Lateral Epicondylitis

Overview

Lateral epicondylitis, commonly known as tennis elbow, is a painful condition that occurs due to inflammation or degeneration of the tendons that attach to the lateral epicondyle of the elbow. It is often associated with overuse or repetitive strain, and recent research highlights its connection to impaired microvascular circulation in the tendons. This condition can significantly impact daily activities and occupational tasks, especially for individuals engaged in repetitive arm movements.

Introduction

Tennis elbow is a prevalent musculoskeletal condition, particularly among individuals aged 30–50 years. In India, with the growing popularity of sports and repetitive work-related activities, the incidence of lateral epicondylitis is on the rise. While traditionally considered a mechanical overload issue, studies now suggest that compromised microvascular circulation plays a key role in delaying tendon healing. Recognizing the symptoms and initiating timely treatment are crucial to preventing long-term complications.

Symptoms

The symptoms of lateral epicondylitis can range from mild discomfort to debilitating pain, including:

– Pain or Burning Sensation: Localized on the outer part of the elbow, which may radiate to the forearm.
– Weak Grip Strength: Difficulty in holding objects or performing activities requiring grip.
– Tenderness: Around the lateral epicondyle when touched or pressed.
– Stiffness: Particularly in the morning or after prolonged rest.
– Difficulty in Repetitive Movements: Such as lifting, gripping, or twisting motions.

Causes

The primary cause of lateral epicondylitis is repetitive stress or overuse, but other contributing factors include:

– Repetitive Activities: Tasks involving frequent arm, wrist, or hand motions, such as typing, painting, or gardening.
– Sports-Related Injuries: Common among tennis players, cricketers, and badminton players due to repetitive wrist and forearm motions.
– Microvascular Insufficiency: Reduced blood flow to the affected tendons leads to delayed healing and degeneration.
– Age-Related Degeneration: Tendons lose their elasticity and strength over time.
– Improper Techniques: Incorrect posture or use of tools, equipment, or racquets increases strain on the tendons.

Treatment

The treatment of lateral epicondylitis focuses on pain relief, restoring tendon health, and improving microvascular circulation:

– Medications:
– Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief.
– Topical analgesics to reduce localized discomfort.
– Physiotherapy:
– Stretching and strengthening exercises to restore mobility and strength.
– Techniques such as eccentric loading and grip training.
– Advanced Therapies:
– Shockwave Therapy: Stimulates blood flow and promotes tendon repair.
– Platelet-Rich Plasma (PRP) Injections: Boosts healing through growth factors.
– Ergonomic Adjustments: Modifying workstations or sports equipment to reduce strain.
– Surgical Intervention: Reserved for severe cases where conservative treatments fail. It involves removing damaged tissues and enhancing microvascular circulation.

Prevention and Risk Factors

Prevention:

– Warm-Up Exercises: Essential before engaging in sports or repetitive tasks.
– Ergonomic Modifications: Ensuring proper posture and tool usage in workplaces.
– Gradual Progression: Avoid sudden increases in intensity or frequency of activities.
– Regular Breaks: During repetitive tasks to reduce stress on the tendons.
– Strengthening Exercises: Focused on forearm and wrist muscles.

Risk Factors:

– Occupations requiring repetitive wrist and forearm movements, such as carpentry or painting.
– Sports like tennis, cricket, or badminton with improper technique.
– Individuals in their 30s to 50s, particularly with sedentary or repetitive lifestyles.
– Inadequate rehabilitation following previous elbow injuries.

Insights from Sancheti Hospital

At Sancheti Hospital, we provide a multidisciplinary approach to diagnosing and treating lateral epicondylitis. Our advanced diagnostic tools, including ultrasound and MRI, help assess the severity of tendon damage and microvascular insufficiency.

Our team of orthopaedic specialists and physiotherapists collaborates to deliver personalized care plans that include cutting-edge treatments like shockwave therapy and PRP injections. With state-of-the-art facilities, we focus on improving microvascular circulation and ensuring complete tendon recovery.

Whether through in-clinic care or tailored rehabilitation programs, Sancheti Hospital is committed to helping patients regain mobility, reduce pain, and return to their normal activities swiftly and effectively.