Elbow joint epicondylitis is a very common disease among athletes and representatives of some other professions. The disease is accompanied by inflammatory and degenerative tissue changes in the elbow joint. If untreated, pathology can lead to very dangerous and serious complications.
Many people are interested in any additional information about the disease. Why does elbow epicondylitis develop? Symptoms and treatment, causes and possible complications, preventive measures are very useful information that should not be ignored.
Brief information about the disease
Many people experience problems such as elbow joint epicondylitis. ICD-10 refers this disease to the group “Other enthesopathies” (code M77).
This is a very common disease of the musculoskeletal system, which is accompanied by damage to the tendons, periosteum, epicondyle and its vagina. 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 elbow joint. The causes of the development of epicondylitis can be different.
- Such a disease often develops as a result of the characteristics of the profession, especially if the work is associated with the same type of movements, chronic joint overload, regular microtrauma. The risk group includes builders (plasterers, masons, painters), agricultural workers (milkmaids, tractor drivers), athletes (golfers, weightlifters, tennis players, boxers), musicians, doctors (surgeons), etc.
- The causes include direct injuries of the elbow.
- Inflammation can develop against the background of a violation of local blood circulation and, accordingly, trophic tissue.
- Such a pathology is often associated with some other diseases, in particular, cervical or thoracic osteochondrosis, osteoporosis, and shoulder-shoulder periarthritis.
- The list of causes can be attributed to congenital weakness of the ligamentous apparatus.
Elbow epicondylitis: symptoms and signs
Of course, the clinical picture largely depends on the form of the disease and the stage of its development. Nevertheless, several common symptoms of elbow joint epicondylitis can be distinguished.
- The disease is accompanied by intense pain in the elbow. Unpleasant sensations arise spontaneously, for no apparent reason. The pain during the attack is very strong, burning. Gradually, it becomes aching, but becomes constant.
- The pain syndrome intensifies during physical exertion, prolonged tension of the muscles of the forearm.
- As the disease progresses, the muscles lose strength. Even the usual daily movements cause intense and rapid fatigue.
- In the initial stages, soreness disappears at rest. But as the disease develops, discomfort is present almost constantly.
External epicondylitis
The 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 the “tennis player's elbow”, since it is people who are actively involved in this sport who suffer from pain in the elbow. Soreness can occur when the hand is turned upside down, as well as during a handshake.
Internal (medial) epicondylitis
The medial epicondylitis of the elbow joint is accompanied by tissue damage in the place where the muscle tendons are attached to the medial epicondyle. By the way, this form of the disease also has a special name - "golfer's elbow." Monotonous movements, which are performed due to the tension of the flexor muscles of the wrist, lead to the development of the disease.
Of course, golfers are not the only "victims" of this disease. Tailors and train drivers often encounter such a problem. Such sports as throwing a nucleus or throws also predispose to the development of an ailment.
As a rule, an attack of pain is associated with pressure on the epicondyle. Unpleasant sensations intensify during flexion of the forearm. The ailment often becomes chronic. The ulnar nerve is often involved in the pathological process.
Other forms of the disease
You already know how and why the medial and lateral epicondylitis of the elbow joint develops (treatment will be described below). But there are other forms of the disease.
- Traumatic epicondylitis is said to be if the disease develops as a result of permanent microtraumas. This is observed, for example, with the constant execution of uniform movements. In most cases, patients over 40 years old face a similar problem. In addition, the disease is often associated with cervical osteochondrosis, ulnar nerve damage, deforming arthrosis.
- A 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 joint, as a rule, is the result of improper treatment of an acute form of the disease or even a lack of therapy. In this case, episodes of exacerbations are replaced by relatively long periods of relative well-being.
Diagnostic procedures
Diagnosis in this case is rarely fraught with difficulties. A medical history and a general examination are enough to suspect the patient has epicondylitis. For example, during the consultation, you can notice that the 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 unpleasant sensations.
Of course, in the future, some additional procedures are carried out. For example, a blood test helps to identify an inflammatory process. An x-ray is performed in order to confirm the presence / absence of a fracture, foci of osteoporosis. If there is a suspicion of the presence of tunnel syndrome, then the patient can be sent for magnetic resonance imaging.
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 strong, then patients are recommended rest and bed rest. In the event that the pain syndrome is very pronounced, the arm 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 are considered such drugs as Nimesil, Nurofen, Ketonal, Diklofenak, Ibuprofen, Nise.
With severe symptoms, blockade with corticosteroids is performed. Metiprednisolone, hydrocortisone is considered effective (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 treatment regimen that improve trophic tissue and normalize blood circulation.
Physiotherapy for lesions of the elbow joint
This disease requires an integrated approach. In addition to drugs, various physiotherapeutic procedures are used. For example, during an exacerbation period, high-intensity magnetotherapy is effective (the treatment course consists of 5-8 sessions). Infrared laser radiation is also effective (the full course of treatment includes 10-15 procedures).
After the inflammatory process has subsided, other methods are used. During rehabilitation, shock wave therapy, electrophoresis (using potassium iodide, acetylcholine, novocaine), phonophoresis (anesthetics and hydrocortisone are used during the rehabilitation). Patients are shown cryotherapy using dry air. Good results can be achieved with regular naphtholone and paraffin-ozokerite applications.
Elbow joint epicondylitis: treatment with folk remedies
Drug therapy lasts several weeks, followed by a long rehabilitation period. Patients are constantly engaged with a physiotherapist - physiotherapy is extremely important, as it helps prevent muscle atrophy.
What else can be done with a disease such as elbow joint epicondylitis? Folk remedies, of course, exist, but they can only be used with the permission of a doctor.
- Horse sorrel compresses are considered effective. A liter can is filled with fresh leaves of the plant, poured with a bottle of vodka, closed and insisted in a dark place for ten days. A tissue or gauze dressing is moistened in the resulting liquid, 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 prepared independently. Four tablespoons of chopped bay leaf are poured with a glass of sunflower (or olive) oil. The mixture is insisted in a dark place for a week. The resulting oil tincture is rubbed into the skin in the elbow 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 cheesecloth, which is then wrapped around the affected elbow. The compress is covered with cling film and a woolen shawl or towel. Clay is kept on the skin until the mixture has completely cooled. Since the procedure involves the use of heat, it cannot be carried out in acute inflammation.
When is surgery necessary?
In the event that conservative therapy does not produce results and the pain persists for 3-4 months, the doctor may decide to have surgery.
The procedure is usually performed under general anesthesia. The epicondyle is exposed, making a small incision. In front of him, the doctor makes a small incision in the tendon fibers. In this case, the integrity of the bone and extensor attachments is not violated. 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. Sutures are removed after two weeks. This is followed by a rehabilitation period.
Predictions for Patients
The prognosis for patients with epicondylitis of the elbow joint is generally favorable, especially if the disease was diagnosed in time. On the other hand, in the absence of treatment, degenerative processes can spread to the tissues of the joint itself. Complications include bursitis, which is much more difficult to treat and often requires surgical intervention.
Preventive actions
Elbow joint epicondylitis 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. Preventive measures come down to a simple list of rules.
- If you play 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 there is intense physical activity, then you need to use special pads on the elbow or fix the joint with an elastic bandage.
- If the work is associated with constant uniform movements, it is important to periodically take breaks.
- Doctors recommend taking vitamin complexes periodically (1-2 times a year, as a prophylaxis).
- All inflammatory diseases should respond to appropriate therapy on time.
Of course, when the first signs appear, you should not hesitate - immediately contact a specialist.