Epicondylitis: symptoms and treatment


Epicondylitis is a pathology that affects only the area of ​​the elbow joint and leads to a disruption of its functions. The main reason for the formation of such a disease is physical overstrain in conjunction with the attachment of the inflammatory process. However, clinicians identify several more rare predisposing factors.

The first and main symptom of the disease is intense pain, against which other clinical manifestations are formed.

Establishing the right diagnosis requires an integrated approach, and treatment is most often done in conservative ways.

In the international classification of diseases, the ailment can be found under several codes, which differ in the form of the disease. Thus, the code for the ICD-10 is M77.0 and M77.1.

Etiology

The fundamental factor in the formation of pathology is the overstrain of the elbow joint of a physical nature, but degenerative changes precede inflammation.

This type of ailment can provoke:


  • severe working conditions in which a person is forced to constantly strain the muscles of the shoulder and forearm
  • permanent microtrauma in this area
  • chronic sports overload;
  • violation of local blood circulation
  • direct shoulder or elbow injuries;
  • osteochondrosis;
  • humeroparous periarthritis or osteoporosis.

Such a disease is very common in people whose sphere of activity is directly related to the same type of hand movements, in particular, turning the forearm inward and palm down or turning the elbow outward, and the palm facing up.

It follows that the main risk group is:


  1. agricultural workers
  2. builders and doctors
  3. athletes, namely boxers, tennis players, weightlifters, golfers, as well as people engaged in weightlifting and weightlifting
  4. Musicians and workers from the service industry, for example, hairdressers.

It must be taken into account that the above-mentioned working conditions in themselves are not a factor in the formation of the epicondylitis of the elbow. The ailment develops against the background of the strongest overload of the muscles of the forearm, provided that microtraumas of the joint tissues appear. As a result, inflammation begins to form, small scars — they even more affect the decrease in the resistance of the tendons to physical activity.

Less often the disease develops in the background:


  • weakness of the ligamentous apparatus of the elbow joint — but with the condition of its congenital form
  • single strongest muscle overexertion.

Classification

Clinicians agree to distinguish several forms of the disease:


  1. External or lateral epicondylitis of the elbow joint — is formed much more often than the opposite type of pathology. Characterized by slower progression and severe course. Often observed in males and results in damage to the short radius extensor of the hand
  2. Internal or medial epicondylitis of the elbow joint is the rarest type of disease that is often diagnosed in female representatives. In this case, the radial flexor of the hand is damaged.

In addition, there are three stages of the disease:


  • subacute — characterized by the appearance of minor pain and muscle weakness;
  • acute — is characterized by the expression of a strong pain syndrome
  • Chronic — the main clinical sign has a noisy, but permanent manifestation. Such a pattern of the course of the disease is said when the alternation of symptoms of exacerbation and remission is observed for more than three months.

Symptoms

External epicondylitis is expressed by the following signs:


  1. Localization of soreness is on the outer surface of the elbow joint. Pain is strengthened during extension or rotation of the hand
  2. muscle weakness of the affected upper limb
  3. the appearance of soreness when trying to take a full cup from the table
  4. unpleasant sensations arising in cases of pressure on the lateral condyle.

Internal epicondylitis is determined by the following symptomatology:


  • The locus of pain is located on the inside of the elbow joint
  • muscle weakness from the affected side during grasping
  • increased pain while holding the patient’s arm at right angles, or when flexing the forearm
  • the presence of seals during palpation in the area of ​​the medial epicondyle

In addition, it is rare in this disease, the presence of such clinical manifestations:


  1. spasmodic capillaries
  2. Acquired skin in the affected area of ​​a red shade
  3. increase in temperature in the area from the elbow to the forearm.

Diagnostics

When one or more of the above signs appear, you should seek advice from specialists such as a traumatologist or orthopedist, they know how to treat the epicondylitis of the elbow joint.





A distinctive feature of the ailment from other pathologies is that in this disease the basis of diagnosis is a primary examination consisting of:


  • clarifying patient complaints;
  • studying the medical history and life of the patient
  • an objective examination of the patient, which is based on conducting several specific tests, for example, on the symptoms of Thomson and Velt, but only if the patient himself will perform physical exercises. If the clinician will perform movements with the affected limb, then the soreness and other symptoms of the epicondylitis of the elbow joint will not be expressed.

It should be noted that the Thomson test consists in the patient clenched his hand into a fist, while it should be in the rear position. It will quickly unfold so that the palm will be directed upwards.

In order to identify the symptom of Velta, the patient must keep both forearms at the chin level, and simultaneously perform flexion and extension. Such actions performed by the affected hand will noticeably lag behind similar processes performed by a healthy one.

Laboratory examinations are only meaningful in cases of a doctor’s suspicion of having an acute inflammation in the body.

As for instrumental examinations of the patient, CT, MRI or X-ray diffraction is used for differential diagnosis.

Treatment

Therapy consists in prescribing conservative methods of therapy and is performed on an outpatient basis. Therapy includes:


  1. tire overlap
  2. taking drugs;
  3. physiotherapy procedures
  4. gymnastic exercises — are compiled by the attending physician individually for each patient, depending on the form of the course of such a disorder
  5. the use of prescriptions for alternative medicine.

Treatment of epicondylitis with medicines provides for the use of:


  • Non-steroidal anti-inflammatory drugs — it is worth noting that doctors often prescribe ointments, not substances in the form of tablets
  • Glucocorticosteroids — used as an intramuscular injection in the affected area. If ineffectiveness is possible, repeated administration of the drug, but only after a few days;
  • Anesthetics — to neutralize the pain syndrome.

Among the physiotherapy procedures are:


  1. Magnetotherapy
  2. the effect of infrared radiation;
  3. Medicinal applications
  4. phonophoresis
  5. drug electrophoresis.

Also in the treatment of the disease is widely used:


  • hirudotherapy;
  • Mud treatment;
  • massage;
  • Acupuncture.

In addition, the elimination of the disease at home involves the preparation of potions from medicinal herbs and plants used as compresses and for rubbing. The most effective natural substances for the treatment of epicondylitis of the elbow joint folk remedies are:


  1. horse sorrel
  2. bay leaf
  3. nettle;
  4. olive oil
  5. Green tea
  6. blue clay;
  7. beeswax
  8. fat;
  9. garlic juice
  10. Wine Alcohol
  11. birch leaves
  12. Chamomile and black elderberry.

In those situations when conservative treatment of epicondylitis was unsuccessful, the patient needs surgery. Such a method of therapy is extremely rare, because there is a high probability of relapse of the disease, pain and the formation of adhesions. Nevertheless, surgical treatment provides for:


  • myofasciosis;
  • tenotomy;
  • Neurotension
  • elongation or excision of the tendon of the extensor or flexor of the wrist

Prevention and Forecast

Preventative measures for a similar ulnar joint disease are based on the following rules:


  1. elimination of the same exercises, overloading the joint
  2. wearing a fixative — but only if the illness worsens;
  3. regular intake of vitamin complexes
  4. Timely removal of any inflammatory processes.

Provided an early complex therapy and in cases of compliance with preventive recommendations, it is possible to achieve a favorable prognosis, namely, a stable remission.