Epicondylitis of the elbow joint: symptoms, treatment, exercise therapy, prevention

Epicondylitis is an inflammatory process that develops in the tendons of the shoulder muscles in the area of ​​their attachment to the bones of the elbow joint, with a gradual transition of inflammation to the periarticular tissues.

The manifestations of the disease depend on its type and stage, are diagnosed and treated by traumatologists and physicians of sports medicine. For healing, both conservative and operational methods can be used.

Classification of

There are two groups of muscles that provide movement of the elbow joint;their tendons are attached either from the outside or from the inside.

Accordingly, two types of epicondylitis of the elbow joint are distinguished:

1. 1) External: tendons are inflamed, attached to the outside of the elbow. This kind of pathology is also called the "elbow of a tennis player".Often developing in men 40-60 years old, the working arm is affected.
   
2. 2) Internal: the process occurs in the tendons that are attached to the medial side of the joint( flexors and extensors of the hand).It develops mainly in persons 30-50 years old, being a more common type of epicondylitis. Mostly women are engaged in manual work( seamstresses, needlewomen, typists).
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Both types of epicondylitis do not develop at the same time.

Causes of epicondylitis of the elbow joint

Epicondylitis of the elbow joint develops as a result of:

• direct injury( bruise, dislocation, fracture of bone);
  
• often recurring movements in the joint;
  
• inflammatory or degenerative processes in the joint;
  
• constant overloads, as a consequence of which microscopes first appear in the tendon tissue, and subsequently an inflammatory reaction develops, which passes to the underlying bone.

People suffering from epicondylitis are subject to repetitive movements in the elbow joint. These are such professions:

• athletes: tennis players, boxers, wrestlers, weightlifters.
  
• working on a sewing machine.
  
• building professions: painters, loaders, plasterers, carpenters.
  
• agricultural specialties: milkmaids, tractor drivers.

Symptoms of epicondylitis of the elbow joint

Epicondylitis of the elbow joint has classic symptoms, which are as follows:

1) Pain in the elbow:

• acute, sharp, can be felt like a spasm, but can have a nicking character;
  
• develops after an injury;
  
• is localized either from the outside or from the inside of the elbow( with external or internal process, respectively);
  
• extends either on the inside or outside of the forearm;
  
• is strengthened after flexion-extensor movements of the elbow, lifting of weights by this hand;
  
• decreases after rest.

2) Edema and redness of tissues on one side of the joint.

3) Because of pain and muscle strength, a person can not shake hands, clench his fist, take a cup, hold his hand behind his lower back.

4) Passive movements in the elbow are not accompanied by pain.

Diagnosis

The diagnosis of epicondylitis is established by:

• human complaints;
  
• examination of the elbow, its probing, committing passive movements in it and some tests for resistance to certain movements;
  
• X-ray, which does not confirm the diagnosis of "Epicondylitis", but excludes fractures of bones;
  
• ultrasound helps in diagnosis, and also reveals complications of epicondylitis.

Conducting CT or MRI with this disease is ineffective, as it will not provide the doctor with the necessary information.

Treatment of epicondylitis of the elbow joint

Treatment of epicondylitis can be conservative, including the impact of a whole complex of measures, and operative.

To ensure the effect of treatment, the elbow joint must be immobilized. This can be done with special elbow or elastic bandaging.

Medical treatment of epicondylitis

For the treatment of epicondylitis of the elbow joint of any of its localizations, the local treatment is mainly used, aimed at eliminating pain, restoring tendon ruptures, improving blood circulation in the damaged tendon.

1. 1) Anti-inflammatory drugs: Nurofen, Nimesil, Diclofenac. Most often they are used in the form of ointments or gels, applied directly to the joint, but with severe pain, you can use the same drugs in the form of pills and injections.
   
2. 2) Compresses with Dimexide help to improve blood circulation, have a warming, analgesic, and also antiseptic effect. For treatment with this drug it is diluted 1: 3 or 1: 4 with water, moistened with a gauze cloth, which is applied to the damaged area. On top of the napkin covered with polyethylene, and then bandage.
   
3. 3) In case of bacterial complications, the doctor prescribes antibiotics that can be used in the form of tablets or in injectable form.
   
4. 4) In case of complications or severe pain, intra-articular glucocorticoids( "Kenalog", "Hydrocortisone") and anesthetics( "Novocain", "Lidocaine") can be administered.

Physiotherapeutic treatment

Such kinds of physiotherapeutic procedures are applied:

• ultraphonophoresis with analgesic and anti-inflammatory drugs;
  
• diadynamic currents;
  
• action by low-frequency magnetic fields;
  
• applications of paraffin and ozocerite;
  
• shock wave therapy.

LFK

The doctor selects an individual complex of exercises that not only strengthen muscles, but also eliminate pain and muscle cramps in the hand.

Other methods of treatment of epicondylitis

For the treatment of epicondylitis of the elbow joint also apply:

1. 1) Manual therapy. It helps to overcome the functional blockade that develops in the elbow joint with epicondylitis.
   
2. 2) Hirudotherapy: leeches, which are located around the injured tendons, inject into the blood many useful substances that help cope with the inflammatory process.
   
3. 3) Massage: prevents atrophy of muscles, restores work in the joint.

Surgical treatment

It is used when conservative treatment is ineffective. The most common at the moment is the operation of Goman. It consists in the fact that the site of attachment of the tendon to the bone is excision of the tendon site.

This is done using a laser that not only dissects tissues, but also sterilizes the surface being treated, and also stops bleeding.

Prevention of epicondylitis of the elbow joint

To prevent the development of epicondylitis, you must observe a number of specific rules:

1. 1) Conduct light training before more intensive physical exertion - to improve blood supply to the joints.
   
2. 2) Also, before physical exercises, the joints that will work hard must be massaged intensively.
   
3. 3) It is good to eat so that with the food in the body all the necessary microelements, proteins and vitamins get into the body.
   
4. 4) Take breaks if the work is monotonous.
   
5. 5) Sports should be held in special bandages.
   
6. 6) Treat chronic diseases on time.

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