What is Epicondylitis?
Epicondylitis is an inflammation of the tendons surrounding the epicondyle, which is the bony protuberance in the elbow. The condition causes severe pain in the region surrounding the joint. It is commonly seen in adults due to occupational activities and sports activities that result in exertional pressure on the flexor or extensor carpi radialis brevis muscles in the forearm.
What Causes Epicondylitis?
The causes of epicondylitis include:
- Repetitive and forceful movements of the hand and wrist
- Lifting heavy weights
- Small tendon tears
- Weak shoulder or wrist muscles
Types of Epicondylitis
The two types of epicondylitis are:
- Medial Epicondylitis: This is the inflammation of the tendon that attaches the forearm muscle to the medial (inner)aspect of the elbow. This condition is also known as golfer’s or baseball elbow. It affects the tendon connecting the flexor carpi radialis brevis muscle, impairing flexion activities of the wrist and hand. It is caused by applying great force while serving in tennis, pitching a baseball, chopping wood with an axe etc.
- Lateral Epicondylitis: This is the inflammation of the tendon that attaches the forearm muscle to the lateral (outer)aspect of the elbow. This condition is also known as tennis elbow. It affects the tendon connecting the extensor carpi radialis brevis muscle, impairing extension activities of the wrist and hand. It is caused by an improper backhand stroke while playing tennis and repeated hand motions in activities such as painting, carpentry, or playing musical instruments.
What are the Symptoms of Epicondylitis?
The following are the most common symptoms of epicondylitis:
- Focal tenderness in the epicondyle region (around elbow)
- Severe pain even at rest
- Instability with hand movements
- Weakness in the hand
- Difficulty with hand flexion (moving hand and fingers inwards) and extension (opening hand and fingers outwards)
- Difficulty with palm and finger movements
- Numbness or tingling sensation at the elbow
Diagnosis of Epicondylitis
The diagnosis of epicondylitis can be made by a physical examination and medical history taken by your doctor. Your doctor assesses the area affected and asks you to move your hand against resistance to elicit symptoms.
Your doctor may also order the following tests to rule out associated complications such as fractures, ligament tears, and nerve damage such as:
- MRI (Magnetic resonance imaging)
Treatment of Epicondylitis
Conservative management is the first line of treatment for epicondylitis which typically takes 6-12 months for complete healing and recovery. The treatment plan includes the following:
- Resting of the affected hand and stopping any action that causes pain for at least 3 months
- Use of anti-inflammatory and muscle relaxant medications
- Corticosteroids to reduce swelling and pain
- Application of ice packs three times a day for at least 10-15minutes
- Use of a brace to keep the arm still for at least 2 weeks
- Strengthening exercizes or physical therapy
- Surgery is only indicated if epicondylitis is associated with complex fractures and complications
Prevention of Epicondylitis
The following measures can help to prevent epicondylitis:
- Avoid exertional activities and weightlifting when experiencing elbow pain
- Warm up regularly before activities or sports
- Avoid continuous strain to the hand
- Use proper technique and equipment while playing sports.