Epicondylitis - the defeat of the elbow with the formation of the so-called "tennis elbow" - progressive degenerative process in the joint, where the muscles are attached to the projections in the humerus.
The process leads to severe inflammation of the surrounding tissues and dysfunction of the hand, it is often occupational injuries of athletes, whose activities are connected with active movements of the hand - tennis, golf, baseball.
Causes
The main cause of epicondylitis become permanent stress and microtrauma at the elbow associated with occupational or sports activity. Usually this happens when the games with the active involvement of hands, when lifting and carrying heavy loads, with inadequate load on the elbow.
Basically epicondylitis occurs because repetitive actions flexion-extension of the elbows, with simultaneous load region hands in the hand and forearm area.
Provoke epicondylitis professional actions by twisting or untwisting hands (repairmen, car mechanics, athletes), blows to the elbow.
Most of this condition develops in individuals with congenital connective tissue dysplasia and "looseness" of the joints, often combined with osteochondrosis epicondylitis in neck or thoracic spine.
Men are affected more often than women. Distributed epicondylitis athletes, massage therapists, carriers, painters. More often right-hand, left-handed, on the contrary.
Kinds
Depending on the localization of lesions and pain can distinguish three types of epicondylitis:
The lateral (outer) epicondylitis
- This form is called "tennis elbow", while it is mainly localized lesion on the outer part of the elbow.
- Oppressive feeling arises over the bones belonging to the area of the joint and tendon sprains.
- Violated a hand movement as wearing, grasping or lifting of objects by hand.
The medial (inner) epicondylitis
- It is also called "golfer's elbow", the damage is localized on the inside of the joint, where the stretching of tendons and discomfort in the bones.
Inflammation of the rear part of the elbow
In this condition develops bursitis, Affects the mucous bags.
Typically occurs at the drop of the elbow, the excessive extension arms, when making sudden movements.
symptoms of epicondylitis
The lateral shape
The most basic feature of the initial and outer epicondylitis are pain - a local tenderness at the outer part of the elbow.
Pain may give up on the shoulder and on the outer edge of the hand, can irradirovat forearm. Pain arises also when driving, can be manifested at the elbow zone feeling on the outer portion thereof, as well as in torsion arms inwardly with its folding at the elbow, hand alone does not hurt. Passive movements of the elbow and is not painful, the pain occurs only with the active resistance, when muscle tension.
The pain may be aggravated by compression of a fist and bending of the wrist, the pain intensifies gradually, appearing already at low movements or by holding the hand of small weights.
Externally, the hand is not changed, the range of motion in it is not limited to, at a palpation the doctor can determine the point maximum pain, bred both in the tendon attachment and mounting area muscles.
Sometimes the swelling of the tissues in the area of damage squeezes branches of the radial nerve, which is manifested paresis of the muscles, the extensor fingers and wrist.
Usually external epicondylitis occurs chronically, to create relaxation and rest, and muscle damage tendon pain disappear, but when heavy loads or resuming training again arise. Strengthening load provokes severe pain attacks.
medial form
Internal epicondylitis usually occurs in those who are exposed to a mild but long and monotonous physical stress (machinists, dressmakers, fitters, golfers). This form often in women.
Pain in the medial epicondylitis arise in the interior of the elbow, with pressure on the inner epicondyle. Pain aggravated by bending the arm and twisting it in, give in the area of the inside of the shoulder to the underarm and forearm to the thumb. This form also occurs chronically.
Diagnostics
The basis of the diagnosis - clinical manifestations, as well as a thorough examination of the patient and asking kind of activity.
In the future, use X-rays of the joint multi-view, and if necessary - computed tomography. Changes in the joint can be detected only with chronic long-term course.
Blood and biochemistry do not change with epicondylitis.
Thrust epicondylitis should be distinguished from the epicondyle fracture, rheumatic and other damage to the elbow joint, intra-articular fracture of the humerus.
Methods of treating epicondylitis
The treatment takes a doctor traumatologist. Treatment is mainly conservative, primarily carried out:
- topical application of anti-inflammatory drugs on the basis of ibuprofen or diclofenac
- when pain shown administering corticosteroids mixture with anesthetics,
- in advanced and complex cases, use of extracorporeal shock wave therapy,
- girudoterapija (application of medicinal leeches),
- acupuncture, acupuncture,
- postisometric relaxation of tight muscles zone
- root tincture of sorrel, bay leaf oil solution on the affected area,
- rest at the joint area with the retaining bandage (Bandage eight-shaped with a protective elbow).
The load on the hand should be given gradually, initially using the methods of physical therapy and low traffic.
Forecasts for the treatment of
If early diagnosis can be achieved complete healing epicondylitis in a few weeks, on average, relief comes in 3-5 days, but rehabilitation lasts for about a month.
The process tends to recur, so you need prophylaxis dosing loads on the arm, avoiding stereotypical movements.
