4 August 2021 Author : Pedro Lourenço Lateral epicondylitis is a common problem of the elbow joint and a frequent reason for seeking medical care from an orthopedist. It was first described in 1873 by F. Runge, a German physician. Despite the current designation 'tennis elbow' , lateral epicondylitis can arise in both athletes and non-athletes. It affects 1%-3% of the population; Has an incidence peak in the early fifth decade of life; Tends to appear earlier associated with professional and/or physical activity; It has no gender preference. Causes of lateral epicondylitis The causes of lateral epicondylitis are many, in most cases an obvious single cause is not identified. It can occur associated with repetitive activities of pronation-supination, that is, rotation of the forearm, with the wrist in extension, such as those that happen, for example: In the practice of racket sports; When using a computer mouse. Despite these triggering factors, recent studies suggest that genetic factors also play a role in the development of lateral epicondylitis. Symptoms and diagnosis The most common complaint is pain : It can be intermittent or continuous; Its severity is variable, it can interfere with current activities or even with sleep. In more advanced cases, it may be difficult to do specific movements or positions. Diagnosis is based on complaints, physical assessment and carrying out some tests with the patient and, when necessary, using some diagnostic imaging tests. For a correct diagnosis it is essential to identify the precise location of the pain . The landmark for pain is the lateral epicondyle - the bony prominence on the side of the elbow. Pain is aggravated with wrist extension against resistance. The tendinitis (inflammation of the tendon) and/or microrupture that marks the onset of lateral epicondylitis usually occurs in the tendons of the extensor muscles of the carpus and fingers. These are the muscles and tendons in the forearm, which connect the elbow and hand. Radiography, ultrasound and magnetic resonance imaging are imaging techniques that can aid in the diagnosis of tennis elbow. They also allow us to exclude other diseases that can cause similar symptoms, such as osteochondritis, instability, and radial tunnel syndrome. Tennis elbow treatment The overall goal of treatment is to control pain, maintain movement, improve strength and endurance, and regain normal functionality. Some cases of lateral epicondylitis that are self-limiting, that is, the symptoms disappear within a few months. Often these patients only take analgesic medication to relieve pain. Conservative treatment with changes in usual activity is effective in many patients. Depending on the cases, it may include: Rest; Local cold application; Injectable medication; Physiotherapy with different approaches, including stretching and muscle strengthening. Another option, with promising results, is infiltration with platelet-rich plasma from the patient. When none of these approaches solves the problem, surgery can be proposed to repair the affected muscles and tendons . This intervention can be performed openly (with an incision) or by arthroscopy (through small holes). Excellent results are described for both techniques. Meet the orthopedics team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
