Epicondylitis
This article will explain the origin, causes, symptoms, and treatment options for epicondylitis.
What is Epicondylitis?
Epicondylitis - also known as epicondylopathy, epicondylosis and epicondyalgia - describes a painful irritation of the tendon on the inside or outside of the elbow. It affects the muscles of the forearm above the epicondylus (bone extension) of the humerus. The disease is usually triggered by intense unilateral stress or incorrect posture.
Epicondylitis is commonly referred to as tennis arm/tennis elbow or golfer's arm/golfer's elbow. This can be misleading as it implies that the condition impacts on athletes only, when in fact it can also affect those in other professions such as professional drivers, office workers, musicians, and craftsmen. Fortunately, there are ways to prevent this condition and to treat it effectively if necessary.
Causes
There are two different types of epicondylitis:
Tennis Arm occurs when the extensor muscles in the forearm are put under excessive strain (epicondylitis humeri radialis). Golfer's Arm occurs when the flexor muscles in the forearm are put under excessive strain (epicondylitis humeri ulnaris).
Possible triggers leading to painful irritation to the tendon are incorrect loading as well as overloading of the forearm musculature. To be more precise, continuous shocks and vibrations caused by monotonous, repetitive arm and hand movements can lead to these conditions. The overstraining causes minimal tears in the tendon origins, leading to inflammation.
Untrained musculature, as well as poor techniques in sports, can lead to incorrect loading. However, repetitive movements in the elbow joint cannot be avoided in some occupational groups. That is why it is all the more important to think about appropriate preventive measures at an early stage.
Symptoms
The tendon in the forearm muscles begin to hurt the moment light pressure is applied to the elbow with the hand. Occasionally, there can be visible swelling in the upper part of the muscle and/or reddening of the affected area. Stretching and swinging the arm causes motion pain.
Affected patients have difficulty closing their fists and the wrist is generally weakened. If the inflammation is severe, it can be difficult to even unscrew a bottle, use a screwdriver, or play an instrument. However, the pain is not limited to the elbow but usually radiates into the upper and lower arm or wrist.
Diagnosis
If a patient begins to experience stabbing pain in the elbow, doctors first check whether the pain is exacerbated by pressure pain at the respective epicondylus humeris. In addition, there are provocation tests, such as stretching the wrist against resistance, flexing the hands and fingers (stretching pain), lifting a chair (chair test), or clenching a fist.
To rule out a slipped disc or a nerve bottleneck, the cervical spine is often also examined. An X-ray, sonography or MRI can determine whether the diagnosis is Epicondylitis.
Prevention
Ideally, pain-inducing movements should be avoided. This means reducing repetitive, one-sided arm movements and thus preventing overloading of the elbow joint in everyday life, work, and sports. Unfortunately, this is not always possible.
To prevent incorrect loading, it is recommended that sufferers use ergonomically adapted tools to correct improper movement patterns. Taking regular small breaks for stretching and loosening exercises can also help prevent illness. Slight Epicondylitis often heals without treatment if the arm is rested for a while and the painful movement is avoided.
External relief
Whether preventative or acute, most aids relieve elbow strain by changing the pulling direction of the tendon. For example, bandages can reduce muscle tension and strain on the affected area. Epicondylitis braces exert targeted pressure on the tendon origins.
Important: Braces should be placed adjacent to the painful spot on the muscle belly - not directly onto it.
Many bandages can be used for both tennis arm (extensor muscles on the outside of the arm) and golfer's arm (flexor muscles on the inside of the arm).
The Dynamics Plus Epicondylitis Support offers an alternative mode of action, which has been proven to be effective against the cause of the disease. It absorbs muscle vibrations caused by hand and finger movements and relieves strain on the elbow.
Non-operative treatment
To begin, the affected arm must first be immobilised as rest is essential for recovery. As soon as the movement sequence no longer causes the patient severe pain, physiotherapy can be started to stretch and strengthen the arm muscles in a targeted manner.
For those who are unavoidably always moving (for work, for example) wearing an epicondylitis brace is recommended. The targeted pressure, which can be adjusted individually, changes the pulling direction of the tendons and relieves the elbow joint.
Acute pain can be alleviated by cold treatments and anti-inflammatory medication. Further treatment options can include the use of ultrasound, Botox, electrical stimulation, or shock wave therapy.
Alternatively, the Dynamics Plus Epicondylitis Support can be used alternative treatment method for active patients who wish to continue exercising or performing other activities. It offers large padding to absorb muscle vibration in the forearm. By absorbing shocks and vibrations, the transmission of stimuli is inhibited and the inflammation can heal.
Surgery and post-treatment care
If all conventional therapy options have been exhausted and the patient's condition does not improve within six months, surgery can be considered. The doctor will decide, on a case-by-case basis, whether an operation is really necessary.
This is a low-risk operation and is performed on an outpatient basis, lasting approximately 40 minutes. The inflamed tendon tissue is exposed and removed via a skin incision on the outside of the elbow. This reduces the tension on the tendon. In some cases, a small piece of the bone crest is also removed. Sometimes nerve fibres are also cut through to prevent pain from being transmitted.
After the operation, the arm must be completely immobilised for about two weeks. This is followed by physiotherapy. In most cases, it takes four to six weeks for the patient to be able to move the arm without pain again. Afterwards, it is recommended that they wear a bandage as a precautionary measure against heavy strain.
