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General Practice 2023

Lateral epicondylitis: what é, symptoms, causes and treatment

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Lateral epicondylitis: what é, symptoms, causes and treatment
Lateral epicondylitis: what é, symptoms, causes and treatment

Lateral epicondylitis is an inflammatory process that occurs in the tendons, which are the final part of the muscle that attaches to the bones, causing pain in the lateral region of the elbow that can radiate to the arm or wrist, which can cause difficulty moving the joint and limit some day-to-day activities.

Lateral epicondylitis, also known as tennis elbow, is more common in athletes who play tennis, but it can also occur in people who perform very repetitive movements in their daily lives, as in the case of people who work with tennis. typing, writing or drawing, for example.

The diagnosis of epicondylitis is made by the orthopedist or general practitioner, who may indicate the most appropriate treatment that can be done with the use of anti-inflammatory drugs and physiotherapy, for example.

Main symptoms

Symptoms of lateral epicondylitis can appear without apparent cause, they can be constant or happen overnight, the main ones being:

  • Pain or burning sensation in the elbow, on the outer side, especially when the hand is facing upwards;
  • Numbness or tingling in the forearm, wrists or hands, especially when the elbow is bent;
  • Pain worsening when shaking hands, opening the door, combing hair, writing or typing;
  • Stiffness or pain when stretching the arm;
  • Swelling and tenderness in the elbow joint;
  • Pain radiating to the forearm or wrist;
  • Decreased strength in the arm or wrist, which can make it difficult to hold a glass of water.

When elbow pain also occurs in the innermost region, medial epicondylitis is characterized, whose pain tends to worsen when one is exercising, for example. Learn more about medial epicondylitis.

The symptoms of lateral epicondylitis may appear gradually over weeks or months and should be evaluated by the general practitioner or orthopedist.

How to confirm the diagnosis

The diagnosis of lateral epicondylitis is made by the orthopedist, through the evaluation of symptoms, history of activities that may cause the symptoms, and physical examination, in which the patient is asked to perform wrist extension at the same time as that the doctor performs resistance, with pain during the performance of this movement in the case of epicondylitis.

In addition, the doctor may also order imaging tests, such as X-rays, ultrasound, MRI or CT scans, for example, to assess damage to tendons and muscles.

Main causes

Despite being popularly known as tennis elbow, lateral epicondylitis is not exclusive to people who practice this sport.This is because this type of epicondylitis occurs as a result of repetitive movements, which can injure the tendons present at the site, causing inflammation.

Some factors can contribute to the development of lateral epicondylitis such as:

  • Professional activities that repetition of movements or weight lifting, such as carpentry, plumbing, gardening, painting, typing, drawing or writing excessively and/or frequently;
  • Age, being more common in people between 30 and 50 years old, although it can also occur at any age;
  • Practice sports, which require the use of equipment and performance of impulse, such as tennis, baseball, squash or shot put.

Also, lateral epicondylitis can occur due to activities that involve repeatedly bending the elbow, such as playing the violin, for example.

How the treatment is done

The treatment of lateral epicondylitis is performed by the orthopedist with the aim of reducing tendon inflammation and relieving symptoms, which may vary according to the intensity of the symptoms, and full recovery may take weeks to months.

The main treatments that may be indicated by the doctor are:

1. Rest

Resting the elbow joint helps in the recovery of lateral epicondylitis and relieves the pain and discomfort that arise when moving, and for this reason, it is necessary to avoid or reduce activities that require bending the elbow, for several weeks to months, as directed by the doctor.

2. Cold compresses

Applying cold compresses to the elbow helps reduce pain and reduce swelling by relieving inflammation in the tendons.

To make the cold compress, you must put ice inside a thermal bag or put a bag of gel in the freezer to cool, and then wrap the bag or gel bag in a clean and dry towel, and apply on the affected region, letting it act for 15 to 20 minutes, 2 to 3 times a day.

3. Remedies

Remedies for lateral epicondylitis that your doctor may prescribe are oral anti-inflammatories, such as ibuprofen or naproxen, to fight inflammation of the elbow tendons and relieve pain.

Oral anti-inflammatories are usually used for a short period of time, due to possible side effects such as stomach pain, nausea, increased intestinal gas, gastritis, dizziness, lightheadedness or increased blood pressure.

Other remedies that the doctor may indicate are anti-inflammatory ointments for topical use on the elbow, such as diclofenac diethylammonium, for example.

4. Physiotherapy

Physiotherapy can be indicated by the doctor and should be done under the guidance of the physical therapist, with stretching and strengthening exercises for the forearm muscles to increase flexibility and improve elbow stability, helping to control pain and improve the movements.

Physiotherapy treatment must be chosen by the physical therapist individually, and the use of equipment such as TENS, ultrasound, laser, shock waves or iontophoresis, for example, may also be indicated.

In addition, the physical therapist may indicate the use of kinesio tape, as it helps to restrict the movement of the affected muscles and tendons, promoting improvement of symptoms. See what it's for and how kinesio works.

Another treatment option that a physical therapist can perform is transverse massage techniques to help speed recovery.

Watch the following video with tips on how to properly massage for lateral epicondylitis:

5. Corticosteroid injection

The physician may also inject corticosteroids directly into the painful area around the elbow and is usually indicated when other treatment options have not been effective in relieving the symptoms of lateral epicondylitis.

Cortisone is commonly used, a type of strong anti-inflammatory that helps fight inflammation and relieve symptoms quickly.

6. Platelet-rich plasma

Platelet-rich plasma is a portion of blood taken from the person and filtered in the laboratory, which can be used as an injection applied by the doctor in the elbow region, being made in a hospital environment, to help with healing tendons and relieve the pain of lateral epicondylitis.

7. Surgery

Surgery for lateral epicondylitis is indicated by the physician in cases where no other treatment option has been effective, and pain persists, even after 6 to 12 months of treatment.

This surgery is done by the doctor removing the damaged tissue from the elbow. Physical therapy sessions are usually required after surgery to speed up recovery.

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