Despite advances elucidating the causes of lateral and medial epicondylitis, the standard of care remains conservative management with NSAIDs, physical therapy, bracing, and rest. Scar tissue formation provoked by conservative management creates a tendon lacking the biomechanical properties and mechanical strength of normal tendon. The following review analyzes novel therapies to regenerate tendon and regain function in patients with epicondylitis. While these treatments are in early stages of investigation, they may warrant further consideration based on prospects of pain alleviation, function enhancement, and improved healing.
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It is less common than lateral epicondylitis. As with lateral epicondylitis, it typically occurs in the 4 th to 5 th decades of life. There is no recognized gender predilection. Patients typically present with insidiously medial elbow pain.
The pain can worsen with wrist flexion and forearm pronation activities. Patients may offer a history of sports activities, including golf, overhead throwing sports, and racket sports. The patient's history may include the occurrence of an acute sports injury or acute trauma. It is thought to occur from valgus forces transmitted to the medial elbow during forearm pronation and wrist flexion may exceed the strength of the muscles, tendons, and supporting ligaments.
Cumulative stress or overuse can lead to tendinosis involving the musculotendinous junction of the flexor-pronator muscle group at the medial epicondyle, with microtrauma and partial tearing that may progress to a full-thickness tendon tear. MR imaging is the most widely used modality for assessment, although ultrasound also may be performed.
May be identified as outward bowing, heterogeneous echogenicity, or thickening of the common tendon, with subjacent fluid collection and intratendinous calcification.
Discrete tears appear as hypoechoic regions with adjacent tendon discontinuity. Other clinical approaches include the use of a splint, one or more local corticosteroid injections, application of ultrasound waves and guided rehabilitation program.
Surgery is often performed if there is no clinical response after 3 to 6 months of conservative treatment. Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Updating… Please wait. Unable to process the form. Check for errors and try again. Thank you for updating your details. Log In. Sign Up. Log in Sign up. Articles Cases Courses Quiz. About Blog Go ad-free. As of the latest update, Google Chrome and Microsoft Edge have made a breaking change to how file uploads are handled.
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Epicondilitis lateral (codo de tenista) - Tennis Elbow
Tennis elbow aka Lateral Epicondylitis is a condition which causes pain over the outside lateral surface of the elbow. It is not an inflammatory condition, and is moreso related to the fact that tendons have a poor blood supply- as a result tears in tendons have a much poorer ability to heal compared with other tissues e. Tennis elbow can occur in anyone but is more common in people who perform repetitive wrist or elbow activities, particularly, as the name suggests, in tennis players because of the backhand stroke. Most people with tennis elbow get better without an operation. It can take up to a year for the pain to improve. There are numerous treatments which can be tried to help improve the pain during this period.
Current advances in the treatment of medial and lateral epicondylitis
It is less common than lateral epicondylitis. As with lateral epicondylitis, it typically occurs in the 4 th to 5 th decades of life. There is no recognized gender predilection. Patients typically present with insidiously medial elbow pain. The pain can worsen with wrist flexion and forearm pronation activities.
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