Epicondylitis is a degenerative inflammatory lesion of tissues in the area of the elbow joint. It develops at the sites of attachment of the tendons of the inner and outer surfaces of the forearm to, respectively, the inner and outer condyles of the humerus. Pathology develops gradually, manifested by pain in the elbow joint, which increases with extension (with external epicondylitis) and with grasping (with internal epicondylitis). Treatment is usually conservative: correction of the load on the joint, immobilization, physiotherapy, physical therapy.
Epicondylitis is a degenerative–dystrophic process in the area of attachment of the tendons of the forearm muscles to the condyles of the humerus and the tissues surrounding these tendons. Depending on the localization, it is manifested by local pain on the outer or inner surface of the elbow joint. Develops as a result of chronic overload of the forearm muscles. The diagnosis of epicondylitis is made on the basis of characteristic clinical data. The treatment is conservative, the prognosis is favorable.
Epicondylitis of the elbow joint is one of the most common diseases of the musculoskeletal system. At the same time, it is not possible to accurately estimate the incidence rate, since a large number of patients do not go to doctors due to poorly expressed symptoms. The disease usually develops at the age of 40-60 years, while right–handed people are more likely to be affected by the right, and left-handed people – the left hand.
The lesion in the area of the external (lateral) condyle is called the elbow of a tennis player, since this disease is often observed in tennis players. However, much more often the disease develops in connection with professional activity. The cause of epicondylitis is stereotypical, constantly repeating movements – the extension of the forearm and its rotation outward. External epicondylitis often affects massage therapists, construction workers (painters, carpenters, bricklayers), tractor drivers, milkmaids, handymen. The disease develops more often in men.
Internal (medial) epicondylitis, which is also called golfer’s elbow, occurs with repetitive movements of low intensity and develops mainly in people engaged in light physical labor – seamstresses, typists, etc. The disease is more often observed in women.
As a result of chronic overload and repeated microtrauma, a degenerative process develops in the tendon tissue, accompanied by inflammation of the surrounding tissues. Small scars are formed, which further weaken the resistance of the tendon to loads, which, in turn, contributes to an increase in the number of micro-injuries. In some cases, the symptoms of epicondylitis occur after a direct injury. Congenital weakness of the ligamentous apparatus increases the risk of developing this disease and causes its more severe course.
With lateral epicondylitis, there is clearly localized pain on the outer surface of the elbow joint, which occurs when the hand is extended and rotated outward. In the study of muscle strength, the weakening of the muscles on the diseased side is determined when the hand rotates outward and resists capture. The text of the coffee cup (pain when trying to lift a cup filled with liquid from the table) is usually positive. When pressing on the lateral condyle, obvious, but not acute soreness is determined.
With medial epicondylitis, the pain is localized along the inner surface of the elbow joint. In the study of muscle strength, there is a weakening of the muscles on the sick side when grasping. There is an increase in pain when pronating at right angles and bending the forearm with resistance. Palpation determines soreness and tightness in the lower part of the medial condyle. The milking test (increased pain during simulated milking) is positive.
The diagnosis of epicondylitis is made on the basis of patient complaints and external examination data. Additional research is usually not required. Differential diagnosis of epicondylitis is carried out with diseases of the elbow joint itself (aseptic necrosis of articular 