Tennis elbow is one of the most common syndromes of musculoskeletal strain. The professional name of this syndrome is lateral epicondylitis.
Damage to the tendons of the muscles that extend the hand and fingers results in a painful condition of the elbow, especially during repeated movements. All forearm muscles have an insertion with the so-called. epicondyle, or bony protrusions in the area of the lower part of the elbow. At this tendon origin, degenerative changes occur that cause tennis elbow, primarily due to changes at the level of microcirculation. Therefore, long-term cases of this syndrome do not represent a true inflammatory condition, which is essential in the implementation of treatment.
In addition to prolonged elbow overload, the reason may be a one-time trauma, eg when carrying a heavy load. Thus, tennis elbow is most often seen as an occupational disease, for example in athletes, dentists, surgeons, etc., ie a person with frequent use of the forearm muscles.
However, in accordance with the modern way of life, this condition is most often encountered due to excessive use of computers, so it is justified to talk about the emergence of “computer elbow”. The first symptom, pain, occurs on the outside of the forearm below the elbow joint.
The pain usually begins gradually and later intensifies in intensity. Depending on the severity of the damage, the pain may be mild and occur some time after the activity, it may last during the activity and intensify, or it may be constant. Sensitivity to touch in the elbow area is also often present.
In addition to the disorder described as tennis elbow, it should be noted that there is another form of this disease, and it is called golfer’s elbow. In principle, it is the same condition, only the other area is affected – the code “tennis“elbow is primarily affected area of the lateral epicondyle, or the outside of the elbow, while in”golfer’s“elbow” primarily affected area of the medial epicondyle, ie the inner side of the elbow, and the tendons of the muscles on the inner side of the forearm that are responsible for flexion, ie. bending the fist. A tennis elbow, therefore, should be distinguished from a golfer’s elbow. The characteristics of the disease, except for the site of primary damage and pain, are practically identical.
The mobility of the forearm in both conditions is sometimes reduced and it is difficult to correct it. Over time, the muscles weaken.
The diagnosis is made on the basis of a specialist examination and clinical tests on the elbow joint, as well as data on the occupation and sports activities of the patient. At the Ribnjak Polyclinic, we sovereignly use diagnostic ultrasound, which makes it possible to determine the exact location of the damage.
The orthopedic specialist is trained to make a differential diagnosis according to the group of compression states of the nerves in the elbow area. The pressure on the nerve structures of the elbow can give a false picture of the tennis elbow, so in case of doubt it is necessary to do additional processing, or examination of nerve conduction or electromyoneurography – EMNG.
Treatment of this syndrome can be conservative and operative.
Unsuccessful conservative treatment, which often includes corticosteroid injections, wearing a forearm bandage, etc., results in the necessity of surgical treatment. The operation is performed under regional anesthesia, sometimes using the so-called. “Pale paths”, ie compression bandages which, by pressing on the blood vessels, enable better visualization during the procedure.
The idea of surgical treatment is the so-called. disinsertion, ie separation of the tendon origin, with possible removal of the pathologically altered part of the elbow bone. Recovery after the procedure can take time, so patience in the postoperative period is essential. It should be noted that surgical treatment is resorted to only when all other treatment options for this overexertion syndrome have been exhausted.
At the Ribnjak Polyclinic, in addition to physical therapy services in the treatment of this syndrome, we very successfully use the method of treatment with platelet rich plasma (PRP), in accordance with the current therapeutic principles of treatment.
Numerous scientific studies confirm faster recovery after the application of platelet rich plasma due to the beneficial effect of platelet-derived growth factor on micro-damage in the tendon origin area.
The application of this method, therefore, leads to the regeneration of the injured area in a completely natural way.
In conclusion, it is a very widespread overexertion syndrome, which requires a specialist approach from diagnosis, monitoring of the progression of the condition, to treatment and recovery. The highly educated staff of our institution takes all the necessary measures required by the described painful condition of the elbow, in order to achieve a successful treatment result.
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