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Epicondylitis

Epicondylitis is a condition when the outer or inner part of the elbow becomes painful and tender, usually as a result of a specific strain, overuse, or a direct bang. Sometimes no specific cause is found. Sometimes called Tennis Elbow on the outer side and Golfer's Elbow which affects the other side of the elbow.

Symptoms The outer part of the elbow is painful and tender to touch. Movements of the elbow, and also movements which involve lifting, with the hand on top, hurt.

Causes Although called tennis elbow, lateral epicondylitis is much more commonly seen in people who are over using their arm doing something else. It could equally well be called "plasterer's elbow" or "mechanic's elbow" or "painter's elbow".

The most common cause is over use of the muscles which are attached to the bone at this part of the elbow. That is to say, the muscles which pull the hand backwards (the wrist extensors). All the extensor muscles of the hand attach to the elbow at the outer part (the lateral epicondyle). If they are strained or over used they become inflamed, which means they are swollen, painful and tender to touch. Sometimes the inflammation is caused by a direct injury or bang. Sometimes, especially when the cause is direct injury or strain, the muscles are actually partially torn.

Rarely the inflammation comes on without any definite cause, and this may be due to an arthritis, rheumatism or gout. Sometimes the problem is partly or completely due to a neck problem, which is causing pain in the elbow via the nerves from the neck. Diagnosis Your doctor or physiotherapist will test for tenderness over or near to the bony bump on the outside of the elbow. He will also test to see whether the pain gets worse when you bend the wrist back (extend it) against resistance. In the event of both these signs being present, it is likely that you have tennis elbow. Your doctor may also examine your neck, as this may be the cause, or part of the problem. After all many of the things that might strain your elbow might also put a strain on your neck.

Treatment

  • Rest helps, with avoidance of the activities which over use the elbow.
  • Physiotherapy treatments, which may include heat or ultrasound therapy.
  • Realignment of the bones of the elbow is often very helpful.
  • Immobilization may be indicated if other treatment does not produce remissions. You can buy a brace from a sports shop or pharmaceutical supplier, which can be helpful. This is probably largely because it reduces the amount you can use your elbow.
  • Specific exercises are the key to correction.
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