Epicondylitis - degenerative inflammation of the tissue surrounding the elbow joint, which accompanies the reactive inflammation of the tissues surrounding and intense pain.Clinically, the disease is divided into an outer shoulder epicondylitis (also known as "tennis elbow") is the most common and the inner shoulder epicondylitis (epitrohleit). outer shape epicondylitis occurs mainly in individuals who, because of their professional activities produce stereotyped repetitive flexion - extension movements forearm (painters, tennis, massage therapists, carpenters, etc.).The most commonly affects epicondylitis outer right hand, as it is usually dominant and thus loaded more left.In women, the disease occurs much less frequently than men.The average age of the disease varies between forty and sixty years
Epicondylitis - causes of
epicondylitis arises and subsequently develops due to micro-traumas and muscle tension, which are attached to the humerus nadmyschelkam.Sometimes the d
in the pathogenesis of epicondylitis have long identified the value of micro traumas, but can not be denied that the development of this disease is not the last role played by the violation of local blood circulation and developing degenerative processes.This is evidenced by the accompanying frozen shoulder, low back pain and spine gradual onset.About trophic factors (disturbance of local blood circulation) indicates razvshiysya in places of attachment of tendons osteoporosis
Epicondylitis - symptoms
epicondylitis often begins after an episode of overload, and are also important repetitive elbow flexion and repetitive movements of the brush in the retracted position of the hand.Quite often, the pain in the elbow joint occur even when the normal rhythm of life.This is due to the gradual development of involutive changes in the locomotor system which appear to arise in the epicondyle of the humerus without apparent external cause degenerative processes.Once appearing, caused by epicondylitis pain may not subside for weeks or even months.Called epicondylitis pain quite clearly localized - with internal epicondylitis patients strongly indicate internal and external epicondylitis at the outer surface of the elbow joint.Often there is the pain of irradiation on the inner or outer surface of the forearm.At rest, no pain.Appearance of the elbow joint is not changed, not limited to passive motion.
For external appearance of epicondylitis pain with its subsequent intensification triggered opening and supination bones;with internal epicondylitis - a provocateur is bending at the wrist joint.Sometimes the pain of epicondylitis in localized areas adjacent tendons.
Adrift outer epicondylitis is chronic.After securing the appropriate muscles to rest, after a few weeks (sometimes months) pain subsides.In the event of renewed stress, pain relapses occur very often.
In contrast to the outer shape, the inner epicondylitis is more common in women who are carrying out repetitive mild exertion (montazhnitsy, seamstresses, typists).In most cases, the patient worried about the pain involved in making pressure on the domestic podmyschelok that also occur and then amplified in the flexion of the forearm.Along the inner edge of the forearm characterized by irradiation of the pain.Internal epicondylitis is also characterized by its chronic course
Epicondylitis - diagnostics
diagnosis of epicondylitis set based solely on the findings of the clinical examination.Confirms the diagnosis of additional information obtained by means of special tests that determine the resistance of the active movement.Laboratory and instrumental methods in the diagnosis of this disease is not usually used only if there is an explicit exception to the injury of bone damage radiography.Differential diagnosis is carried out with the following diseases: infringement of the ulnar nerve pinching of the median nerve, septic necrosis of the articular surfaces, arthritis
Epicondylitis - Treatment
Treatment of epicondylitis necessarily complex, to the extent that changes in the tendons and muscles of the hand and forearm, the degree of dysfunction of the elbowjoint disease duration.The main objectives of the treatment of epicondylitis: the elimination of the lesion in pain;improvement and / or recovery of regional blood flow;restoration of the elbow full range of motion;Warning atrophic changes of the forearm muscles.
liquidation in the lesion pain solved using both conservative and radical treatment.In the acute phase of lateral epicondylitis seven-eight days is conducted immobilization of the upper limb at the elbow bent arm.
In the case of chronic epicondylitis flow shown elastic bandage bandaging the elbow and forearm (at night the bandage must be removed).Good analgesic effect has hydrocortisone ultrasound (phonophoresis).Is widely used ozocerite and paraffin applications, currents Bernard.To reduce local trophic and for the purpose of pain relief, shown holding blockades (4-5 blockades range 2-3 days) lidocaine and novocaine places of attachment fingers and wrist extensors.After removing the plaster splint shown warming compresses with boric Vaseline, camphor alcohol or just vodka.In order to improve in the affected area of the regional circulation shows electrophoresis with novocaine, potassium iodide, acetylcholine, or UHF therapy.In order to prevent and to treat muscle atrophy and to restore the proper functioning of the joint shows the use of the forearm and shoulder massage, exercise therapy, dry air baths, mud baths.
In the absence of results of conservative treatment for three - four months, resort to radical (surgical) treatments.Today is widely used operation Homan, who suggested back in 1926 excise extensor tendons of the fingers and hand.
Prevention of epicondylitis is mandatory prevention of chronic surge above muscle groups in a rational technique sports or working (professional) movements in the correct selection of the necessary equipment and the choice of working position.In chronic epicondylitis with frequent relapses and unsuccessfully complex treatment, the patient is recommended to change the nature of the work.