Internal epicondylitis of the elbow joint treatment. What is a tennis or golfer elbow? Treatment with folk remedies

Moisov Adonis Alexandrovich

Orthopedic surgeon, doctor of the highest category

Moscow, st. Dmitry Ulyanov 6, bldg. 1, metro station "Akademicheskaya"

Moscow, st. Artsimovich, 9 bldg. 1, metro "Konkovo"

Moscow, st. Berzarin 17 bldg. 2, metro station "October field"

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Education and professional activities

Education:

In 2009 he graduated from the Yaroslavl State Medical Academy specializing in general medicine.

From 2009 to 2011 passed clinical residency in traumatology and orthopedics on the basis of the emergency hospital medical care them. N.V. Solovyov in Yaroslavl.

Professional activity:

From 2011 to 2012 he worked as a traumatologist-orthopedist at the emergency hospital No. 2 in Rostov-on-Don.

Currently works in a clinic in Moscow.

Internships:

May 27 - 28, 2011 - Moscow city- III International Conference "Foot and Ankle Surgery" .

2012 - Training Course on Foot Surgery, Paris (France). Correction of deformities of the forefoot, minimally invasive surgery for plantar fasciitis (heel spur).

February 13-14, 2014 Moscow - II Congress of Traumatologists and Orthopedists. “Traumatology and Orthopedics of the Capital. Present and Future ".

June 26-27, 2014 - took part in V All-Russian Congress of the Society of Hand Surgeons, Kazan .

November 2014 - Advanced training "Application of arthroscopy in traumatology and orthopedics"

May 14-15, 2015 Moscow - Scientific and practical conference with international participation. "Modern traumatology, orthopedics and disaster surgeons."

2015 Moscow - Annual international conference.

May 23-24, 2016 Moscow - All-Russian Congress with international participation. ...

Also at this congress was a speaker on the topic "Minimally invasive treatment of plantar fasciitis (heel spur)" .

June 2-3, 2016 G. Nizhny Novgorod - VI All-Russian Congress of the Society of Hand Surgeons .

In June 2016. Assigned. Moscow city.

Scientific and practical interests: foot surgery and hand surgery.

Medial epicondylitis (golfer's elbow)

Medial epicondylitis is commonly known as the golfer's elbow. But this does not mean that only golfers suffer from this ailment. But golf is a common cause of medial epicondylitis. Many other repetitive movements can also lead to epicondylitis:

Throws;
Sports activities;
Using various types of hand tools;
Consequences of elbow joint injuries.

Any activity that actively uses the muscles of the forearm can cause symptoms of epicondylitis. Epicondylitis- degenerative-dystrophic process at the site of muscle attachment to the epicondyle of the humerus.

Elbow anatomy

Why is the disease called medial epicondylitis?

Epicondylitis (epicondylitis, translated from Latin epicondylus - epicondyle + ending itis indicates an inflammatory process). Pain that is defined on the inner "bone" of the elbow - the medial epicondyle. The flexor muscles of the wrist and fingers are located on the forearm and are attached to the medial epicondyle through the tendon portion. And at the point of attachment, these tissues often experience heavy loads under the above conditions. As a result of this, microinflammation, damage and, naturally, pain, edema develop.

Causes of medial epicondylitis of the elbow joint

Excessive stress on the muscles and tendons of the forearm is the most common cause of epicondylitis. Certain types activities (professional) can cause inflammation in the area of muscle attachment to the epicondyle. This activity does not have to be sports-related.

In some cases, the symptoms of ulnar epicondylitis are not associated with inflammation.

Instead of inflammatory cells, the body produces a type of cell called fibroblasts. When this happens, collagen loses its strength. It becomes brittle and can break down. Every time collagen breaks down, the body responds by forming scar tissue in the tendon. Eventually, the tendon thickens from additional scar tissue.

Small tears form in the tendons of the forearm, which are regenerated by scar tissue. Scar tissue is not as strong and cannot completely restore the structure of the tendon part.

Medial epicondylitis - symptoms

The main symptoms of a golfer's elbow are:

Pain at the medial epicondyle of the elbow. Pain usually begins at the medial epicondyle and may radiate down the forearm;
Flexion of the fingers, flexion of the hand at the wrist can increase the pain;
Feeling of reduced grip strength when carrying objects or clenching your hand into a fist.

Treatment of medial epicondylitis of the elbow joint

The doctor will listen to the patient's complaints and examine them carefully. You will need to answer questions about the nature of the pain, how the pain affects your daily activities, and whether you have had an elbow injury.

Also, special tests for stretching the corresponding muscles are used, which helps in clarifying the diagnosis.

Your doctor may ask you to take an X-ray of your elbow to rule out bone pathology or the consequences of an injury you might have forgotten. An x-ray can also show if there is calcification (calcium deposits) at the site of attachment of the tendons to the epicondyle, which indicates a prolonged inflammatory reaction in this place, as a result of chronic injury.

The symptoms of medial epicondylitis are very similar to a condition called ulnar tunnel syndrome... It is a condition caused by compression of the ulnar nerve. In the cubital canal: between the olecranon, the medial epicondyle and the ligament.

Conservative treatment of medial ulnar epicondylitis

In cases where the tendon becomes inflamed, conservative treatment for medial elbow epicondylitis is usually effective within four to six weeks of symptom onset. Then the treatment is limited to 1 month. But if the inflammation is chronic and the patient has not attempted treatment for a long time, then full recovery can take up to six months.

The essence of conservative treatment for golfer's elbow is to preserve collagen from further destruction. The goal is to help the tendon heal.

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs):

If the problem is caused by inflammation, nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed first. They are known to many: "Nimesil", "Nise", "Ketorol", "Nurofen" and others.

Take the drug of any of the drugs, 1 tablet 2 times a day, always after meals, but no more than 5 days, because drugs have a detrimental effect on the gastric mucosa. The drugs are contraindicated in patients with gastric ulcer or duodenal ulcer.

If this therapy is ineffective, steroid drugs are prescribed.

Injection with steroidal anti-inflammatory drugs.

Steroid medications forcefully reduce inflammation in the lesion. Sometimes two or three injections are given within a week if a single injection is unsuccessful. Steroid injections are effective in many ways, but they do carry some risks. In the case of repeated frequent injection, the strength of the tendons (collagen fibers) decreases, up to rupture.The most common and effective drug in the treatment of medial epicondylitis is "Diprospan"

Performed blockade by Diprospan.

Immobilization: Elbow brace

Shockwave therapy

Extracorporeal shock wave therapy uses an apparatus that produces shock waves that penetrate the skin into the inflammation (painful area) of the epicondyle. Its main positive effect is the improvement of microcirculation. Due to this, inflamed tissues heal and regenerate faster. As a rule, 4-6 procedures are performed. The frequency of execution is -1 times a week. This time is needed for the body to begin to cope with inflammation on its own, after the shock wave therapy "pushed" it by improving the blood supply.

The main contraindication for UHT:

Oncological diseases

Purulent inflammation in the therapy area

Surgical treatment of medial epicondylitis

Sometimes conservative treatment of ulnar epicondylitis is not able to relieve a person of the disease, or at least reduce pain. In these cases, the operation is performed.

During the operation, the surgeon accesses the tendon part of the flexor muscles of the forearm in the projection of their attachment to the medial epicondyle. The operation is performed under local or local anesthesia and a pneumo-gut on the humerus in order to prevent even the slightest bleeding. Otherwise, it will be impossible to distinguish between healthy tendon tissue and scar tissue. It is this scar tissue that the surgeon must carefully remove.

In some cases, just removing the scar tissue is not enough to heal. Therefore, they resort to the operation "Tendon release"

The tendon is dissected from its attachment to the medial epicondyle. Scar tissue is separated from healthy tendon fibers, areas of tendon calcification (calcium deposits) are removed. Next, the tendon is sutured to the fascia of the nearby muscle (fascia is the tissue that covers muscles and organs throughout the body).

The operation is performed on an outpatient basis, which means that you do not have to stay in the hospital, but go home 30 minutes after the operation.

After operation

Recovery after surgery for medial epicondylitis takes one to three months.

Immediately after the operation, the elbow joint is immobilized (limited movement) by fixing it in a removable orthosis, which keeps the arm bent at an angle of 90 degrees.

A few days after the operation, the patient begins to gradually develop the elbow joint and flexor muscles, increasing the range of motion every day. Active rehabilitation begins approximately two weeks after the operation. And so on until complete recovery.

Surgical treatment of epicondylitis 34,000 rub.

Do not self-medicate!

Determine the diagnosis and prescribe correct treatment only a doctor can. If you have any questions, you can call orask a question on.

Elbow epicondylitis is a degenerative process also known as tennis elbow. Don't be fooled by the name. Studies have found that carpenters, for example, are more likely to suffer from this disease than tennis players. The reason for the unusual name is as follows - the first large description of the disease was made, using the example of tennis players.

There are many civilian professions that have nothing to do with professional sports, but they have one thing in common - stereotypical monotonous movements - the mentioned carpenter, gardener working as a hoe, computer operator who spends all day typing text. Although this pathology is considered safe, take care of your joints in advance, it is better to prevent the disease than to cure it later.

What is epicondylitis?

Epicondylitis (tennis elbow, tennis elbow) is a disease based on degenerative muscle damage in the places of their attachment to the bone. Epicondylitis is a chronic disease that, if treated incorrectly, can progress to more and more painful flare-ups.

In the area of the elbow joint, there are bulges on the humerus called the epicondyle or epicondylus. They do not participate in the work of the joint, but serve to attach muscles and tendons. Under certain circumstances, inflammation of the tendons in the epicondyle region develops. This disease is called "epicondylitis of the elbow joint", although the joint itself is usually not affected by inflammation.

The pathological process involves muscles and tendons in the place where they attach to the bone. This disease is quite common, especially people after 35 years old suffer from it. But many patients do not go to the doctor, as the inflammation is mild and usually goes away quickly. According to statistics, both men and women are susceptible to such inflammation. Moreover, the most common epicondylitis of the right elbow, since there are more right-handers than left-handers, and the disease develops from increased stress.

In fact, ulnar epicondylitis is a microtrauma. There is a slight rupture of the tendon in the elbow area, which later becomes inflamed. Most often this happens due to an unsuccessful or abrupt movement of the hand, as well as due to a constant load on this muscle group. The patient may not even notice the injury itself, sometimes there is not even pain at this moment. But over time, swelling increases, this place becomes inflamed. This is how epicondylitis develops.

But not all doctors recognize that the disease appears as a result of injury to muscles and tendons. Many believe that such inflammation can be due to osteochondrosis. But in any case, this disease never develops on its own, inflammation is always secondary, so for effective treatment it is important to understand what caused it. After eliminating the provoking factors, the disease goes away faster.

Causes of the appearance of epicondylitis of the elbow joint

Most often, inflammation develops as a result of increased stress, for example, with constant flexion and extension of the elbow or hand. Therefore, there is a certain risk group, people from which most often suffer from this disease. These are athletes who lift weights or a barbell, who are involved in tennis, rowing, and wrestling.

Painters, bricklayers, milkmaids, masseurs, violinists, hairdressers, typists are also susceptible to this disease. Often, inflammation develops due to the constant carrying of heavy objects, such as bags. Therefore, pathology can occur in housewives. There are also other causes of elbow epicondylitis:

Soft tissue bruises or injuries to the elbow joint;
Congenital weakness of the ligamentous apparatus;
Violation of blood circulation or metabolic processes;
Osteochondrosis of the spine, osteoporosis or periarthritis of the shoulder scapula.

Sport. As we have already noted, the most common reason lateral epicondylitis - overstrain of the muscles attached to the lateral epicondyle (the short radial extensor of the hand, the extensor of the fingers, the extensor of the little finger and the ulnar extensor of the hand are attached by a common tendon to the lower part of the epicondyle; just above and separately from them, the long radial extensor of the hand is attached to the humerus).

In scientific studies, it has been proven that among all these muscles, a particularly important role is played by the short radial extensor of the hand, which stabilizes the entire hand in an extended position with a straightened elbow joint. This stabilization is especially important when playing sports. When this muscle is overloaded, micro tears occur in it in the area of attachment to the epicondyle of the humerus, micro tears appear in it, which, in turn, leads to inflammation and pain.

In any case, a coach should play an important role in the prevention of lateral epicondylitis in athletes, since improper impact technique significantly increases the risk of this disease. In addition, the short radial extensor of the hand is located in such a way that when flexing and extending the elbow top part muscles can be injured, which can also lead to inflammation and pain.

Professional activity. It is a mistake to think that lateral epicondylitis can only be in tennis players or in athletes in general. Monotonous movements, especially when you have to hold the lesson on weight long enough, can also damage the muscles that attach to the lateral epicondyle. Painters, painters, gardeners, carpenters ... the list goes on.

Scientists even studied the frequency of this disease, and it turned out that it was statistically significantly more common in car mechanics, cooks and butchers compared to people in other professions. In all these cases, the profession has one thing in common - the need to repeatedly lift something with a straightened brush.

Age. Another cause of inflammation in the area of muscle attachment is age-related changes in muscles and tendons. Sometimes the disease can develop without any apparent reason, in which case they speak of "sudden" lateral epicondylitis.

Epicondylitis symptoms

As a rule, the disease develops gradually. The pain is mild and intermittent at first, but over several weeks or months it gradually progresses and may become permanent. Often the onset of pain is not preceded by any trauma. The most common symptoms of lateral epicondylitis are:

Pain or burning sensation on the outside of your elbow
Decreased strength of the forearm muscles that extend the hand and fingers.

These symptoms are aggravated by stress on the muscles attached to the lateral epicondyle of the humerus (holding the racket, tightening the screws with a screwdriver, etc.). Most often, pain occurs on the leading side (on the right in right-handers and on the left in left-handers), but the disease can occur on both sides.

Overstrain of muscles and tendons in the elbow region is the main cause of the development of epicondylitis. Repetitive strength movements in the elbow joint can cause overstretching of the elbow tendons. It doesn't have to be overwhelming in professional tennis. Hammering nails, carrying buckets of water in the country, trimming bushes - all this can lead to the development of a tennis player's elbow.

When tissues are damaged, inflammation develops, which is a protective reaction of the body. Leukocytes migrate to the site of inflammation, clearing it of damaged tissues and promoting healing. In medical terminology, diseases accompanied by inflammation have the ending -it. For example, inflammation of the tendons is called tendonitis. Accordingly, inflammation of the tissues near the lateral epicondyle is called lateral epicondylitis.

It should be noted that tennis elbow is not always accompanied by tissue inflammation. In the absence of inflammatory changes in the tendons, the disease is called tendinosis. In tendinosis, stretching and micro-tearing lead to degenerative changes in the tendon.

In such a tendon, the arrangement of collagen fibers is disrupted. Tendon cells begin to be replaced by fibroblasts - cells that produce a slightly different type of collagen, not so strong and without an ordered arrangement of fibers. Gradually, the tendon degenerates: it becomes thicker due to the growth of defective connective tissue. Naturally, such a tendon can be damaged even with minor injuries.

The exact mechanism of development of epicondylitis is still not known. According to one common hypothesis, micro-tears appear in the tendon attached to the lateral epicondyle due to overload. The restoration of the integrity of the tendon is hampered by continued stress, which can also lead to the formation of new damage. The proliferation of connective tissue at the site of injury leads to weakening of the tendon and the occurrence of pain.

Few people know what epicondylitis is, although many are faced with this pathology. But some relieve elbow pain on their own, without going to a doctor. This attitude can lead to complications and loss of arm mobility. Therefore, it is important to know the main symptoms so that the treatment of epicondylitis of the elbow joint is started on time.

The main symptom of the disease is pain. Usually it is aching, localized in the elbow area, but can radiate to the shoulder or forearm. The pain becomes sharp, even burning when performing active hand movements. A particularly strong reaction is to flexion and extension of the elbow, wrist, and clenching the hand into a fist. At first, pain occurs only when moving, with the development of inflammation, it becomes constant.

Elbow swelling and redness usually occurs when epicondylitis is complicated by arthritis. With the development of inflammation, the mobility of the joint is severely limited. Over time, muscle weakness and rapid arm fatigue develop. With external epicondylitis, the patient cannot even pick up a cup of tea from the table. You can also identify this form of the disease by the pain during the handshake. And medial epicondylitis is characterized by weakness and pain when flexing the forearm or moving the hand.

Types of epicondylitis

This disease is of two types: medial and lateral epicondylitis. This classification takes into account the site of attachment of the affected muscles and tendons. Lateral epicondylitis of the elbow joint occurs most often in athletes. Therefore, this pathology is also called "tennis elbow". After all, inflammation develops from the outside, at the site of muscle attachment to the epicondyle of the humerus.

A disease can appear from any monotonous hand work, for example, sawing wood, painting a wall, or from a sharp lifting of weights. External epicondylitis occurs about 10-15 times more often than its second type. Medial, or internal, epicondylitis develops less frequently and is easier. In this case, the tendons on the inside of the elbow joint at the point of attachment to the forearm bone become inflamed. Most often it is caused by monotonous brush movements. Therefore, in recent times people who work at a computer for a long time began to suffer from such a pathology.

Medial epicondylitis very often acquires a chronic course, since the pain is not so intense, and not every patient decides to consult a doctor about this. Sometimes post-traumatic epicondylitis is also isolated, which develops due to non-compliance with the doctor's recommendations during the rehabilitation period after injury. And the chronic form of the disease is very common, since it can be completely cured only if you consult a doctor on time and follow all his recommendations.

Diagnostics

To heal faster, you need to know which doctor is treating epicondylitis. Usually, for pain in the elbow, patients turn to a traumatologist or surgeon. A specialist can make a diagnosis only on the basis of a conversation and an external examination.

The diagnosis of the disease is simplified due to its specificity. After all, pain occurs only with active hand movements. And with passive movements, when the doctor bends the patient's arm, there is no pain. In this, epicondylitis differs from arthritis, arthrosis and various injuries. A characteristic feature of the disease is also the fact that the soft tissues in the elbow area are very painful to palpation.

When making a diagnosis, the doctor may ask the patient to run multiple tests. Thompson's test goes like this: you need to put your hand on the table, palm up and try to clench your fist. In a patient with epicondylitis, the palm quickly unfolds. For the Velta test, you need to raise your arms to the level of the chin and bend-unbend them at the elbow. In this case, the diseased hand will noticeably lag behind the healthy one. The disease can also be determined by this sign: if the patient tries to hold his hand behind, placing it on the lower back, the pain will intensify.

Additional diagnostic methods are usually not used. Only if the doctor suspects another disease, he can refer the patient for examination. X-rays are taken if there is a suspicion of a fracture or osteoporosis, MRI in order to exclude tunnel syndrome. If acute arthritis or bursitis is suspected, a biochemical blood test may be done.

Tell your doctor about how the disease developed, how you think it started, how quickly the pain or other symptoms progressed. Special attention pay attention to the peculiarities of your physical activity - who you work, what sport and how often you do it.

To diagnose lateral epicondylitis, your doctor will ask you to perform special hand movements (diagnostic tests). Typically, these special tests can make a diagnosis without any doubt, but in some cases ultrasound, radiography, or even magnetic resonance imaging may be needed.

Epicondylitis treatment

Treatment of epicondylitis is complex, based on the duration of the disease, the level of dysfunction of the joint, as well as changes in the tendons and muscles in the area of the hand and forearm. The main objectives of the treatment of epicondylitis of the elbow joint can be formulated in a certain way:

Eliminate pain at the site of the lesion;
To restore or improve regional blood circulation;
Restore full range of motion in the elbow joint;
Prevent forearm muscle atrophy.

The solution to the first problem in the treatment of epicondylitis is carried out by using traditional and surgical methods. Treatment of lateral epicondylitis in the acute stage occurs by such a method as immobilization of the upper limb for a period of 7-8 days with the forearm bent at the joint (80 degrees), and the wrist joint - with small dorsal extension. In the case of a chronic course, doctors recommend bandaging the forearms and elbow joint with an elastic bandage, but remove it at night.

Injection of corticosteroid drugs. Local single (less often - double) administration of drugs such as diprospan, kenalog or hydrocortisone can very effectively relieve pain, but you need to understand that treatment with corticosteroids without modifying the load and finding out the causes of pain is not the best way.

Moreover, in our opinion, the treatment of lateral epicondylitis should begin with modifications of loads, exercises, orthoses, taping, and only if the effect is insufficient, proceed to the injection of corticosteroid drugs.

Extracorporeal shock wave therapy. The essence of this method is that sound vibrations cause microtrauma, which, in turn, stimulates the healing process. In some ways, the principle of action is similar to the homeopathic approach - like is treated with like.

Unfortunately, at present this technique still has the status of an experimental one and most of the research is of an advertising nature or, in general, has been carried out with serious flaws. On the other hand, there are a number of serious scientific studies in which shock wave therapy has been shown to be effective. In any case, it cannot be considered a first-line treatment at this time.

Ultrasound has a good analgesic effect in the treatment of epicondylitis of the elbow joint, but it is even better to use phonophoresis (the so-called ultrasound with hydrocortisone). Bernard currents, ozokerite and paraffin applications are also widely used. In order to anesthetize the area and improve local trophism, blockades are carried out at the attachment point of the extensors of the fingers and hand with novocaine or lidocaine, which are very often combined with hydrocortisone.

Over the entire period of treatment for epicondylitis of the elbow joint, 4-6 blocks are performed (an interval of a couple of days). When the plaster splint is removed, use warming compresses with petroleum jelly, camphor alcohol, or ordinary vodka compresses. To improve regional blood circulation in the affected area, UHF therapy, electrophoresis with acetylcholine, novocaine or potassium iodide is used. In addition, medications such as nikoshpan and aspirin are prescribed to treat medial epicondylitis of the elbow.

To change the trophism of tissues at the site of tendon attachment, blockade with bidistilled water is used. Although such blockages have a good effect, it should be said that the very process of drug administration is quite painful. In the case of a chronic course of the disease, injections of vitamins such as B1, B2, B12 are prescribed.

To prevent and treat muscle atrophy and restore joint function, massage of the muscles of the forearm and shoulder, mud therapy, exercise therapy and dry air baths are used. In addition, special exercises for elbow epicondylitis help well.

In the case of a chronic course of this disease with frequent exacerbations and unsuccessful treatment, patients must change the nature of their work. In the vast majority of cases, conservative (non-surgical) treatment is possible. It is effective 80-95% of the time.

Surgical intervention

In cases where there is no acceptable effect from conservative treatment within 6-12 months, the way out is seen in surgical treatment... Almost all methods of operations for the treatment of tennis elbow are reduced to the fact that the muscles are separated from the area of attachment to the condyle of the humerus, chronically inflamed and altered tissues are removed and the muscles are reattached to the bone.

Surgical methods for the treatment of medial epicondylitis of the elbow joint are used with unsuccessful conservative treatment for 3-4 months. The so-called Hohmann operation is widely used. In 1926, he proposed excising some of the tendon at the extensors of the fingers and hand.

Today, such an excision is not performed at the point of transition into the muscle, as was proposed in the original version, but near the area of attachment of the tendon to the bone itself. After such an operation, it takes some time to recover, carry out the appropriate procedures and perform special exercises for epicondylitis of the elbow joint.

The operation can be performed either in the traditional open way (through a 4-6 cm long incision) or arthroscopically (through two 1 cm punctures). It is rather difficult to compare these techniques with each other, but it is worth noting that open surgery, probably, allows you to more thoroughly see all the changes in the area of muscle attachment to the bone. In any case, the operation is inevitably accompanied by the risks of complications, which, although rare, can arise despite all the skill of the surgeon:

Infectious complications (the need for repeated operations)
Damage to blood vessels and nerves
Slow growth of muscle to bone, resulting in a long rehabilitation period
Decreased forearm strength
Decreased flexibility of movements

After the operation, the arm is immobilized (immobilized) with an orthosis for 1-2 weeks, which reduces muscle tension. After that, they begin physical exercises, which are selected individually by the doctor. Stretching exercises begin no earlier than 2 months after surgery. Return to sports activities usually occurs 4-6 months after surgery. Fortunately, in most cases, the strength of the muscles of the forearm is fully restored after such operations.

Although the disease is not considered severe and does not lead to disability, people at risk need to know how to treat elbow epicondylitis. Otherwise, inattention to such a pathology can lead to the development of a chronic form of the disease, which will be much more difficult to get rid of later.

The goal of treatment should not only be to relieve pain. It is necessary to use methods that would improve metabolic processes and blood circulation in tissues, and would help relieve inflammation. But the main thing is the restoration of joint mobility. To do this, you need to prevent muscle atrophy and restore their work.

Treatment of lateral epicondylitis of the elbow joint, as well as medial, should be complex. An individual hike is also very important. Therefore, the doctor usually conducts a complete examination to determine the presence of comorbidities or chronic diseases. Most often, conservative therapy is sufficient. But in advanced cases, excision of the affected tissue may be recommended. Recently, the operation has been done in a less traumatic way - with the help of laser ablation. For the treatment of epicondylitis of the elbow joint, several methods must be applied at once:

NSAIDs internally and externally;
With severe pain - novocaine blockade;
Special exercises;
Immobilization;
Physiotherapy;
Massage;
Traditional methods.

Immobilization of the elbow joint

Treatment usually begins with limiting the stress on the joint. The patient is shown rest, sometimes it is necessary to change the type of activity. In the acute period of the disease, it is recommended to use a special orthosis on the elbow joint, which will help to immobilize it.

Lack of stress promotes faster healing and prevents pain. In severe cases, a plaster cast or splint may be required. The elbow is fixed in a bent position, sometimes it is still required to fix the wrist joint. Such immobilization is carried out for up to 7 days.

Sometimes it is recommended to constantly wear a bandage for epicondylitis of the elbow joint, if its course has acquired a chronic form. Instead of a special device, you can use an elastic bandage before anticipated physical activity. This will help prevent muscle strain and strain.

Drug therapy

Most often, the patient is worried about pain. You can cope with them with the help of pain relievers. How to treat epicondylitis should be recommended by a doctor. Basically, NSAIDs are prescribed, since they help relieve not only pain, but also inflammation. It can be Ibuprofen, Ketorolac, Naproxen, Nimesil, Nise and others.

If such treatment is ineffective or if the pain is severe, the doctor may prescribe injections. It can be the same non-steroidal anti-inflammatory intramuscularly, so they act more effectively. Or, novocaine blockade of the elbow joint is performed, usually 4 times with an interval of a couple of days. To enhance the effect, Novocain is mixed with Hydrocortisone or Methylprednisolone.

External agents are often used in the form of ointments or solutions for compresses. The best drugs are based on non-steroidal anti-inflammatory drugs - "Voltaren", "Ketoprofen", "Indomethacin", "Diklak" and others. They need to be rubbed into the affected area with gentle movements so as not to increase pain. Compresses with "Dimexidum" are also effective.

In addition, other drugs may be used. To improve blood circulation, "Aspirin" or "Nikoshpan" are prescribed. In the chronic form of the disease, vitamins of group B or the drug "Milgamma" are shown.

Physiotherapy

After the pain subsides, physiotherapy exercises are necessarily prescribed. Exercises should be aimed first at stretching and relaxing the muscles of the forearm and shoulder, and then at strengthening them. You can do it yourself, but it is better to use a complex selected by a doctor. It is very important to follow some rules: gradually increase the load, prevent the appearance of pain, but the main thing is to do the exercises daily. At the initial stage of training, the basis of the complex should be passive movements:

With a healthy hand, hold the sore hand by the wrist and bend it slowly to an angle of 90 degrees;
Stand in front of the table and put your palms on it, bend forward so that the hands are at a right angle with the forearm;
Sit down, put your hands with your fingers on the back side, leaning back slightly to achieve that the hands make an angle of 90 degrees with the forearm.

When such passive movements are easy, it means that the muscles are stretched. After that, you can do exercises to strengthen them. This can be flexion and extension of the arms at the elbows, clenching of the fist, rotation of the shoulders, circular movements with the hands, or scissors. It is useful to use various Bubnovsky simulators or simpler ones - a rubber cord, a gymnastic stick, an expander.

Massage and physiotherapy

Massage for the treatment of epicondylitis is also used after the end of the acute stage. This method improves blood circulation and metabolic processes well. It helps relieve pain and get rid of inflammation faster. Massage also helps to restore hand mobility, as it strengthens damaged muscles and prevents muscle atrophy.

Treatment of epicondylitis of the elbow joint by manual therapy is also effective. Properly performed, the procedure will help restore joint mobility and muscle function. A type of manual therapy is post-isometric relaxation, which is more modern and effective method treatment.

Such treatment for epicondylitis of the elbow joint is applied at any stage. In the acute period, pulsed magnetotherapy, laser radiation, ultrasound, diadynamic therapy help well. After the pain subsides, phonophoresis, paraffin or ozokerite applications, cryotherapy, Bernard currents or shock wave therapy are used to restore tissues.

Such treatment improves metabolic processes and blood circulation in tissues, relieves pain and reduces inflammation. To improve blood circulation and trophism of soft tissues, UHF therapy is useful, as well as electrophoresis with potassium iodide or "Acetylcholine".

Acupuncture, mud therapy, hirudotherapy, regular and dry air baths are also effective. Usually, a full range of such procedures can be obtained during spa treatment.

Traditional methods and self-treatment of epicondylitis

Very often, epicondylitis at the very beginning of its development is not perceived very painfully. That is why the attitude towards it is appropriate, patients are in no hurry to see a doctor, trying to cure a sore joint on their own. Of course, self-medication can have dangerous consequences, but if you nevertheless decided on it, then you should keep in mind a few basic principles:

If pain appears for several days, completely exclude movements / exercises that provoked the pain. If you play tennis, pay attention to the size of the racket itself and the tension on the strings - when you resume training, you may need to change the racket. For pain relief, it is recommended to take anti-inflammatory drugs (for example, ibuprofen every 4-6 hours) until the pain completely stops.
If pain reappears, apply cold (cryotherapy) to the area of the elbow joint from the outside for 15-20 minutes several times a day. Cryotherapy is continued for 3-4 days.
After a significant reduction in pain, the local cold is changed to local heat (several times a day), which finally removes the pain.
After the persistent disappearance of pain, they begin stretching exercises. With the brush of the other hand, slowly bend the wrist of the sore arm until a feeling of tension and slight pain in the elbow area appears, hold this position for 10-15 seconds, slowly shaking the hand. Repeat three sets 10 times a day.
After the stretching exercises are completely painless, start strengthening and stretching exercises. They take a hammer or other heavy object into the hand (the hand is turned with its back surface up, flexion at the elbow is about 100-120 degrees). The hand and forearm are supinated and returned to their original position. 10 approaches, rest 2-3 minutes, 2 more times for 10 approaches (2-3 times a week).
A similar exercise is repeated, but the hand is turned with the back surface down (figure). 10 approaches, rest 2-3 minutes, 2 more times for 10 approaches (2-3 times a week).

Treatment of epicondylitis of the elbow joint at home is possible with the help of alternative methods. You should not be limited to them, complex treatment is more effective. In addition, only a specialist can diagnose, perhaps the elbow pain has completely different causes. Therefore, before using any alternative methods, you need to consult a doctor. The following recipes are considered the most effective and common:

Use an ointment made from comfrey root and nutria lard;
Blue clay compresses;
Rubbing or applying tincture of horse sorrel roots with vodka;
Laurel oil in the form of compresses also relieves pain well;
Warming compresses with vodka or camphor alcohol are effective;
Iodine mesh on the joint area.

Prophylaxis

Since this disease is quite common, it is very important to know how to prevent it. This is especially necessary for athletes. When playing sports, you must follow the rules for performing exercises and safety precautions when working with equipment. Be sure to warm up before class. If there is a predisposition to the disease, taping should be used, which will help reduce the load.

People who perform monotonous work with their hands need to take periodic breaks, try to avoid overload. Change the monotonous work for a few minutes and you will immediately feel relief.

With chronic epicondylitis, do not forget about daily exercise and the importance of self-massage. This pathology seems frivolous, but still you should not self-medicate. So that the disease does not turn into a chronic form, does not lead to complications, it is necessary to consult a doctor in time and follow all his recommendations.

Source: "travmaorto.ru, moyaspina.ru, orthoped.i.ua"

megan92 2 weeks ago

Tell me, who is how to deal with joint pain? My knees hurt terribly ((I drink painkillers, but I understand that I am struggling with the investigation, not the cause ... Nifiga does not help!

Daria 2 weeks ago

For several years I fought with my aching joints until I read this article by some Chinese doctor. And I have long forgotten about the "incurable" joints. Such are the things

megan92 12 days ago

Daria 12 days ago

megan92, so I wrote in my first comment) Well, I'll duplicate it, it's not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

And this is not a divorce? Why are the Internet selling ah?

yulek26 10 days ago

Sonya, what country do you live in? .. They sell it on the Internet, because shops and pharmacies charge their extra charge. In addition, payment only after receipt, that is, first looked, checked and only then paid. Yes, and now everything is sold on the Internet - from clothes to TVs, furniture and cars.

Editorial response 10 days ago

Sonia, hello. This drug for the treatment of joints is really not sold through the pharmacy chain in order to avoid an overpriced. To date, you can order only on Official site... Be healthy!

Sonya 10 days ago

I apologize, I did not notice the information about cash on delivery at first. Then, it's OK! Everything is in order - for sure, if the payment is on receipt. Thank you very much!!))

Margo 8 days ago

Has anyone tried alternative methods of treating joints? The grandmother does not trust pills, the poor one has been suffering from pain for many years ...

Andrey 1 week ago

What folk remedies have I tried, nothing helped, it only got worse ...

Ekaterina 1 week ago

I tried to drink a decoction of bay leaves, no use, only ruined my stomach !! I no longer believe in these folk methods - complete nonsense !!

Epicondylitis of the elbow joint: symptoms and treatment.

Epicondylitis is a disease secondary in etiology, manifested by inflammation and dystrophic changes in the epicondyle bone and soft tissues surrounding the elbow joint.

It develops slowly, it is diagnosed already at the stage of inflammatory-dystrophic changes, at the stage of overload and the onset of dysfunction and pain.

It is diagnosed in the age period 30-50 years, more often in men.

Treatment takes a long period, is multistage and does not exclude surgical intervention.

The elbow joint is articulatio cubiti, one of the articulated joints containing three bony guides - the diaphysis of the radial and ulnar, and the epiphysis of the humerus.

This is a whole tissue apparatus, multidirectional and variously attached tendon and muscle fibers.

Accordingly, one complex joint consists of three simple ones.

Epicondylosis is a specific area of the bone - the epicondyle, which is not part of the joint, but performs an important function.

It fixes the muscles and tendons that extend and flex the arm at the elbow and fingers.

Causes of epicondylitis of the elbow joint

Etiological risk factors for the development of epicondylitis are:

Occupational hazards in builders and agricultural workers, all professions associated with physical labor can have provocative movements for the development of epicondylitis - painting and plastering, lifting and carrying weights, constant staying at the control of complex mechanisms (tractor, crane, harvester), manual milking of cows, carpentry, seamstresses, couriers, porters.
Sports chronic microtraumas and injuries that accumulate over time and cause wear and tear of the ligamentous-muscular apparatus - boxing, tennis, discus and javelin throwing, golf, barbell, sports and rhythmic gymnastics.
and . Symptoms of this disease provoke violations of peripheral innervation, perversion of nerve impulses and painful radiation to the arm area.
Bad habits - preference for one hand when carrying a bag or suitcase, the usual support on the elbow in everyday life.
A single open or closed hand injury with a reflected or direct injury to the elbow joint area. Perhaps after incomplete treatment or inadequate rehabilitation.

Pathogenesis and varieties of elbow epicondylitis

The pathogenesis of the disease develops in stages, expanding the area of inflammation and deepening the degree of degeneration.

The inflammatory process, with epicondylitis, involves those areas of tissue that have undergone increased, frequent, chronic overload and microtrauma.

First, inflammation of the periosteum develops in the epicondyle region - periostitis, due to the constant load and increased blood flow to this zone.

Over time, reactive wrist bursitis develops.

Due to chronic inflammation, a violation of the trophism and innervation of tissues occurs, therefore, it leads to a dysfunction of the hand in the elbow and wrist joints.

According to the etiological factor and localization of the inflammation locus, they are distinguished: internal and external.

This is a classification of epicondylitis known for its symptoms, especially among athletes.

The division is based on the predominant use of the muscles of the shoulder or forearm:

Medial epicondylitis of the elbow joint, internal (emphasis on the muscles of the forearm) - "golfer's elbow", inward rotation of the elbow is disturbed - pronation: flexion of the elbow and fingers.
Lateral epicondylitis of the elbow joint, external (overloading of the muscles of the shoulder area) - "tennis elbow", outward rotation of the elbow is disturbed - supination: extension of the elbow and fingers. External develops more often, since the movements that it provides are most in demand in Everyday life, due to functional features. This type of epicondylitis is also typical for the profession of a massage therapist.

Accordingly, household and professional load is: unilateral (according to the dominant hand) or bilateral.

By the depth of the lesion and the degree of tissue capture the inflammatory-generative process distinguishes the following forms of the disease: periosteal, tendon and muscle.

Symptoms of elbow epicondylitis

The clinical picture of epicondylitis of the elbow joint is manifested by the stage of exacerbation of a chronic disease and is manifested by signs characteristic of dysfunction of the musculoskeletal system.

Epicondylitis symptoms:

Pathognomic is the "handshake symptom" - pain when trying to squeeze a hand or an object with your fingers. Over time, it becomes painful to even clench your hand into a fist.
The obvious and frequent symptoms of epicondylitis are sharp, sharp pain in the elbow area radiating up and down the outer or inner surface of the arm. At rest, there is no pain, it appears only when you try to make the usual movement with your hand.
The progressive nature of pain, in the case of ignoring or intensive development of the inflammatory process, can be complicated unpleasant symptoms paresthesia and paresis of the extensor muscles of the forearm and fingers. Since the edematous tissues exert compression on the branch of the radial nerve.

Diagnostics of the epicondylitis of the elbow joint

Diagnosis of epicondylitis of the elbow joint involves external examination, assessment of the spectrum of elbow joint mobility and its painlessness.

For the choice of treatment, the most informative are the degree of dysfunction and sensitivity.

Often, instrumental examination methods are added: X-rays in frontal and lateral projections, arthroscopy.

Elbow epicondylitis treatment

Treatment of elbow epicondylitis is aimed at reducing pain, increasing movement in the joint and restoring the physiology of the joint:

Periarticular blockage with hormonal and anesthetic drugs - novocaine or lidocaine with hydrocortisone, diprospan or prednisolone. The injection mode is selected individually with an interval from one day to one week, in the amount of 4-5. These injections are painful but effective and shorten the healing process.
Immobilization of a limb for 7-10 days, by means of bandaging with an elastic bandage in a physiological position for the affected tissue group.
Orally or parenterally indicated vitamin complexes group B - neurovitan, neurobex, neuroubin. In ampoules for injection - cyanocobalamin, milgamma, neurobion.
To reduce pain and reduce reactive inflammation, non-steroidal anti-inflammatory drugs are present in the treatment of epicondylitis - nimesil, diclofenac, ibuprofen.
After removing the immobilizing dressing, warming compresses are shown as vodka or semi-alcoholic ones.
Physiotherapeutic methods of treatment are often used both at the stage of exacerbation and as restorative techniques: phonophoresis with hydrocortisone or lidase, electrophoresis with novocaine or potassium iodide, laser, UHF, Darsanval and Bernard currents. Also shown are applications with paraffin and ozokerite, mud therapy, local wrapping procedures with green and white clay.
Necessarily in the recovery period are recommended: regional and general therapeutic massage, physiotherapy exercises.
Radical intervention is indicated in case of ineffectiveness of conservative treatment methods within six months. Excision of the irreversibly degraded part of the tendon in the bone zone is performed.
Spa treatment and swimming in the pool will help recovery and prevent exacerbations during professional sports.

Any person in the process of everyday life makes a lot of movements and performs certain work with the help of the upper limbs - hands. Violation of their physiological mobility leads to the impossibility of performing the usual actions, which significantly reduces overall comfort. Pain in the elbow, which develops under the influence of dystrophic changes in the tendons and main muscles, often becomes the cause of restriction of movement. There is a medical name for this pathological condition - epicondylitis of the elbow joint, popularly known as the "tennis elbow".

Causes leading to the development of the disease epicondylitis

Epicondylitis is characterized by degenerative - inflammatory changes occurring in the tendons and muscles located in the projection of the elbow joint. In most cases, the external epicondyle is involved in the pathological process, that is, the place where the muscles - the extensors of the hand are fixed, while talking about the development of external epicondylitis.

Internal epicondylitis occurs when the tendons and muscles involved in the process of extending the hand are affected. The disease is typical for middle-aged people and most often men suffer from its symptoms. A prolonged degenerative process in the muscles and tendons leads to the involvement of the tissues surrounding the elbow in the inflammatory process.

The main cause of epidyncolitis is considered to be constant overload of the hands (stereotyped movements and rotation of the joint), which have an effect on them. Moreover, the hand is affected, with which a person performs the predominant number of movements, for right-handers this is the right upper limb, for left-handers, respectively, the left. The pathological process is recorded in people of the following specialties:

Malyarov.
Seamstress
Massage therapists.
Musicians.
Athletes.

Epidinkolitis may first appear after repairs - painting and whitewashing the walls. Often, the disease is combined with osteochondrosis of the cervical spine, connective tissue dysplasia syndrome, and bursitis of the elbow joint. Traumatic epidyncolitis occurs after minor injuries of the elbow joint - bruises, dislocations, sprains.

The clinical picture of epidincolitis

During the course of the disease, an acute, then subacute and chronic stage of the course of the disease is isolated. In the acute stage, pain is pronounced, weakness appears in the hand, the patient cannot make the movements that are familiar to him. In the subacute stage, the symptoms of the pathological process are exacerbated only when lifting weights or when performing sudden movements.

If signs of epidincolitis are recorded for three or more months, it is considered that the disease has passed into a chronic phase with further periods of exacerbations and remissions, the duration of which depends on treatment and compliance with preventive measures to prevent relapse.

The main manifestation of epidincolitis is considered to be pain that increases with all movements performed with the help of the ligaments of the elbow joint. Soreness can spread through the muscles to the hand, periodically manifest in the shoulder. Visually, the area above the elbow joint without the presence of bursitis is not changed; palpation determines the point of slight compaction and severe pain in the medial epicondyle.

In the chronic stage, pain syndrome appears with an overload of the elbow joint, a long course of dystrophic processes leads to muscle atrophy. Severe weakness in the upper limb in the later stages of the disease does not allow a person to perform the most primitive movements - to take a cup in his hand, write, button up.

Epidincolitis treatment

In most patients, a sharp soreness quickly turns into a dull, aching pain with which a person adapts to live without receiving appropriate treatment. This leads to the fact that pathological changes continue, the structure of muscles and tendons changes and the disease becomes chronic.

Timely therapy of the disease with the medicines proposed by the doctor and methods of restoring mobility will allow the patient to cure the disease and prevent its negative manifestations that worsen the quality of later life.

The diagnosis is made on the basis of visual examination and appropriate tests performed by the doctor. It is necessary to identify whether the joint has been traumatized; for this, an x-ray is performed. Computed tomography can show changes in muscles and tendons only with a long course of the disease, on early stages no internal pathological changes were noted.

Differential diagnostics is carried out with such diseases of the musculoskeletal system as arthritis, bursitis, in young patients, the influence of joint hypermobility syndrome is determined.

The goal of conservative treatment of epidincolitis is considered to be the achievement of the following tasks:

Elimination of pain and limitation of mobility in the elbow joint.
Improving the blood supply to the elbow muscles and tissues.
Prevention of muscle atrophy.

Treatment is selected by the doctor based on the patient's complaints and the severity of difficulties in performing movements in the elbow joint. Usually, in the absence of sharp pains, the patient is advised to temporarily limit the movements of the inflamed hand.

A sick leave is issued to athletes, workers, whose professions are associated with the need to perform stereotypical manipulations and lifting weights. After recovery, work must be started gradually, providing a uniformly increasing load. In the complex therapy of epidincolitis, the following points are distinguished:

Immobilization of the elbow joint for up to 10 days. The imposition of a plaster cast is necessary in order to prevent the execution of movements, it also helps to reduce the inflammatory process. In the chronic stage, the mobility of the joint is limited by using elastic bandages; in case of exacerbation, the limb in them should be fixed during sleep.
Pain relief and removal of inflammation are achieved by taking non-steroidal anti-inflammatory drugs, these include Diclofenac, Nise, Nimesil. With severe pain, joint blockade is used with injections of novocaine or lidocaine. Non-steroidal anti-inflammatory drugs can also be used externally in the form of ointments with the corresponding drug components in the composition.
In cases that are difficult to treat, an injection of a therapeutic mixture of glucocorticosteroids with analgesics is carried out into the joint.
When epidyncolitis is detected after bruises and microtraumas, the application of a cold compress for several days is indicated.

All of the above measures are performed in the acute phase of the disease, later on, the use of physiotherapy and therapeutic exercises is shown. Such physical methods of exposure to the affected area of the joints as UHF, electrophoresis with anesthetic drugs, acetylcholine, potassium have a good result. Warming and anti-inflammatory compresses on the joint area can also be used as a home treatment method. After the disappearance of intense pain, the doctor always recommends special exercises aimed at developing the muscles. The simplest element physical exercise overextension of the hand in different directions, this allows you to increase the elasticity of the connective tissues and provides better resistance to microtrauma in the future.

Patients with epidyncolitis are advised to reconsider their professional activities, perhaps the usual work can be performed using other movements. If the cured patient starts to perform monotonous movements again, then the exacerbation of the disease will not have to wait long. Athletes are advised to start training gradually and not neglect preventive examinations by a doctor and the use of physiotherapy. After the main treatment, mud therapy procedures, massage, and the use of folk methods have a noticeable positive effect.

With persistent pain for several months and with severe difficulty in movement, the patient is shown a surgical intervention - excision of the affected and altered tendons in the places of their attachment. The operation is quite fast, it is carried out under light anesthesia, an immobilizing splint is applied for the period of subsequent recovery, in the future, to develop the joint, it is necessary to use therapeutic exercises and massage.

The use of self-made compresses in conjunction with traditional therapy also brings noticeable pain relief. To prepare the ointment, you will need natural fat, which must be melted and mixed with an equal amount of crushed comfrey root. The mixture is thoroughly mixed until homogeneous and used in the form of compresses. A napkin with this ointment can be fixed on the joint for several hours. Comfrey and fat ointment partially restores the structure of the periosteum and ligaments.

Traditional practice of treatment of epicondylitis

Simple recipes can help reduce inflammation and relieve pain traditional medicine... To do this, use a tincture of horse sorrel root. Fill a half liter container with rinsed and dried plant roots. Having filled the roots with vodka, it is worth letting the preparation brew for 10 days. Compresses are performed from the resulting tincture by applying a moistened swab or napkin directly to the affected elbow. The remedy is advised to apply before bedtime.

Another popular recipe is bay leaf-based solution. To prepare the medicine, you need a glass of unrefined vegetable oil and mix it with four full tablespoons of crushed dry bay leaves. Insist the resulting mixture for a week and strain at the end of this period. The resulting oil solution can be rubbed directly into a sore spot or used as compresses. The remedy will help relieve inflammation and eliminate obsessive pain.

A feature of the treatment of this disease is the long-term nature of the recovery. When eliminating unpleasant pain sensations, you should not stop following medical prescriptions. Epicondylitis, especially in the chronic stage, is able to return again when the destructive effect on the elbow resumes.

In order to prevent exacerbations, the patient must take precautions when performing stereotyped movements. In some cases, the only way to completely recover may be only a change in professional activity.

Epicondylitis of the elbow joint is considered a secondary form of the disease, which progresses against the background of numerous extensions (flexions) of the joint of a monotonous nature.

The disease affects certain groups of people: construction workers, agricultural workers and professional athletes.

Epicondylitis of the elbow joint is a disease that affects the area of the elbow joint and is characterized by degenerative and inflammatory changes.

The medical term is used for inflammatory processes in the epicondyle and the tendons and vagina adhering to it.

The pathology is not limited to a single bone lesion - inflammatory processes are localized in the area of muscle attachment to the forearm.

It is believed that this disease does not belong to the category of severe, and therefore is not associated with a loss of working capacity. However, the complaints of patients about epicondylitis of the elbow joint and their appeal to local clinics are not decreasing.

Typical symptoms

Elbow epicondylitis comes in two forms:

Internal (medial). In this form, the disease affects the muscles responsible for the processes of flexion (extension) of the hand - the inner zone of the elbow joint. The internal form of the disease occurs more often and is considered the most common dysfunction of the human support and motor system.
External (lateral). It is characterized by muscle damage in the outer zone of the forearm. This place is popularly called "tennis elbow", therefore it is often observed among tennis fans and professional tennis players.

There are several symptoms that are mild:

epicondyle pain when palpating;
decrease in strength in the cyst of the hand;
increased pain attacks during pronation and flexion of the cyst in the dorsal zone.

Muscle weakness is recognized by the following symptoms:

Thomsen's symptom: the hand drops quickly when trying to hold it in a clenched fist during dorsiflexion.
Welsh's symptom: with simultaneous extension and supination of the forearms, you can notice the lag of the affected side.
Dynamometry is accompanied by weakness of the hand in the affected side of the joint.
When trying to hold the hand behind the lower back, pain of an intensifying nature arises.

How to recognize an ailment?

Often the disease cannot be identified in time. Most people do not pay attention to painful attacks in the elbow area, and do not associate it with serious disorders.

As a result, epicondylitis of the elbow joint can have a latent form, which is difficult to treat in the future.

With epicondylitis of the elbow joint, pain attacks are localized in the elbow area, but the joint itself is usually not damaged.

Inflammatory processes affect the tendons.

As a result of physical overload, the fibers of the tendons are torn at the points of their connection with the periosteum, which is accompanied by edema and inflammatory processes.

To a greater extent, the areas of tendon fibers that connect the tendon to the ulna are injured.

Video: the cause of pain in the elbow joint

The reasons for the development of the disease

Currently, the exact causes of epicondylitis of the elbow joint have not been identified.

It is known that people suffer from this disease due to numerous movements of a monotonous nature (flexion and extension of the elbow joint).

The causes of epicondylitis of the elbow joint can be:

features of professional activity (athletes, workers in the construction and agricultural fields are more likely to be affected by the disease);
lifting and carrying heavy objects;
great physical activity;
heavy construction (repair) work.

It's important to know!

During the execution of monotonous movements in the muscles of the forearm, microcracks may form in the area of the humerus. Because of this, an aseptic inflammatory process appears in the adjacent skin areas.
More often, the disease affects the lateral epicondyle in the area of the humerus, as a result of which external epicondylitis develops.
Internal epicondylitis appears due to destruction of the muscle tendons of the flexor hand.
These two forms of epicondylitis do not occur simultaneously.

How to treat?

Treatment of epicondylitis of the elbow joint begins with identifying the true cause of the disease.

For the appointment of effective treatment, it is necessary to conduct a thorough examination using the methods of magnetic resonance imaging and ultrasound examination.

This is required to exclude other possible diseases.

Patients often go to the doctor when the inflammatory processes are progressive.

Because of this, there are certain difficulties in treating the disease.

When choosing a method of treatment, several factors are taken into account:

the degree of dysfunction of the elbow joint;
the nature of changes in the muscles (tendons) in the forearm and hand.

Treatment of the disease has the main tasks:

Eliminate pain attacks in the affected area.
Restore or improve blood circulation in the affected area.
Restore the motor function of the elbow joint.
Prevent the process of muscle atrophy in the forearm area.

To accomplish the tasks set, a specific or complex treatment is used:

drug treatment;
physiotherapy treatment;
surgical methods.

Drug treatment

Medical treatment for epicondylitis of the elbow joint is quite effective.

It helps to eliminate pain attacks and the disease itself in the initial stages of its onset.

Medication treatments include:

Ointments

To relieve pain and inflammation with epicondylitis of the elbow joint, special ointments and gels (Nurofen and others) are used.

Dimexide

50% Dimexidum solution is used for various dysfunctions of the supporting and motor apparatus, including epicondylitis of the elbow joint.

A napkin is moistened with a medicinal solution and applied to the site of the affected joint. Then the affected area is wrapped in polyethylene and cotton cloth.

Daily compresses from Dimexidum help to eliminate pain syndromes at the elbow.

Tablets and antibiotics

For primary forms, antibiotic therapy is used.

In this case, the patient's sensitivity to the action of medications and individual intolerance should be taken into account.

Antibiotics such as macrolides, penicillins, and cephalosporins can be given by injection or by tablet.

To relieve pain syndromes, the attending physician may prescribe non-steroidal anti-inflammatory drugs for oral administration (Nimesil, Nise, Ketorol and others), as well as in the form of ointments and gels.

Iodine

Elbow flexion pain can be relieved with iodine.

Rubbing in an iodine solution allows not only to relieve pain syndromes, but also to improve the blood supply to the affected joint.

Blockade

Corticosteroid preparations in the form of injections - Dispropane, Kenalog - can relieve pain syndromes and improve the patient's condition.

For anesthesia and improvement of trophism, blockages are performed at the site of attachment of the fingers and the extensor hand.

They use Novocaine, Lidocaine. The patient is assigned 5 blocks with a time interval of 2 days.

Intra-articular injections from drugs are very effective in treating the disease.

Such injection procedures are performed with strict adherence to the norms of asepsis, antiseptics in order to prevent purulent complications.

The bursa is punctured with a special needle through which a solution of antibiotics and hydrocortisone is injected.

Physiotherapy treatment

The course of physiotherapeutic procedures for any form of epicondylitis of the elbow joint is an obligatory part of the treatment.

The following methods are used:

Phonophoresis

Phonophoresis is a type of ultrasound treatment: this procedure is in some cases more effective than conventional ultrasound.

Ultrasonic vibrations effectively affect the affected joint and promote the rapid penetration of drugs into the body.

For the effectiveness of treatment, it is important to choose the right dose of the drug, set the required frequency and operating mode of the equipment.

DDT

A type of physiotherapy treatment is DDT (dynamic currents).

This effective method normalizes trophic processes, improves blood circulation, promotes wound healing, and eliminates inflammatory processes in tissues.

The DDT method is very effective for diseases of the musculoskeletal system, including elbow dysfunctions.

Magnetotherapy

The main goal of magnetotherapy is to eliminate pain syndromes.

Low-frequency magnetic fields act on the damaged surface of the joint, as a result of which the patient's pain is relieved or completely eliminated.

Magnetotherapy is easily tolerated by the elderly and patients with a weakened body. This is the main advantage of this method.

Shock wave therapy

During shock wave therapy, a special apparatus acts on damaged tissues and joints.

This method of physiotherapy is highly effective:

under the influence of shock waves of various frequencies, salt crystals of calcium are destroyed;
increased blood flow;
salt deposits are washed out from ligaments and tendons.

Under the influence of shock wave therapy, the affected elbow joint is cleansed and restored.

The procedures help to completely eliminate the pain syndrome.

Surgery

With advanced forms, surgical intervention may be required.

Among the surgical methods for treating epicondylitis of the elbow joint, the recognition was won by the operation of Homan - excision of the tendon in the extensor cyst and fingers.

Currently, such an excision is performed at the site of attachment to the bone of the tendon.

In addition, for the purpose of opening, processing the damaged area, a laser is used.

The device allows you to reduce tissue trauma, effectively eliminating the infectious agent.

At the end of the laser operation, the wound is sutured and a tight bandage is applied to it.

Exercises

Remedial gymnastics is considered an effective treatment for epicondylitis.

Special exercises are aimed at stretching the connective tissues. For the elbow joint with epicondylitis, these are exercises for extending the wrist joint.

After 5 correctly selected sessions, painful muscle spasms in the arm will decrease.

Video: gymnastics

Manual therapy

Manual therapy is considered a proven traditional method for treating musculoskeletal dysfunction.

Functional blockade during manual therapy acts on the surface of the joints and restores the normal range of joint motion.

The indication for manual therapy is pathogenesis, when the basis clinical picture the ailment is the limitation of joint mobility.

Hirudotherapy

Hirudotherapy is a method of treating a disease with leeches. The medicinal leech is called "mini-factory", which contains many biologically active substances.

The main components of the leech prevent the blood clotting process and dissolve blood clots.

Medicinal leeches have excellent bactericidal properties that can effectively eliminate inflammation.

Massage

To prevent muscle atrophy and restore joint performance, a therapeutic massage is prescribed.

Manipulations affect the forearm area.

In addition to the massage, mud therapy and dry air baths are prescribed.

Home treatment

When conservative treatment does not bring tangible results, you can use folk methods at home.

The most effective are folk recipes:

It is necessary to purchase the roots of horse sorrel, put them in a jar, pour ½ liter of vodka. Wait 10 days for the herbal solution to brew well. The resulting composition is recommended to be applied to the injured elbow before bedtime. Such compresses help relieve pain and inflammation. The duration of the procedures is 10 days.
You need to take vegetable oil (200 gr.) And 4 tablespoons. bay leaf (finely chopped). Mix the two components in a container and close the lid. The composition should be infused for 7 days. Then the oil is filtered and rubbed into the damaged elbow. You can make oil compresses, which must be kept for 20 minutes. This recipe allows you to relieve pain syndromes and warm up the surface of the damaged joint.
If the disease develops as a result of an injury, a cold compress can be prepared at home to help relieve pain syndromes. The compress must be applied to the affected area several times a day.

Disease prevention

In order to prevent the appearance of epicondylitis of the elbow joint, certain preventive rules must be observed:

Athletes should do a gentle warm-up before starting an intense workout to prepare their joints for physical activity... This is especially true for tennis players.
Do not forget about beneficial features massage. Light kneading and stroking will be helpful before starting exercise.
Professional athletes shouldn't forget about strength training. They will help strengthen the articular tendons, which will prevent them from possible damage during basic physical exertion.
If you have a chronic infection, you should see a doctor immediately. Progressive infectious diseases can undermine the defenses of the immune system and weaken the entire body. This can lead to the destruction of cartilage and tendons.
During repetitive work, you need to take short breaks so that the muscles can relax.
You need to remember about vitamins. For the full functioning of the ligaments, a sufficient amount of vitamins of the B1, B6 and B12 groups is required. You can include foods rich in these vitamins in your diet, or use them in pill form.
When playing sports, it is recommended to use fixation bandages and special creams to avoid damage to the elbow joints.