Epicondylitis is an inflammatory lesion of the epicondylitis of the humerus( the place where the tendons of the muscles of the forearm attach to the humerus).Depending on the lesion of the lateral or medial epicondyle, the lateral and medial epicondylitis, respectively, are distinguished. The cause of the development of inflammation is most often permanent overstressing of these muscle groups with their permanent microtraumas. This is most often found in professional athletes and in people who are engaged in heavy physical labor or activities associated with active movements of the upper limbs. Lateral epicondylitis is also called the "elbow of a tennis player", and the medial epicondylitis is called "the elbow of a golfer" because of the wide spread of the disease among athletes of this sport.
There are 2 types of epicondylitis - lateral and medial
The most commonly encountered right-sided lateral epicondylitis. There is a pathology of pain in the elbow of the affected arm, the inability to perform active and passive movements in full. If this happens, then you need to think about how to treat the epicondylitis in order to get rid of the symptoms as quickly as possible and start the usual activities, which is especially important for professional athletes.
Treatment of epicondylitis should be started immediately after the onset of the first symptoms. In this case, the pathology can be well treated with conservative methods, and there is no need for surgical treatment and long-term rehabilitation in the case of chronic epicondylitis.
Treatment during treatment
The epicondylitis can be cured only by applying an integrated approach. Treatment is selected strictly individually depending on the patient's profession, the duration of the disease, the severity of the pain syndrome, the presence of structural pathological changes in the supracondylum and muscle tendons.
The main tasks of treatment of epicondylitis:
- to eliminate pain in the elbow area;
- restoration of movements in a sick hand in full;
- normalization of blood circulation and metabolic processes for the rapid restoration of damaged structures;
- prophylaxis of secondary pathological changes in the area of the disease( muscle atrophy, hypertrophy of tendons and epicondyle of humerus).
Beginning to treat epicondylitis in every case without exception is necessary with the creation of functional rest and a protective regime for a sick hand. To do this, it is necessary to limit the amplitude of movements that cause pain, to refuse for the duration of treatment from professional activity. If these measures do not allow you to completely get rid of the pain, which is quite often, then it is necessary to resort to therapeutic immobilization( immobilization) of the affected hand.
In order to limit movements in the elbow afflicted with epicondylitis, several orthopedic devices( from the simplest to the modern ones) are used:
- tight elastic bandaging;
- patchwork dressing;
- sometimes use a special orthosis, which reliably fixes the hand in the middle physiological position;
- is effective and a bandage with epicondylitis, which can be made of elastic bandage or use a ready-made special device( such often can be seen in athletes during training - prevention of injury).
As a rule, 7-10 days of immobilization are necessary, after which it is necessary to gradually start to exercise and special therapeutic exercises.
The goal of drug treatment is the elimination of pain and inflammation. Apply 3 groups of drugs - non-steroidal anti-inflammatory, glucocorticoid hormones and local anesthetics.
The basis of treatment is the use of NSAIDs( diclofenac, aceclofenac, ibuprofen, naproxen, capotrophen, meloxicam, celecoxib, etc.).These drugs exclude inflammation, which is the basis of epicondylitis, than relieve the patient of pain. There are many medicinal forms that complement treatment( injections, ointment, gel, patch, tablets and capsules).
Modern orthosis for immobilization of the elbow joint area with epicondylitis
If using NSAIDs can not get rid of the pain, then they resort to the next stage of therapy - the introduction of glucocorticoid hormones into the lesion area, sometimes together with local anesthetics( blockade of the elbow joint).Of the existing drugs in this group, betamethasone dipropionate( Diprospan), hydrocortisone and prednisolone are the most suitable. The use of triamcinolone is undesirable, since the drug often leads to depigmentation, scar processes at the site of administration.
Injection of SCS is made directly to the lesion site( lateral or medial epicondyle), in some cases, additional injections are made to the painful palpation points along the affected tendons. Often, along with corticosteroid hormones, local anesthetics( lidocaine, novocaine) are injected into one syringe. This combination helps to effectively eliminate pain. Do this injection only 1 time at the beginning of treatment, if the pain persists, it is possible to repeat the injection after 7-10 days, but not more than 2 injections per course, otherwise atrophy and aseptic necrosis of the epicondyle is possible.
Physiotherapy treatment is an integral part of the treatment of epicondylitis, both in the acute period and during the rehabilitation phase.
Recently, shock wave therapy has been very popular due to its effectiveness. This effect on the damaged area by ultrasonic waves of high frequency. This activates the reparative processes at the site of injury and promotes rapid recovery.
The following techniques are also widely used:
- laser therapy;
- electrophoresis with hydrocortisone and anesthetics;
- diadynamic therapy;
- applications with ozocerite and paraffin;
- local cryotherapy.
Shock wave therapy of epicondylitis is absolutely painless and highly effective method of treatment.
. Physiotherapy and massage.
. Medical gymnastics and massage refers to mandatory activities at the stage of recovery or rehabilitation after surgery.
Exercises for epicondylitis should begin immediately after a persistent cessation of pain. For the beginning perform exercise therapy, oriented to stretching of the diseased muscles. To do this, with a healthy hand, slowly bend the wrist of the diseased limb, hold it in this position for 5-10 seconds, slowly rocking, then return to the starting position. You need to repeat three approaches 10-15 times.
After stretching exercises do not cause any pain or discomfort, they begin exercises to strengthen the muscles.
Complex exercises for strengthening the muscles with epicondylitis
Massage with epicondylitis can improve the process of microcirculation in damaged tissues and accelerate the healing process.
Treatment with folk remedies is quite popular, as home recipes can more effectively fight the pain.
The most popular folk remedies for the treatment of epicondylitis is bay leaf oil, which is rubbed into the affected area or used as compresses.
Also widely used are compresses from the tincture of horse sorrel. To do this, take half a kilo of the roots of this medicinal plant and fill them with half a liter of 40% alcohol, insist for 10 days, then apply as compresses for local treatment.
For a warming compress, take 200 grams of blue clay, pour it with a glass of boiling water and mix thoroughly. Then make a warm clay and gauze compress, which is applied to the sore spot for 1 hour three times a day, wrapping with a warm cloth.
Surgical treatment of epicondylitis is initiated in the case of ineffectiveness of all conservative techniques for 6-10 months. The operation consists in surgical excision of the site of chronic inflammation of the epicondyle with subsequent plastic. Intervention is carried out either by a traditional method with a large incision of tissues, or by a modern minimally invasive arthroscopic method.
It should be emphasized that surgical treatment has many consequences and it is not always possible to fully restore the function of the hand. Therefore, at the first signs of epicondylitis, seek medical help - do not wait for the pain to make you do it.
- Importance of
- treatment Medication
- Physiotherapeutic procedures
- Physiotherapy and massage
- Folk recipes
- Surgical treatment