain. Effective means such asNimesil, Nurofen, Ketonal, Diclofenac, Ibuprofen, Nise.
For severe symptoms, blockade with corticosteroids is performed. Effective is metiprednisolone, hydrocortisone (they are mixed with anesthetics and administered only later). Such drugs help to quickly relieve pain and improve the patient's condition. Sometimes drugs are introduced into the therapy regimen that improve tissue trophism and normalize blood circulation.
Physiotherapy for elbow injury
This disease requires an integrated approach. In addition to drugs, various physiotherapy procedures are used. For example, during an exacerbation, high-intensity magnetotherapy is effective (the course of treatment consists of 5–8 sessions). Infrared laser radiation is also effective (a full course of treatment includes 10-15 procedures).
After the inflammatory process has subsided, other techniques are applied. During rehabilitation, shock wave therapy, electrophoresis (using potassium iodide, acetylcholine, novocaine), phonophoresis (anesthetics and hydrocortisone are used during the procedure) are performed. Patients are shown cryotherapy using dry air. Good results can be achieved with regular naphtholone and paraffin-ozocerite applications.
Epicondylitis of the elbow joint: treatment with folk remedies
Drug therapy lasts several weeks, followed by a long period of rehabilitation. Patients are constantly engaged inphysiotherapist - exercise therapy is extremely important as it helps prevent muscle atrophy.
What else can be done with a disease such as epicondylitis of the elbow joint? Folk remedies, of course, exist, but they can only be used with the permission of a doctor.
- Compresses from horse sorrel are considered effective. A liter jar is filled with fresh leaves of the plant, filled with a bottle of vodka, closed and infused in a dark place for ten days. In the resulting liquid, a cloth or gauze bandage is moistened, which is then applied to the skin over the affected joint. The compress is fixed and left overnight.
- There are other recipes that are used for epicondylitis of the elbow joint. Treatment with folk remedies includes the use of laurel oil. It can be purchased at a pharmacy or you can prepare it yourself. Four tablespoons of chopped bay leaves are poured into a glass of sunflower (or olive) oil. The mixture is infused in a dark place for a week. The resulting oil tincture is rubbed into the skin in the elbow area daily.
- Blue clay wraps are considered effective. Clay powder is poured with hot water and mixed so that a homogeneous mass is obtained. The warm mixture is spread on gauze, which is then wrapped around the affected elbow. From above, the compress is covered with cling film and a woolen shawl or towel. The clay is kept on the skin until the mixture has cooled completely. Since the procedure involves the use of heat, it should not be used for acute inflammation.
When neededoperation?
In the event that conservative therapy fails and the pain persists for 3-4 months, the doctor may decide to perform a surgical intervention.
The procedure is usually performed under general anesthesia. The epicondyle is exposed by making a small incision. In front of him, the doctor makes a small incision in the tendon fibers. This does not violate the integrity of the bone, extensor attachments. Also, the procedure is not associated with damage to nerve fibers and blood vessels. After the operation, the patient is sutured, and the arm is fixed with a plaster cast. The stitches are removed after two weeks. This is followed by a period of rehabilitation.
Prognosis for patients
Prognosis for patients with epicondylitis of the elbow in most cases is favorable, especially if the disease was diagnosed in time. On the other hand, if untreated, degenerative processes can spread to the tissues of the joint itself. Complications include bursitis, which is much more difficult to treat and often requires surgery.
Prevention measures
Epicondylitis of the elbow joint is a very unpleasant disease that requires immediate treatment. But even after successful therapy, patients need to take some precautions in order to avoid complications and relapses. Prevention comes down to a simple list of rules.
- If youdo sports, it is important to follow the correct technique for performing all exercises.
- Before any kind of physical activity, you need to do a warm-up in order to warm up the muscles and other structures.
- If intense physical activity is coming, then you need to use special pads on the elbow or fix the joint with an elastic bandage.
- If the work is connected with constant monotonous movements, then it is important to take breaks from time to time.
- Doctors recommend periodically taking vitamin complexes (1-2 times a year, as a preventive measure).
- All inflammatory diseases should respond to appropriate therapy in time.
Of course, when the first signs appear, you should not hesitate - immediately contact a specialist.
