What is lateral epicondylitis or tennis elbow

Lateral epicondylitis, much more commonly known as tennis elbow, consists in the inflammation of the tendons that connect the muscles of the forearm to the outside of the elbow, causing pain. This type of disorder affects the muscles and tendons that are inserted into the lateral epicondyle (insertional tendinopathy) responsible of the wrist or fingers extension. At first the lateral epicondylitis pain usually affects the tendons and then it increases with activities that involve the associated muscles. Over time, the discomfort can radiate along the forearm and persist even at rest, followed by hand, wrist and elbow functionality reduction. An episode of lateral epicondylitis can typically last from six to twelve weeks, although in some people the pain can range from less than three weeks to an interval of six months to two years. The age most affected by this inflammation ranges from 30 to 50, although anyone can be affected due to repetitive wrist and arm movements linked to working or sporting activities.

Causes

Lateral epicondylitis is usually caused by functional overload, that means excessive and continued elbow use. This occurs in particular sports activities (racket sports, throwing sports, golf and fencing), working activities (plumber, bricklayer, butchers, cooks, painters, etc.) and recreational activities (playing the violin, gardening, etc.), in which the same movements are repeated over time. Such gestures may involve wrist twisting or extending, lifting weights and overusing the forearm muscles. Other factors that can lead to the onset of tennis elbow are repeated microtraumas and direct damages to the lateral epicondyle.

Symptoms

The main symptom is pain located in the external region of the elbow which can also radiate along the forearm, wrist and hand awakened by extension and supination movements. The pain associated with lateral epicondylitis can be of different intensity. Initially, the inflammation affects the tendons during the extension movements of the wrist against a resistance or even when the arm is at rest. The pain worsens when the muscles of the affected limb are used, worsening with twisting movements such as the simple gesture of turning the door handle. The pain can radiate along the forearm towards the wrist and in the back of the hand. In general, the signs of tennis elbow are: pain and swelling localized on the outside of the elbow and forearm, weak and painful grip strength, worsening of pain with wrist movements, morning stiffness.

Diagnosis and risks

It is advisable to contact the doctor for a correct and timely diagnosis of lateral epicondylitis if the pain in the elbow is persistent. There are many elements to consider to identify the disorder, such as the extent of symptoms and their location, but also the presence of professional or sporting activities that are risky for the lateral epicondylitis  formation. The patient must clearly indicate the location of the arm inflammation, clarify if he has suffered a traumatic episode and if he suffers from other concomitant pathologies that can affect pain (eg arthritis). The doctor can proceed to identify the disorder by directly palpating the affected area and looking for signs of local swelling. The doctor may also recommend further clinical tests to rule out additional causes, such as x-rays, magnetic resonance imaging and electromyography.

Cures and treatments

Lateral epicondylitis tends to heal spontaneously with rest. However, the pain can last for long periods of time, especially if you continue to perform the same repetitive activities that promote the formation of tennis elbow. Furthermore, this type of disorder, if not treated properly, can relapse or become chronic. So the first steps to be followed to heal are to rest the affected arm and to avoid activities that are risky for the disorder. To reduce inflammation, it is advisable to apply cold packs several times a day against the elbow for a few minutes. To relieve pain, it is possible to take painkillers or NSAIDs, both systemically and topically through creams or gels. In some cases, the physiotherapist intervention is recommended, who can help to reduce joint stiffness. For a short time, support bandages or braces can be used to relieve pain and promote rest. Sometimes in the particularly painful cases the infiltrative cycle can be considered for the patient. In the most serious pain forms in which there is no improvement after at least one year of conservative therapy, surgery can be considered.

A good ally to fight tennis elbow without taking drugs in a non-invasive way is through the electromagnetic waves use. In fact, magnetotherapy is indicated for treating lateral epicondylitis. This treatment is able to relax the affected muscle, to improve microcirculation, to accelerate trophism, to relieve pain and to accelerate the healing and rehabilitation process.