What is Epicondylitis?
Epicondylitis, commonly referred to as
tennis elbow (lateral epicondylitis) or
golfer's elbow (medial epicondylitis), is an inflammation of the tendons that attach to the epicondyles of the humerus. This condition is often associated with repetitive motion and overuse, leading to pain and tenderness around the elbow joint.
Prevalence and Incidence
Epicondylitis is a relatively common musculoskeletal disorder. The
prevalence of lateral epicondylitis ranges from 1% to 3% in the general population, while medial epicondylitis is less common, affecting about 0.4% to 1.1%. The incidence of epicondylitis peaks between the ages of 30 and 50 years, with a slight male predominance.
Risk Factors
Several
risk factors contribute to the development of epicondylitis. Occupational activities involving repetitive wrist and elbow movements, such as those performed by plumbers, carpenters, and assembly line workers, are significant contributors.
Sports activities, particularly those involving racquet sports and throwing, also increase the risk. Other factors include poor technique, inadequate equipment, and lack of proper conditioning.
Pathophysiology
The underlying
pathophysiology of epicondylitis involves micro-tears and degeneration of the tendon fibers, leading to localized inflammation and pain. The condition is primarily degenerative rather than inflammatory, with histological studies showing angiofibroblastic hyperplasia and disorganized collagen.
Diagnosis
Diagnosis of epicondylitis is primarily clinical, based on a detailed history and physical examination. Common
symptoms include pain and tenderness over the affected epicondyle, exacerbated by activities involving wrist extension or flexion. Imaging studies such as ultrasound and MRI may be employed to rule out other conditions and assess the extent of tendon damage.
Treatment and Management
Management of epicondylitis involves a combination of conservative and, in some cases, surgical approaches. Initial
conservative treatment includes rest, ice application, nonsteroidal anti-inflammatory drugs (NSAIDs), and physical therapy.
Corticosteroid injections and platelet-rich plasma (PRP) injections are also used in refractory cases. Surgical intervention is considered when conservative measures fail to provide relief after 6 to 12 months.
Prevention
Preventive strategies focus on addressing modifiable risk factors. These include proper
ergonomics in the workplace, using appropriate techniques and equipment in sports, and engaging in regular conditioning and strengthening exercises for the forearm muscles. Early intervention and education on activity modification can also help reduce the risk of developing epicondylitis.
Public Health Impact
Epicondylitis has a significant impact on public health, particularly in terms of lost productivity and healthcare costs. The condition can lead to prolonged work absence and disability, especially in occupations requiring repetitive upper limb use. Addressing epicondylitis through workplace interventions and preventive measures can help mitigate its
economic burden and improve the quality of life for affected individuals.
