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"Tennis Elbow" popular name joint pathology. Epicondylitis of the elbow joint occurs not only in professional athletes, but also in people who do heavy work or perform monotonous hand movements throughout the day.
When the tendons and muscles become inflamed at the sites of attachment to the bones, pain appears and it is difficult to bend and straighten the arm. Why does joint pathology develop? How to treat tennis elbow? Listen to the opinions of traumatologists and orthopedists.
- Clinical picture
- Effective treatments
- Medications
- Joint gymnastics
- Manual therapy
- Treatment with leeches
- Folk remedies and recipes
- Surgical intervention
Causes of pathology
The inflammatory process develops against the background of high load on the elbow joint. The longer the negative impact lasts, the more severe the degree of tissue damage.
Main reasons:
- hard physical labor;
- sports injuries;
- cervical osteochondrosis;
- degenerative-dystrophic changes in the cartilage tissue of joints after 40–50 years;
- hand movements repeated throughout the day.
Risk group:
- athletes: boxers, tennis players, weightlifters;
- construction workers (plasterers, painters, masons);
- people engaged in heavy physical labor (laborers, loaders);
- agricultural workers (milkmaids, tractor drivers).
Most often, tennis elbow is diagnosed in men aged 40 years and older.
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Clinical picture
The destructive process occurs in various parts of the elbow. Doctors distinguish two types of epicondylitis in the elbow joint area:
- lateral – pain syndrome is noted in the outer part of the elbow;
- medial – pain is felt in the inner part of the elbow joint.
The following signs help to recognize the disease:
- pain in the elbow of varying intensity;
- discomfort increases with flexion and extension of the elbow, with load;
- pain radiates to the forearm area;
- in some patients (if the case is severe), the elbow swells slightly.
Effective treatments
Patients do not always attach importance to pain in the elbow and forearm; they often miss the optimal time to start therapy and are treated at home. Chronic pain for a long time not only causes discomfort, but also indicates a sluggish inflammatory process. Only complex therapy eliminates negative symptoms and breaks the chain of inflammation in the elbow joint.
Do not replace other types of treatment with home methods: It is the long-term use of ointments, gels, tinctures and compresses that often creates a false feeling of “recovery.” The pain weakens, but the problem does not disappear, it only goes deeper. Advanced stages of epicondylitis often require surgical treatment.
Medications
The main goal of therapy is to eliminate the inflammatory process. An orthopedist-traumatologist prescribes agents for topical application and oral administration.
Non-steroidal anti-inflammatory compounds have a positive effect on the affected tissues and eliminate inflammation. Potent medications in the form of tablets and ointments are used after meals: the active components are absorbed into the blood, penetrate the stomach and intestines, and irritate delicate mucous membranes.
Effective drugs of the NSAID group:
- Diclofenac.
- Ortofen.
- Nise.
- Cinepar-active.
- Voltaren Emulgel.
- Ketoprofen.
- Indomethacin.
- Nurofen.
- Naprofen.
Important! NSAIDs should not be used uncontrollably: the compounds have an impressive list of side effects. You need to be especially careful when taking it orally medicines(pills). Gels and ointments are also applied strictly according to the instructions: it is forbidden to lubricate the sore elbow more often than required. Failure to comply with the rules leads to an overdose, negative influence anti-inflammatory components on various organs and systems.
Gels and ointments with anti-edematous effect:
- Lyoton.
- Troxevasin.
- Gel with horse chestnut.
- Venoruton.
- Heparin ointment.
- Troxerutin.
Compositions for topical use improve blood circulation in the problem area, reduce pain, and remove swelling of varying degrees.
Physiotherapeutic procedures
Once a diagnosis of elbow epicondylitis is made, procedures are permitted even at the acute stage. This point distinguishes the treatment of “tennis elbow” from the treatment of many joint pathologies, in which physiotherapy is used after the acute inflammation has been relieved. The difference is in the names of the methods: not all procedures are suitable for relieving severe inflammation and pain.
In the acute stage, the following methods are effective:
- infrared laser radiation;
- diadynamic therapy;
- transdermal anesthesia using the Eliman-401 apparatus.
When the inflammatory process subsides, the list of procedures expands:
- applications with paraffin and ozokerite;
- medicinal electrophoresis with hydrocortisone;
- local cryotherapy using cold air;
- applications with naphthalan;
- shock wave therapy;
- massotherapy.
Physiotherapeutic treatment reduces pain in the problematic elbow and normalizes the mobility of the elbow joint. A full course of therapy prescribed by the attending physician is required. The sooner the inflammatory process disappears, the less discomfort lasts. The effectiveness of physiotherapy increases by combining useful procedures with taking non-steroidal anti-inflammatory drugs, applying pain-relieving ointments with an anti-inflammatory effect, limiting exercise, and eliminating provoking factors.
Joint gymnastics
After stopping the inflammatory process, the orthopedist-traumatologist prescribes a complex of physical therapy. In case of acute inflammation, it is important to limit the mobility of the affected elbow using a fixing bandage. After eliminating destructive changes, elbow immobility causes harm: You can’t leave your muscles unloaded for a long time. Long absence movement impairs blood circulation, provokes stagnation of blood and lymph, and causes weakness of muscle tissue.
Many experts recommend special exercises to patients to relieve pain in the elbow joint. Video instructions with recommendations from a rheumatologist-psychophysiologist will help you understand what exercises can be performed for problems in the elbow and forearm area:
Manual therapy
The skillful hands of a competent chiropractor relieve pain and reduce discomfort in the affected joint. The specialist uses several techniques: mobilization, relaxing and segmental massage, manipulation. To achieve a noticeable effect, you will need from 10 to 15 procedures.
Manual therapy is used as part of complex treatment. It is important not to make a mistake when choosing a chiropractor: low qualifications or lack of knowledge (the appointment is conducted by a pseudo-doctor) often worsens the health of the joints, leading to injuries and limited mobility.
Treatment with leeches
One of the popular alternative medicines. After a course of hirudotherapy, swelling disappears, pain decreases, and blood circulation in the affected tissues is activated. Experts recommend taking 4-6 sessions for the most beneficial effect on special points, irritation of which accelerates blood circulation in the problem area.
Folk remedies and recipes
Compositions made from natural ingredients help eliminate or reduce negative symptoms. Traditional treatment complements the use of medications, physiotherapy, massage and therapeutic exercises. You can use homemade ointments, compresses, and rubs only after consulting an orthopedic traumatologist or rheumatologist.
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Effective means:
- bay oil against pain and inflammation. Pour warm vegetable oil (250 ml) into a jar, put powdered laurel leaves (5 tbsp), mix, put the closed container in a dark place. After 7 days, the healing product is ready. Daily rubbing of laurel oil into a sore elbow will speed up recovery and reduce negative symptoms of damage to the elbow joint;
- green tea against inflammation. Brew large-leaf tea, pour strong tea leaves into molds, and put in the freezer. Massage the painful area daily with an iced tea cube wrapped in a thin cloth. In case of intolerance low temperatures A compress made from strong tea leaves is suitable green tea. Soak folded gauze or a clean cloth in the healing liquid and apply to the elbow for 20–30 minutes. During the procedure, replace the bandage with a new one twice;
- compress of honey and aloe. An affordable remedy to reduce the inflammatory process. Mix a tablespoon of agave pulp without skin and honey (you will need 2 times more), apply to the painful area, cover with wax paper and a bandage. If there is no special paper, clean paper will do. soft fabric plus a bandage. The duration of the procedure is 30 minutes, the frequency is daily, the optimal time is before bedtime;
- blue clay for the treatment of epicondylitis. The procedure is carried out after the acute inflammation has been eliminated. To prepare a warm compress you will need 2 tbsp. l. blue clay and heated water. Dilute the natural powder with liquid to a paste, apply to the painful area, cover with cellophane and a warm scarf. After 20 minutes, wash your hand. Carry out the procedure every day (morning and evening) for a week.
Important! In acute inflammation, heating causes harm and increases the spread of destruction to new areas. Heat in any form is prohibited, alcohol tinctures and compresses too.
Surgical intervention
In the absence of effect from complex conservative therapy, in severe cases of epicondylitis in the area of the elbow joint, surgery is performed. The surgeon removes damaged tissue that could not be restored.
The optimal method of surgical intervention is arthroscopy. The use of endoscopic instruments reduces the risk of blood loss, reduces the likelihood of infection, and shortens the duration of the rehabilitation period.
After surgery, high loads on the problem joint are prohibited. The patient must gradually enter the usual rhythm of life, protect the elbow from blows, injuries, and excessive loads. In severe cases, the doctor recommends changing your occupation to prevent relapses of epicondylitis in the elbow joint.
Preventing sports injuries and avoiding excessive stress on the elbows reduces the risk of diseases such as epicondylitis or, popularly, “tennis elbow.” If pain, swelling, or pain spreads to the forearm, a rheumatologist or orthopedic traumatologist will help. In advanced cases of epicondylitis, treatment is carried out by a surgeon.
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“Tennis elbow” (or lateral epicondylitis) is a chronic disease characterized by pain and inflammation in the elbow area (namely at the point where the muscles connect with the epicondyles of the humerus).
Causes of the disease
The cause of tennis elbow is excessive stress on the muscles, forearms and tendons of the hands. Most often, this disease affects tennis players. Athletes, performing monotonous, repeated hits on the ball with a racket, subject their muscles and tendons to enormous stress, which causes the development of lateral epicondylitis, most often right-sided.
Tennis elbow affects not only sports fans, but also people who do repetitive physical exercise(chopping wood, working with a wrench, playing golf, hammering nails, painting, etc.), which causes chronic tension in the tissues of the elbow area.
Sometimes such a disease, which simultaneously affects all neighboring areas: muscles, ligaments, tendons and periosteum, can be caused by an injury or bruise to the elbow. Often lateral epicondylitis is combined with osteochondrosis of the cervical and thoracic spine.
Tennis elbow affects half of tennis players and 14% of the general population. Female this disease affects less often than the stronger half of humanity (in age category 30-50 years).
Diagnosis of elbow disease
The presence of lateral epicondylitis in the body can be determined by pain in the elbow area, the back of the forearm, the epicondyle area, the hand or fingers.
At first insignificant, the pain gradually increases, increasing with a strong fist clench, handshake, grasping certain objects with the hand, or lifting minor weights: it could even be a mug of water. Any simple movements with this progressive disease subsequently become unbearable torture.
Tennis elbow, the treatment of which involves the use of complex therapy, is easy to diagnose initial stage development, detecting tissue swelling and extensor muscle tears.
“Tennis Elbow”: Treatment
Treatment of tennis elbow syndrome is carried out comprehensively and is aimed at reducing the load in the elbow area, relieving pain and inflammation, completely regenerating the affected organ and strengthening it. Effective therapy and quick recovery will be ensured by timely contact with medical personnel at the first signs of the disease. How to treat tennis elbow? On initial stage the affected organ needs to be provided with complete rest. For mild pain, self-massage in the muscle area and application of dry heat will be required.
Non-steroidal anti-inflammatory and painkillers are effective among medications: Ibuprofen, Ortofen, Indomethacin, Butadione, Diclofenac. “Tennis elbow” is effectively treated with physiotherapeutic procedures (laser, electrophoresis of novocaine or hydrocortisone, ultrasound, sinusoidal currents). It is recommended to apply iodine mesh to the elbow area in the morning and evening.
Fixing the sore arm
To fix the injured arm, you should definitely use an elastic bandage or orthosis applied in the form of a figure eight. “Tennis elbow” heals quickly with the use of such special bandages, which support the elbow joint, reduce the load on the arm and protect against various kinds injuries In case of acute pain, the arm is suspended on a scarf or a plaster bandage is applied to it (for a period of 3 to 5 weeks).
Traditional medicine recipes
In the treatment of this disease, traditional medicine recipes have proven themselves well, the action of which is aimed at getting rid of elbow pain and relieving inflammation. An effective remedy is the comfrey plant, the roots and fresh crushed leaves of which (1:1) must be combined with 1/4 part of melted honey and 1/4 part vegetable oil. All this needs to be ground to a homogeneous mass and applied warm to the affected area. Apply a layer of gauze and compress paper on top, bandage it and leave it for a day. The medicinal paste should be stored in the refrigerator for 2-3 weeks or in the freezer for several months. If treated correctly, after a short time you can forget about such a disease as “tennis elbow.”
Treatment folk remedies involves relieving inflammation of the epicondyle with onions combined with tar. To prepare it, you need to cut the onion into two parts, drop two drops of pine tar into the middle of the halves. Both halves should be applied to the sore joint in the area of the epicondyle. The bandage should be fixed and left for 30 minutes. Treatment must be carried out twice a day.
Milk compress against elbow inflammation
A milk compress helps well, the preparation of which requires heating the milk to 60C⁰, dissolving crushed propolis in it: a teaspoon per 100 ml of liquid. You need to soak a gauze napkin with the warm milk mixture, wrap it around the affected joint, cover it with parchment paper on top and insulate it. Leave the compress for 2 hours. Treatment is carried out for 20 days twice a day.
“Tennis elbow”: exercises
As the patient heals, he can gradually begin physical therapy exercises and slowly return to normal activities, while speeding up his own recovery at home. To do this, it is recommended to spare the muscles, not make sudden movements, and perform light physical exercises, the effect of which is aimed at strengthening and stretching the muscles and tendons around the elbow area.
- Raise your arm to shoulder level and bend it at the wrist. With the other hand you need to gently pull the hand towards the elbow. Perform for half a minute five to ten times.
- Place your forearm on your knee so that your hand hangs freely. Take a load weighing 0.250-0.500 kg in your hand and slowly bend and straighten your arm at the wrist. Repeat the exercise 5-10 times.
- You need to sit down, put your forearm on your knee so that your hand is perpendicular to its surface. Squeeze the hammer handle and slowly rotate your wrist to the left, then to the right (5-10 times).
- Place a rubber band on your fingertips and stretch it 20 times, spreading your fingers apart. After a short break, repeat the exercise three times. If there is insufficient resistance, you can put two rubber bands on your fingers.
- Squeeze a tennis ball in your hand about 20 times. Do the exercise three times with short breaks.
As a rule, the prognosis for treatment of tennis elbow is favorable in 95% of cases.
In rare cases, conservative treatment is powerless and surgical intervention has to be resorted to.
Preventive methods
- effective warm-up and regular power training: carried out wisely, they are aimed at improving the strength qualities of muscle groups, strengthening the tendons of the elbow area, and counteracting fatigue when playing tennis;
- regular massage, including basic techniques: kneading, stroking, rubbing;
- the use of warming gels and ointments;
- visiting a sauna is a method that effectively affects injured tendons; elevated temperature causes the appearance of new capillaries, increasing metabolic processes in the injured elbow;
- vitaminization of the body, required to activate metabolic processes at the tissue and cellular levels; Such vitamin complexes as “Unicap”, “Centrum”, “Vitrum” are effective.
Hardening procedures for tendon diseases are extremely contraindicated. This can cause prolonged vasospasm, which can delay healing for an indefinite period.
Tennis elbow - epicondylitis, as it is called in medicine, is a disease that leads to degenerative-inflammatory changes in the area of the elbow joint; more precisely, inflammation develops in the attachment of the muscles to the humerus.
There are two types of epicondylitis, internal and external. The second type occurs when the outer area of the forearms is affected, and is where the term tennis elbow is used.
The term has a simple explanation, because such a lesion most often occurs in tennis players due to the specifics of the game and the work of the elbow.
Reasons for development
First of all, the disease develops for reasons of professional activity, and most often affects athletes. However, additional risk factors may include:
- Frequently carrying heavy objects.
- Performing movements with the elbow for a long time (symptoms are common among construction workers).
In principle, in medical circles there is still no exact reason for the development of epicondylitis, but it is known for sure that prolonged and monotonous movements of the elbow joint with extension and flexion can ultimately lead to the development of tennis elbow.
Symptoms
The symptoms of the disease are quite pronounced, since tennis elbow always causes pain.
Sharp and severe pain can manifest itself specifically, and these pain sensations have their own interesting features, which help distinguish pain and tennis elbow from arthritis of the shoulder joint, for example, or inflammation of the elbow joint.
First of all, pain occurs only with a certain load on the elbow. In this case, symptoms occur with rotational movements of the forearm. That is, if the movement of the arm and elbow occurs without the participation of muscles, then there is simply no pain.
Tennis elbow only appears when a muscle affected by inflammation is involved in the movement.
Secondly, pain does not just occur in the elbow area, it is projected in a certain location - along the lateral surface of the shoulder bone. This helps determine exactly where inflammation is present.
There are pitfalls here, since the same pain, almost the same, is also present with myalgia, so it is best to check the diagnosis with a doctor.
Interestingly, in order for symptoms to begin to appear, it is not necessary to seriously engage the muscles of the forearm and shoulder; even a simple handshake is enough. Tennis elbow will immediately show pain.
In addition, tennis elbow can occur with very minor movements, extending the forearm, with minimal stress, even when lifting an empty cup.
That is, there is not necessarily a large load, inflammation immediately makes itself felt, even with minimal effort.
In general, all symptoms can be reduced to a specific list:
- Dull pain appears on the outer surface of the elbow, which radiates to the forearm.
- The pain becomes sharp with grasping and rotational movements.
- When touching the elbow, the patient experiences pain, the syndrome develops
- There is redness in the affected area, this is how inflammation manifests itself.
- Tennis elbow syndrome can lead to limited movement, not only in the elbow area, but also impair the movement of the fingers.
How to treat tennis elbow
Tennis elbow can be treated in several ways. But here it is important to immediately determine what these could be:
- Non-drug, conservative treatment.
- Drugs.
- Physiotherapeutic treatment.
- Surgery.
Separately, you can clarify that it is possible to use therapy using traditional methods, but this is rather additional help.
The choice of tactics depends on the degree of damage and development of the disease. In some cases, monotherapy is used, and in others, several options are used simultaneously.
If the pain syndrome is pronounced, then treatment begins with eliminating the pain and immobilizing the elbow joint. This must be done for better healing. A cast or a special orthosis is used on the elbow joint.
Wherein:
- Any load on the elbow is completely eliminated.
- The elbow joint should be warm.
- You need to do a simple massage on your elbow to increase blood flow.
Now, as for medicines, drugs can solve several problems at once. Treatment with medications:
- Relieves and reduces inflammation in the elbow joint and forearm.
- Eliminates and relieves pain.
- Speeds up recovery.
Here we are talking not only about painkillers for joint pain, but primarily about non-steroidal anti-inflammatory drugs.
Note that tennis elbow syndrome is most often treated with:
- Diclofenac,
- Ketorolac,
- Ibuprofen,
- Nimessulide,
- Indomethacin,
- Xefocama.
The most effective treatment will be complex, in which drugs are used both in the form of tablets and ointments for topical use or rectal suppositories.
If there is no effect, then they begin to use steroid drugs, these are corticosteroids that are injected into the joint area by injection.
Along with medications, it is necessary to prescribe vitamin complexes. Which will take long courses, but will also help treat tennis elbow and generally strengthen the body.
A prerequisite for effectively getting rid of the problem will be the use of physiotherapy. In addition, it is an integral part of therapy. Physiotherapeutic treatment will help:
- Accelerate healing processes.
- Improve microcirculation.
- Relieve inflammation and reduce the overall inflammatory process.
- Significantly reduce pain.
Therapy with these drugs involves the use of electrophoresis, phonophoresis, DDT, and ultrasound.
As for therapy with folk remedies, here you can pay attention to the use of special lotions and compresses with anti-inflammatory herbs.
However, it is not recommended to treat the disease with folk remedies, because at least, you definitely can’t use only alternative medicine. As a rule, therapy with folk remedies can reduce the manifestation of symptoms, but more often it simply leads to blurring clinical picture, and to the subsequent transition of the disease to a chronic form.
However, if the problem cannot be solved with medication, folk remedies, and steroid drugs, then tennis elbow is treated promptly.
A surgical operation is performed to radically remove the inflamed area of tissue. The operation is carried out as follows:
- The muscle at the attachment point with the humerus is separated.
- The changed and inflamed tissue is removed.
- The muscle returns to the bone.
And in conclusion, let's say that tennis elbow is always a disease with favorable prognosis, that is, it is always treatable and completely eliminated.
Tennis elbow is also called lateral epicondylitis, epicondylitis of the lateral epicondyle of the humerus, or tennis elbow. This disease actually occurs in tennis players and is associated with heavy loads on the tendons and muscles located in the elbow joint during certain strokes of the racket on the ball. But this disease is not limited to tennis players, and can be caused by stress and repetitive activities such as hammering nails, chopping wood, painting, golfing, landscaping, and so on.
Causes
The most common causes of the development of this disease are the presence of hidden injuries to the tendons or muscles located next to the elbow, and damage to the surface of the bones. Tennis elbow is caused by frequent flexion and extension of the elbow, which causes chronic tissue tension.
Tennis elbow affects almost half of tennis players and 1–4% of the general population. An interesting fact was noticed - this disease affects women much less often than men. Tennis elbow is diagnosed in most cases in men between the ages of 30 and 50.
Symptoms
Tennis elbow disease is characterized by pain in the area of the elbow joint, the lateral epicondyle (an elevation located in the elbow area), and pain can also spread to the back of the forearm, hand, and even fingers. The pain may worsen even when lifting a small weight (such as a cup of tea).
In the first days of the development of the disease, patients, as a rule, complain of sensitivity or slight pain in the area of the epicondyles, which intensifies with movements of the forearm and wrist, grasping any objects with the hand, shaking hands and clenching the fist strongly.
The course of the disease is always progressive and is characterized by increasing pain, in which the simplest movements become torture for the patient.
Diagnostics
To diagnose tennis elbow, your doctor will first ask you about your medical history in detail. Since it is impossible to determine the disease using blood tests and x-rays, the diagnosis is made based on the patient’s clinical picture. For example, if a patient complains of pain in the elbow area, aggravated by straightening or holding an object in the hand, and upon palpation at the tendon attachment sites a compaction is felt distal to the middle part of the epicondyle measuring about 1 cm, then an experienced specialist may suspect lateral epicondylitis.
If the patient has pain in the medial part of the elbow, weakness in the muscles during grasping movements, and when palpating the flexor-pronator tendons, induration and pain are felt, then medial epicondylitis should be suspected. Quite often, this type of epicondylitis is confused with ulnar nerve neuritis or tunnel syndrome. Therefore, to confirm medial epicondylitis, a simple simulated milking test is performed, which causes increasing pain.
Additional examination (MRI, X-ray, ultrasound of the elbow joint) may also be necessary to make an accurate diagnosis and exclude other diseases.
An accurate diagnosis can be made by MRI (with a magnetic field power of 1 tesla or more) and ultrasound. With their help, tennis elbow can be diagnosed at an early stage of development by detecting extensor muscle tears and tissue swelling.
Prevention
To ward off this disease, you should adhere to the following rules:
- Having a good warm-up. Warm-up is one of the most important factors in the prevention of tennis elbow disease. Before starting classes, it is necessary to prepare the tendons for shock and vibration load by massaging and stretching the tendons of the forearm and shoulder.
- Daily self-massage and massage. Preliminary massage is mandatory before an activity or physical activity and can be carried out either by a massage therapist or directly by the player. The main techniques here are stroking, kneading and rubbing. The use of heating ointments and gels is very effective: “Finalgon”, “Kramer”, “Alzhipan” and others. It is also recommended to carry out a massage after exercise, while rubbing in life-giving ointments - “Traumel-S”, “Dolgit”, “Tsel-T”, “Chondroxid”.
- Visiting the sauna. It has long been known that steam baths and saunas have the best effect on diseased tendons and their attachments. High temperature promotes the formation of new capillaries, which enhance metabolic processes in the damaged elbow. Contraindicated for various diseases tendons are hardening procedures. It is strictly forbidden to cool your elbow in snow, cold pool water or shower. This leads to prolonged spasm of the elbow vessels and prevents a speedy recovery.
- Having regular strength training. Since any professional in his sport strives to improve strength qualities various groups muscles, reasonable training is recommended in gyms, various exercises with barbells and dumbbells. Such regular exercise strengthens the elbow tendons and prevents overwork when playing tennis.
- Timely treatment of foci of chronic infection. Cholecystitis, prostatitis, carious teeth, urethritis, sinusitis, bronchitis, untreated palatine tonsils are those foci of chronic infection that, by their effect on immune system a person provokes it to produce specific immunoglobulins. And they, in turn, can damage tendons and cartilage. Therefore, it is necessary to promptly identify and eliminate diseases in the early stages of development.
- Vitaminization of the body. For the ligaments to function properly, the body needs vitamins C, B1, B6, B12. These vitamins take an active part in the regulation of life processes both at the cellular and tissue levels. It is recommended to take multivitamin complexes such as Vitrum, Centrum and Unicap.
Treatment
Treatment for tennis elbow is mostly conservative. Since any load and muscle tension causes pain, rest is recommended. In some cases, if the pain syndrome is not pronounced, self-massage in the muscle area and the application of dry heat are prescribed. In case of severe pain, a plaster cast is applied to the arm for 3 to 5 weeks, or the arm is suspended on a scarf. Non-steroidal anti-inflammatory drugs are prescribed: diclofenac, ibuprofen, indomethacin and others. Positive results can be achieved using physiotherapeutic procedures. The most effective for this disease are sinusoidal simulated currents, ultrasound and laser.
To relieve acute pain and inflammation, solutions of glucocorticoid hormones or local anesthetics: lidocaine and novocaine are injected into the affected area.
Treatment for tennis elbow depends on factors such as the patient's age, his general state health, pain severity, and medicines which he had previously accepted. The main goal in the treatment of this disease is to reduce the load on the elbow, relieve pain and inflammation, as well as complete restoration and strengthening of the affected elbow. Therefore, in order for the treatment to be as effective as possible, you should contact an experienced specialist at the first symptoms of the disease.
First of all, if you have been diagnosed with tennis elbow, the doctor will recommend that you minimize stress and also prescribe treatment methods that are suitable for your case. To treat tennis elbow, you may be offered acupuncture treatments, as well as pharmacopuncture, which improve blood flow to the joint. Electrophoresis, phonophoresis, shock wave therapy, and therapeutic massage are also used. An elastic bandage can be used to rest the sore arm. After the pain goes away, the patient can gradually move on to physical therapy exercises, and then slowly return to normal daily activities.
After the pain in the elbow is relieved or reduced, the patient can speed up his recovery on his own at home. It is allowed to perform simple physical exercises aimed at strengthening and stretching the tendons and muscles that surround the elbow.
The prognosis for treatment of tennis elbow is usually favorable in 90–95% of cases. In only 5% of all cases, conservative treatment does not help and surgical intervention has to be resorted to.
Tennis elbow (lateral epicondylitis)
Lateral epicondylitis (tennis elbow) develops as a result of inflammation or microtear of the forearm extensor tendons attached to the lateral epicondyle of the distal humerus.
Symptoms of lateral epicondylitis include pain in the area of the lateral epicondyle of the humerus, spreading to the forearm.
Causes of tennis elbow (lateral epicondylitis)
Pathophysiological theories for the development of lateral epicondylitis include non-athletic and occupational activities that require repetitive and forceful pronation and supination of the forearm, as well as excessive use or weakness (or both) of the extensor carpi radialis longus and brevis, which are related to the muscles of the forearm and originate from lateral epicondyle of the ulna. For example, while the tennis backhand stretches the elbow and wrist, the extensor tendons, especially the extensor carpi radialis brevis, can be injured as they roll over the lateral epicondyle and head of the radius. Predisposing factors include poor technique, weak muscles shoulders and wrists, racket strings that are too tight, racket handles that are not the right size, heavy wet balls that hit the target poorly, and the ball hitting the racket off-center.
When overcoming resistance, lateral epicondylitis most often occurs when bending the arm, various types raking movements and exercises on the back muscles when raising the body, especially when the arms are in a pronated position. Often injuries occur as a result of overuse (doing too much activity or performing the same movements with a large number repetitions) or muscle imbalance between the forearm flexors and extensors.
Symptoms of lateral epicondylitis
Pain initially occurs in the extensor tendons when the wrist is pushed against resistance (for example, when driving a screw by hand or hitting a backhand with a racquet). Pain may move from the lateral epicondyle to the middle of the forearm; Over time, subperiosteal hemorrhage, calcification, a spiky growth on the lateral epicondyle, and, most importantly, tendon degeneration may occur.
Pain along the extensor digitorum tendon when the fingers are extended against resistance and the elbow is straight is a reliable diagnostic sign. The diagnosis can be confirmed if the same pain occurs during the following appointment: the patient sits on a chair with the arm straightened at the elbow joint, hands are placed on the table, palm down; The doctor places his hand firmly on the back of the patient's hand, and the patient tries to flex the wrist.
Where does it hurt?
What needs to be examined?
Tennis Elbow Treatment
Treatment for tennis elbow involves two phases. Rest, ice, NSAIDs, and stretching are used initially, along with cortisone injections into the painful area around the tendon. As the pain subsides, perform light resistance exercises on the forearm flexor and extensor muscles first, followed by eccentric and concentric resistance exercises. Activities that cause pain when the wrist is extended or pronated should be avoided. It is often recommended to use elbow pads when playing tennis. Good technique and the type of racquet used can help prevent subsequent injuries.
Although the need for surgical treatment lateral epicondylitis occurs quite rarely; for the treatment of lateral epicondylitis, a surgical method is used, including removal of scars and degenerative tissue at the site of attachment of the extensor tendons.
Medical Expert Editor
Portnov Alexey Alexandrovich
Education: Kyiv National Medical University named after. A.A. Bogomolets, specialty - “General Medicine”
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What to do if you are diagnosed with tennis elbow? Causes and treatment of the disease
Tennis elbow is a common condition. It affects people who are fond of the sport of the same name, especially professionally. Despite the name, they are not the only ones at risk: the pathology occurs in 1-4% of the planet's population. But initially you need to consult a specialist to identify the nature and causes of pain in the joint.
Do not be upset if you are diagnosed with tennis elbow. Treatment using conservative methods, special exercises and folk remedies brings success in 90% of cases.
Causes of pathology
- Sport. The muscles become overloaded and microscopic tears occur. This causes an inflammatory process. The second sport that carries similar risks is golf, which is why the disease is also called golfer's elbow.
Attention! According to James Glick, chief physician of the University of San Francisco team, the insufficiently large size of the tennis racket handle is to blame for the occurrence of the disease in tennis players. In this case, the size of its head and the material from which the strings are made do not matter.
- Profession. The disease affects people who make monotonous movements and are forced to hold their arm up for a long time. “Risk” professions include artists, gardeners, carpenters, painters, car mechanics, cooks, butchers, and milkmaids.
- Age. Lead to inflammation age-related changes in the tissues of the joint.
Sudden epicondylitis is sometimes diagnosed and causes pain in the arm from the elbow to the hand when it is not associated with any known factor.
American doctors believe that the problem of tennis elbow is poorly resolved, since it is associated with the structure of the elbow and the peculiarities of the adaptation of connective tissue to the stresses that arise in professional activities and everyday life.
The disease is provoked by previous injuries, heavy physical labor, as well as other pathologies - osteochondrosis cervical spine ridge and connective tissue dysplasia syndrome.
How to recognize tennis elbow?
The main symptom of tennis elbow is pain, clearly localized in the joint area, but treatment is not prescribed for this symptom alone. An experienced doctor first studies the nature of the sensations. The pain is spontaneous, often accompanied by a burning sensation. In tennis players, it usually appears with shots that require significant tension on the extensor tendons, as well as with the backhand.
If the disease becomes chronic, the pain becomes dull, aching, and intensifies with sudden movements, sometimes radiating towards the hand. At the same time, the mobility of the joint is limited.
Treatment
If you have developed tennis elbow and are worried about pain, you should consult an orthopedic traumatologist, especially if, in addition to everything else, you are experiencing pain from the shoulder to the elbow. The doctor makes a diagnosis and tells you how to treat this disease. Most often, the cause and symptoms of the disease are eliminated with drugs for oral and external use, physiotherapeutic, and manual techniques. At home, they resort to folk remedies, which also help treat the disease.
Attention! The success of therapy depends on many factors, including age, presence of other diseases, severity of pain, and so on.
Drug therapy
For tennis elbow, non-steroidal anti-inflammatory drugs are prescribed internally. These drugs eliminate inflammation and alleviate the patient's condition. The most effective are considered:
Attention! These drugs exhibit a rather aggressive effect on the walls of the stomach. Therefore, most of them should be taken after meals. Details should be clarified in the instructions.
Ointments and gels are used externally - Cinepar-active, Voltaren Emulgel, Indomethacin, Ibuprofen, Ortofen, Piroxicam and others. Injections of corticosteroid drugs are effective in treatment to quickly eliminate inflammation.
Vitamin therapy is important, which helps to establish biological processes. Ascorbic acid and vitamins B1, B6, B12 are considered the most necessary. This will strengthen the collagen cells that form the ligaments. Vitamin complexes include Centrum and Unicap.
Physical Therapy for Tennis Elbow
The patient is prescribed to wear orthoses - at night and during exacerbations, as well as elbow pads and elastic bandages.
The peculiarity of physiotherapeutic procedures for this disease is that they are carried out even during an exacerbation, while in other joint pathologies this is allowed only after the acute inflammation has been eliminated.
In the acute stage of tennis elbow, infrared laser radiation, anesthesia with the Eliman-401 apparatus, and diadynamic therapy - treatment with electric current are prescribed.
When the inflammatory process subsides, other physiotherapeutic techniques are used:
Thermal procedures are shown - sauna, bathhouse. High temperature promotes the formation of new capillaries, which, in turn, accelerates recovery.
Attention! Hardening procedures with alternating hot and low temperatures are contraindicated. The spasms they provoke are harmful to tissues.
As part of conservative treatment, manual therapy is indicated. If the procedure is performed by a skilled doctor, the discomfort in the inflamed joint is reduced. Effective techniques for epicondylitis:
Important! You should approach the issue of choosing a doctor responsibly. If the effect on the musculoskeletal system is incorrect, the limb will suffer even more.
When inflammation worsens, mobility is limited, for which a fixing bandage is prescribed. However, immobilization for too long is harmful to tissues. Therefore, to quickly restore joint mobility, therapeutic exercises are recommended:
- Hands straightened at the elbows are held in front of you. Rotate the hands first counterclockwise, then in the opposite direction.
- The hands are connected into a key, and then the arms are bent and extended at the elbows.
- The upper limbs are bent at the elbow joint, and in this position the hands are clenched into fists and then unclenched.
All exercises are performed in a gentle manner, smoothly, so as not to aggravate the condition.
Attention! Not all doctors agree that joint exercises for epicondylitis help speed up rehabilitation.
Unconventional methods
In the treatment of golfer's elbow, alternative methods that are used in conjunction with the main treatment are often effective.
Treatment with leeches eliminates swelling, reduces pain, and improves blood flow. Full course hirudotherapy ranges from 4 to 6 procedures. The saliva of leeches, which contains biologically, is beneficial to the body. active substances- hirudin, cathepsin, trypsin, hyaluronidase. Relief occurs after the first session.
Attention! Hirudotherapy has a number of contraindications, the main of which are problems with blood clotting and hemophilia. The technique is prohibited during pregnancy, menstruation, and cancer.
Traditional recipes can be used at home after consultation with your doctor.
If acute inflammation is eliminated, it is useful to make applications with blue clay. Two tablespoons of powder are diluted with hot water to a thick paste. This remedy is applied to the sore joint, covered with cellophane and wrapped in a woolen scarf. The duration of the procedure is 20 minutes. Then the skin is rinsed. Clay compresses for tennis elbow are made in the morning and evening for a week.
Comfrey root ointment helps a lot. As a base, take 200 grams of lard, which is pre-heated and filtered to remove the solid mass. Then the fresh comfrey root is washed, finely grated, added to the fat and brought to a boil. Then the ointment is left in the refrigerator for two days.
Before use, the ointment is heated in a water bath, the fabric is soaked in it, and applied to the sore spot. Cover the top with film and wrap it with a warm scarf. Keep the product for 2 hours. The ointment is applied until the pain stops.
Surgical intervention
If conservative methods for epicondylitis do not normalize the condition, then surgery is required to remove the damaged tissue. Arthroscopy is considered the optimal technique. This reduces blood loss and the likelihood of bacterial infection, and shortens the rehabilitation period.
How to prevent the disease?
Primary and secondary prevention is the correct alternation of work and rest. The same type of hand movements, in which the load falls on the elbow joint, are not recommended.
The coach plays a big role in the prevention of tennis elbow. He should help master the hitting technique, since incorrect position of the hand makes the occurrence of the disease more likely. During the rehabilitation process, athletes are recommended to reduce the string tension by 3 kg, increase the racket handle, and switch to a two-handed backhand. Right choice equipment and mastering movement techniques is also important in other sports.
Tennis elbow disease treatment
“Tennis elbow” (or lateral epicondylitis) is a chronic disease characterized by pain and inflammation in the elbow area (namely at the point where the muscles connect with the epicondyles of the humerus).
Causes of the disease
The cause of tennis elbow is excessive stress on the muscles, forearms and tendons of the hands. Most often, this disease affects tennis players. Athletes, performing monotonous, repeated hits on the ball with a racket, subject their muscles and tendons to enormous stress, which causes the development of lateral epicondylitis, most often right-sided.
Tennis elbow affects not only sports enthusiasts, but also people who perform repetitive physical activity (chopping wood, working with a wrench, playing golf, hammering nails, painting, etc.), which causes chronic tension in the tissues of the elbow area.
Sometimes such a disease, which simultaneously affects all neighboring areas: muscles, ligaments, tendons and periosteum, can be caused by an injury or bruise to the elbow. Often lateral epicondylitis is combined with osteochondrosis of the cervical and thoracic spine.
Tennis elbow affects half of tennis players and 14% of the general population. This disease affects the female gender less often than the stronger half of humanity (in the age category).
Diagnosis of elbow disease
The presence of lateral epicondylitis in the body can be determined by pain in the elbow area, the back of the forearm, the epicondyle area, the hand or fingers.
At first insignificant, the pain gradually increases, increasing with a strong fist clench, handshake, grasping certain objects with the hand, or lifting minor weights: it could even be a mug of water. Any simple movements with this progressive disease subsequently become unbearable torture.
“Tennis elbow,” the treatment of which involves the use of complex therapy, is easy to diagnose at the initial stage of development by detecting tissue swelling and muscle tears in the extensor muscles.
“Tennis Elbow”: Treatment
Treatment of tennis elbow syndrome is carried out comprehensively and is aimed at reducing the load in the elbow area, relieving pain and inflammation, completely regenerating the affected organ and strengthening it. Effective therapy and quick recovery will be ensured by timely contact with medical personnel at the first signs of the disease. How to treat tennis elbow? At the initial stage, the affected organ needs to be provided with complete rest. For mild pain, self-massage in the muscle area and application of dry heat will be required.
Non-steroidal anti-inflammatory and painkillers are effective among medications: Ibuprofen, Ortofen, Indomethacin, Butadione, Diclofenac. “Tennis elbow” is effectively treated with physiotherapeutic procedures (laser, electrophoresis of novocaine or hydrocortisone, ultrasound, sinusoidal currents). It is recommended to apply iodine mesh to the elbow area in the morning and evening.
Fixing the sore arm
To fix the injured arm, you should definitely use an elastic bandage or orthosis applied in the form of a figure eight. “Tennis elbow” heals quickly with the use of such special bandages, which provide support to the elbow joint, reduce the load on the arm and protect against various types of injuries. In case of acute pain, the arm is suspended on a scarf or a plaster bandage is applied to it (for a period of 3 to 5 weeks).
Traditional medicine recipes
In the treatment of this disease, traditional medicine recipes have proven themselves well, the action of which is aimed at getting rid of elbow pain and relieving inflammation. An effective remedy is the comfrey plant, the roots and fresh crushed leaves of which (1:1) must be combined with 1/4 part of melted honey and 1/4 part of vegetable oil. All this needs to be ground to a homogeneous mass and applied warm to the affected area. Apply a layer of gauze and compress paper on top, bandage it and leave it for a day. The medicinal paste should be stored in the refrigerator for 2-3 weeks or in the freezer for several months. If treated correctly, after a short time you can forget about such a disease as “tennis elbow.”
Treatment with folk remedies involves relieving inflammation of the epicondyle with onions combined with tar. To prepare it, you need to cut the onion into two parts, drop two drops of pine tar into the middle of the halves. Both halves should be applied to the sore joint in the area of the epicondyle. The bandage should be fixed and left for 30 minutes. Treatment must be carried out twice a day.
Milk compress against elbow inflammation
A milk compress helps well, the preparation of which requires heating the milk to 60C⁰, dissolving crushed propolis in it: a teaspoon per 100 ml of liquid. You need to soak a gauze napkin with the warm milk mixture, wrap it around the affected joint, cover it with parchment paper on top and insulate it. Leave the compress for 2 hours. Treatment is carried out for 20 days twice a day.
“Tennis elbow”: exercises
As the patient heals, he can gradually begin physical therapy exercises and slowly return to normal activities, while speeding up his own recovery at home. To do this, it is recommended to spare the muscles, not make sudden movements, and perform light physical exercises, the effect of which is aimed at strengthening and stretching the muscles and tendons around the elbow area.
Raise your arm to shoulder level and bend it at the wrist. With the other hand you need to gently pull the hand towards the elbow. Perform five to ten times for half a minute. Place your forearm on your knee so that the hand hangs freely. Take a load weighing 0.250-0.500 kg in your hand and slowly bend and straighten your arm at the wrist. Repeat the exercise 5-10 times. You need to sit down, put your forearm on your knee so that your hand is perpendicular to its surface. Squeeze the handle of the hammer and slowly turn your wrist to the left, then to the right (5-10 times). Place a rubber band on your fingertips and stretch it 20 times, spreading your fingers. After a short break, repeat the exercise three times. If there is insufficient resistance, you can put two rubber bands on your fingers. Squeeze the tennis ball in your hand about 20 times. Do the exercise three times with short breaks.
As a rule, the prognosis for treatment of tennis elbow is favorable in 95% of cases.
In rare cases, conservative treatment is powerless and surgical intervention has to be resorted to.
Preventive methods
effective warm-up and regular strength training: carried out wisely, they are aimed at improving the strength qualities of muscle groups, strengthening the tendons of the elbow area, counteracting fatigue when playing tennis; regular massage, including basic techniques: kneading, stroking, rubbing; the use of warming gels and ointments; visiting a sauna is a method that effectively affects injured tendons; elevated temperature causes the appearance of new capillaries, which increase metabolic processes in the injured elbow; fortification of the body, required to activate metabolic processes at the tissue and cellular levels; Such vitamin complexes as “Unicap”, “Centrum”, “Vitrum” are effective.
Hardening procedures for tendon diseases are extremely contraindicated. This can cause prolonged vasospasm, which can delay healing for an indefinite period.
Tennis elbow - epicondylitis, as it is called in medicine, is a disease that leads to degenerative-inflammatory changes in the area of the elbow joint; more precisely, inflammation develops in the attachment of the muscles to the humerus.
There are two types of epicondylitis, internal and external. The second type occurs when the outer area of the forearms is affected, and is where the term tennis elbow is used.
The term has a simple explanation, because such a lesion most often occurs in tennis players due to the specifics of the game and the work of the elbow.
Reasons for development
First of all, the disease develops for reasons of professional activity, and most often affects athletes. However, additional risk factors may include:
Frequently carrying heavy objects. Excessive load on the elbow joint. Performing movements with the elbow for a long time (symptoms are common among construction workers).
In principle, in medical circles there is still no exact reason for the development of epicondylitis, but it is known for sure that prolonged and monotonous movements of the elbow joint with extension and flexion can ultimately lead to the development of tennis elbow.
Symptoms
The symptoms of the disease are quite pronounced, since tennis elbow always causes pain.
Sharp and severe pain can manifest itself in a specific way, and these pain sensations have their own interesting characteristics that help distinguish pain and tennis elbow from arthritis of the shoulder joint, for example, or inflammation of the elbow joint.
First of all, pain occurs only with a certain load on the elbow. In this case, symptoms occur with rotational movements of the forearm. That is, if the movement of the arm and elbow occurs without the participation of muscles, then there is simply no pain.
Tennis elbow only appears when a muscle affected by inflammation is involved in the movement.
Secondly, pain does not just occur in the elbow area, it is projected in a certain location - along the lateral surface of the shoulder bone. This helps determine exactly where inflammation is present.
There are pitfalls here, since the same pain, almost the same, is also present with myalgia, so it is best to check the diagnosis with a doctor.
Interestingly, in order for symptoms to begin to appear, it is not necessary to seriously engage the muscles of the forearm and shoulder; even a simple handshake is enough. Tennis elbow will immediately show pain.
In addition, tennis elbow can occur with very minor movements, extending the forearm, with minimal stress, even when lifting an empty cup.
That is, there is not necessarily a large load, inflammation immediately makes itself felt, even with minimal effort.
In general, all symptoms can be reduced to a specific list:
Dull pain appears on the outer surface of the elbow, which radiates to the forearm. The pain becomes sharp with grasping and rotational movements. When you touch the elbow, the patient experiences pain, the syndrome develops. Redness is noted in the affected area, which is how inflammation manifests itself. Tennis elbow syndrome can lead to limited movement, not only in the elbow area, but also impair the movement of the fingers.
How to treat tennis elbow
Tennis elbow can be treated in several ways. But here it is important to immediately determine what these could be:
Non-drug, conservative treatment. Drugs. Physiotherapeutic treatment. Surgery.
Separately, it can be clarified that it is possible to use therapy using traditional methods, but this is rather additional help.
The choice of tactics depends on the degree of damage and development of the disease. In some cases, monotherapy is used, and in others, several options are used simultaneously.
If the pain syndrome is pronounced, then treatment begins with eliminating the pain and immobilizing the elbow joint. This must be done for better healing. A cast or a special orthosis is used on the elbow joint.
Any load on the elbow is completely eliminated. The elbow joint should be warm. You need to do a simple massage on your elbow to increase blood flow.
Now, as for medicines, drugs can solve several problems at once. Treatment with medications:
Relieves and reduces inflammation in the elbow joint and forearm. Eliminates and relieves pain. Speeds up recovery.
Here we are talking not only about painkillers for joint pain, but primarily about non-steroidal anti-inflammatory drugs.
Note that tennis elbow syndrome is most often treated with:
Diclofenac, Ketorolac, Ibuprofen, Nimessulide, Indomethacin, Xefocam.
The most effective treatment will be complex, in which drugs are used both in the form of tablets and ointments for topical use or rectal suppositories.
If there is no effect, then they begin to use steroid drugs, these are corticosteroids that are injected into the joint area by injection.
Along with medications, it is necessary to prescribe vitamin complexes. Which will take long courses, but will also help treat tennis elbow and generally strengthen the body.
A prerequisite for effectively getting rid of the problem will be the use of physiotherapy. In addition, it is an integral part of therapy. Physiotherapeutic treatment will help:
Accelerate healing processes. Improve microcirculation. Relieve inflammation and reduce the overall inflammatory process. Significantly reduce pain.
Therapy with these drugs involves the use of electrophoresis, phonophoresis, DDT, and ultrasound.
As for therapy with folk remedies, here you can pay attention to the use of special lotions and compresses with anti-inflammatory herbs.
However, it is not recommended to treat the disease with folk remedies; at least, you definitely cannot use only alternative medicine. As a rule, therapy with folk remedies can reduce the manifestation of symptoms, but more often this simply leads to a blurring of the clinical picture, and to the subsequent transition of the disease to a chronic form.
However, if the problem cannot be solved with medication, folk remedies, and steroid drugs, then tennis elbow is treated promptly.
A surgical operation is performed to radically remove the inflamed area of tissue. The operation is carried out as follows:
The muscle at the attachment point with the humerus is separated. The changed and inflamed tissue is removed. The muscle returns to the bone.
And in conclusion, let’s say that tennis elbow is always a disease with a favorable prognosis, that is, it is always treatable and completely eliminated.
Lateral epicondylitis of the elbow, or tennis elbow, is an inflammation of the muscles and tendons where they attach to the bones in the elbow joint.
The causes of the disease can be: excessive hard labour, microtraumas, sometimes it develops against the background of cervical osteochondrosis.
Most often this disease affects people over 40 years of age, as well as those engaged in heavy physical labor, for example:
athletes (tennis players, throwers, weightlifters, boxers); agricultural workers (tractor drivers, laborers, milkmaids); construction workers (painters, plasterers, masons), etc.
Epicondylitis comes in two forms: lateral And medial. In the case of lateral epicondylitis, the pain is expressed along the outer surface of the elbow, with medial epicondylitis - along the inner surface. Symptoms of the disease are pain in the affected area, radiating to the forearm and intensifying when moving the affected arm.
Treatment for tennis elbow
The biggest mistake of a person suffering from epicondylitis of the elbow joint is not starting treatment in a timely manner or stopping treatment at the first signs of improvement.
To get rid of the disease epicondylitis forever, it is necessary to provide complete rest to the hand for the entire period of treatment. If you damage a tendon that has not had time to heal, your arm will begin to hurt again, and epicondylitis will develop into a chronic form, which takes much longer and is more difficult to treat.
Drug treatment
Since pain with epicondylitis of the elbow joint is caused by an inflammatory reaction, anti-inflammatory therapy is used. Experts recommend using locally non-steroidal anti-inflammatory drugs in the form of gels or ointments.
So, one of the effective remedies is Nurofen Gel ( active substance- ibuprofen). It is applied 3-4 times a day with a thin strip 3-5 cm long and rubbed until completely absorbed. The pain goes away within 2-3 weeks.
In more serious cases, when gels and ointments do not help, local injections of glucocorticosteroids mixed with an anesthetic (betamethasone dipropionate) are used. After injections, the pain disappears after 2-3 days. To prevent relapses, an optimal motor regimen without overloading the diseased joint is recommended.
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Physiotherapy
In the acute period of the disease, lateral epicondylitis is used for anti-inflammatory and analgesic effects:
high-intensity pulsed magnetic therapy; diadynamic therapy; percutaneous electroanalgesia (Eliman-401 device); infrared laser radiation.
In the subacute period of the disease "tennis elbow" the following are used:
ultraphonophoresis of hydrocortisone and anesthetic mixture on the damaged area; paraffin-ozokerite applications at a temperature of 45 degrees C; naphthalon applications; extracorporeal shock wave therapy (Medolit device); used in the absence of positive dynamics from other methods of physiotherapy; local cryotherapy on the painful area with dry cold air (temperature -30 C).
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All these procedures are aimed at relieving pain and inflammation in the elbow joint and muscle tension.
Non-drug treatment
Manual therapy is widely used in the treatment of tennis elbow (epicondylitis of the elbow joint). As a rule, sessions are enough to relieve pain in 90% of patients. Manual therapy is especially effective in addition to other treatment methods.
Special gymnastics aimed at relaxing muscles and reducing their painful spasm also helps a lot. It is very important to choose and perform the exercises correctly, so it is better to do this with a doctor. Exercises are performed for several weeks 1-2 times a day every day.
Many patients have noticed significant improvement when treated with medicinal leeches (hirudotherapy). Over 5-6 sessions, the pain noticeably decreases. Leeches are placed on certain points of the body, and the sensory nerve is irritated, which helps to increase blood circulation. Saliva medical leech relieves swelling, reduces pain and has an anti-inflammatory effect.
Surgical methods of treatment
They are used in rare cases when other types of treatment do not bring a positive result. Surgical methods include:
tunneling; excision of the hypertrophied joint ligament.
Traditional medicine recipes
Tincture of horse sorrel roots
Take half a liter jar of roots + half a liter of vodka, leave for 10 days and apply as compresses at night for 10 days.
Bay oil
4 tbsp crushed bay leaf is poured into 200g of vegetable oil, mixed, poured into an airtight container and left for a week in a warm place.
Then filter and use as compresses or rub into a sore spot.
These recipes can be used to relieve pain, but they should not replace competent treatment of epicondylitis (tennis elbow) by a specialist!
Watch a useful and interesting video about epicondylitis with Elena Malysheva:
Prevention
It is easier to prevent any disease than to treat it. This is completely true for a disease such as tennis elbow. To prevent the development of epicondylitis it is necessary:
Before physical activity, do a warm-up to warm up the muscles and tendons; rationally distribute loads without overstraining muscles; fix the elbow joints with elastic bandages during heavy physical activity; take breaks during long monotonous workouts or when performing monotonous work.
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It is not only older people who suffer from joint diseases. When connective and muscle tissue becomes inflamed, pain occurs and it is impossible to bend and straighten the arm. Tennis elbow is the name given to an inflammatory process that often develops in athletes and people whose professions involve monotonous movements in the elbow area.
Causes of the disease
Tennis elbow is commonly referred to as epicondylitis. This is a pathological process that occurs against the background of increased physical stress on the forearm and elbow area. The name itself suggests that tennis players are at risk. Prolonged, monotonous hand movements during training and competitions cause inflammation.
Due to the high load on the tendons, the right hand is more likely to suffer. It's not just tennis fans who can suffer from epicondylitis. The pathology is often called golfer's elbow, because playing golf also becomes a provoking factor for the manifestation of epicondylitis in a player.
People who are involved in deforestation, construction workers, seamstresses, and auto repair shop workers are at risk of getting tennis elbow. Any work associated with monotonous activities in which you need to constantly bend and straighten your arm can cause medial or lateral epicondylitis, in which the epicondyle becomes inflamed.
Tennis elbow can occur after a joint injury. For example, after a severe bruise, an inflammatory process begins, which gradually affects nearby tissues.
Tendons, muscle tissue, and ligaments suffer. Epicondylitis in the lateral or external form can develop against the background of osteochondrosis of the cervical spine.
Signs and symptoms
Tennis elbow syndrome can occur in two forms:
- lateral form of epicondylitis. With this type of disease, the outer epicondyle becomes inflamed;
- epicondylitis in medial form. With medial epicondylitis, the epicondyle becomes inflamed in the internal joint, and the pain syndrome covers the limb from the inside.
Tennis elbow can be identified by the following symptoms:
- pain in the elbow area of varying intensity;
- pain intensifies with active flexion and extension of the arm, as well as with rotational movements;
- pain appears in the forearm area.
Advanced tennis elbow may present with swelling. With the intensive development of tennis elbow pathology, the symptoms intensify.
The pain becomes aching and becomes stronger with any movement. A person suffers from limited mobility of the upper limb.
Diagnostics
To find out that this disease is tennis elbow, it is necessary to carry out diagnostic measures. Diagnostics includes the following procedures:
- The doctor conducts a detailed survey of the patient, finds out how long ago certain symptoms appeared, and what factor provoked the development of inflammation.
- A visual examination of the affected limb is performed.
- Function tests are performed on the sore arm to confirm the diagnosis of tennis elbow.
If necessary, functional diagnostic procedures are prescribed:
- X-ray. The image will show whether the joint is susceptible to calcium deposits at the location of the epicondyle.
- Ultrasound allows you to determine how much the structure of the joint tissues has changed, as well as the area of inflammation.
- MRI. The procedure allows you to examine the condition of the soft tissues and the changes that have occurred to them. Based on the results of the examination, the doctor decides how to treat the joint in the elbow.
Based on the results of the diagnostic examination, the doctor decides how to treat the pathology if the diagnosis of tennis elbow is confirmed.
Treatment Methods for Tennis Elbow
Tennis elbow is treated comprehensively. The main goal of treatment is to eliminate the load on the painful area and relieve pain. Then treatment procedures are aimed at reducing and completely eliminating the inflammatory process, and subsequent restoration of joint mobility.
If tennis elbow is diagnosed, the disease can be cured using the following measures:
- Drug therapy consisting of a course of medications from different groups and external use of painkillers.
- Physiotherapeutic procedures.
- Physiotherapy.
- Treatment at home.
Non-steroidal drugs are prescribed as drug therapy for the treatment of tennis elbow syndrome. Medicines from the category of non-steroids eliminate inflammation, pain and swelling from the diseased joint. Anti-inflammatory drugs include the following medicinal compounds:
- Ibuprofen;
- Nise;
- Voltaren;
- Diclofenac;
- Nurofen;
- Indomethacin.
During the course of treatment for tennis elbow, you must follow the dosage prescribed by your doctor. Uncontrolled use of anti-inflammatory drugs can cause serious complications.
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Non-steroids, even at an acceptable dosage, have many side effects, so deviation from medical instructions can cause a negative effect.
In addition to tablets, external remedies are used in the treatment of golfer's problems. These are ointments and gels with an anti-inflammatory effect, and for the healing of affected muscles, which can cure the disease:
- Troxevasin;
- Heparin;
- gel with horse chestnut;
- Lyoton;
- Piroxicam.
In severe stages of the pathology and in chronic cases of tennis elbow, effective intra-articular injections of corticosteroids are indicated.
If conservative methods do not produce results and the hand hurts, then the only way to get rid of the golfer’s illness is through surgery.
Treatment at home
You can treat tennis elbow disease at home, but your doctor will tell you how. It is important to combine home treatments with medical prescriptions.
Folk remedies help reduce joint inflammation and pain. But inflammation can be completely cured only in combination with medical prescriptions:
- Blue clay compresses. Clay (2 tbsp) is diluted in hot water to the consistency of sour cream. The paste is applied to the affected area in a large layer, covered with polyethylene and a warm cloth. Keep the compress for 20 minutes, then rinse off the residue with warm water. The course lasts a week, compresses are applied in the morning and evening.
- Homemade comfrey ointment helps reduce inflammation. Grate the root of the plant, add melted lard (200 g) to the pulp. Boil the ingredients. Cool the resulting composition and keep in the refrigerator for two days. Before applying, heat the ointment in a water bath. First, a thin cloth is soaked in the ointment, then applied to the affected area for 2 hours.
- Recipe with green tea to relieve inflammation. Brew tea, pour into small containers, and place in the freezer. Every day, massage a frozen tea cube wrapped in a cloth onto the affected area.
- Honey compress with the addition of aloe. Crush the aloe leaf into a paste (1 tbsp), add honey (2 tbsp). Mix the components and apply to the painful area, cover with plastic and bandage. Keep the compress for half an hour every day. It is better to do compresses before going to bed.
- Add crushed bay leaves (5 tbsp) to heated vegetable oil (250 g). Leave to infuse in the dark for a week. Rub into the sore area daily to reduce inflammation.
Home treatment brings results only in combination with conservative treatment methods. You need to understand that folk remedies are only an additional treatment method.
Exercises
Special exercises for joints are prescribed for the diagnosis of tennis elbow after acute symptoms have been relieved. Immobilization of the joint is indicated for a certain time. Prolonged lack of movement can lead to muscle tissue atrophy and cause congestion.
Therapeutic gymnastics is aimed at restoring motor activity of the sore arm, and should be performed under medical supervision.
A set of special exercises is selected individually and depends on the severity of the inflammation and individual characteristics body. If your hand hurts during exercise, then you need to stop moving and adjust the technique.
Surgical intervention
Surgical treatment of tennis elbow is indicated for severe, advanced cases of the development of the inflammatory process. During the operation, joint tissues that could not be restored using traditional methods are removed.
The main surgical method for tennis elbow disease is arthroscopy. This method has the following advantages:
- there is virtually no blood loss;
- low probability of infection during surgery;
- short rehabilitation period.
During the operation, a small incision is made, then
cutting off the tendon at the point of fixation.
Then the damaged area is removed. At the site of excision, the tissue is carefully sutured. The operation is performed under local anesthesia.
During the recovery period, the joint should be at rest. Loads on the arm are introduced gradually. Physiotherapeutic procedures may be prescribed to speed up the recovery period.
Physiotherapy
Treatment options for tennis elbow include physical therapy.
The most effective method Physiotherapeutic treatment is shock wave technique. The waves penetrate the painful epicondyle, causing the tissue to quickly recover. It is necessary to perform about 6 procedures, one per week.
After the inflammation has been relieved, other physiotherapy sessions are indicated:
- applications with paraffin, ozokerite and naphthalene;
- electrophoresis in combination with medications;
- cold treatment.
Physiotherapy is prescribed both during the acute course of the disease and during the recovery period. To relieve acute symptoms, a procedure with infrared laser radiation is indicated, which has an analgesic effect.
Additional procedures may be prescribed. This is a visit to a bathhouse or sauna.
How to forget about joint pain forever?
Have you ever experienced unbearable pain in joints or constant back pain? Judging by the fact that you are reading this article, you are already familiar with them personally. And, of course, you know firsthand what it is:
- constant aching and sharp pain;
- inability to move comfortably and easily;
- constant tension in the back muscles;
- unpleasant crunching and clicking in the joints;
- sharp shooting in the spine or causeless pain in the joints;
- inability to sit in one position for a long time.
Now answer the question: are you satisfied with this? Can such pain be tolerated? How much money have you already spent on ineffective treatment? That's right - it's time to end this! Do you agree? That is why we decided to publish, which reveals the secrets of getting rid of joint and back pain.
“Tennis elbow” (or lateral epicondylitis) is a chronic disease characterized by pain and inflammation in the elbow area (namely at the point where the muscles connect with the epicondyles of the humerus).
Causes of the disease
The cause of tennis elbow is excessive stress on the muscles, forearms and tendons of the hands. Most often, this disease affects tennis players. Athletes, performing monotonous, repeated hits on the ball with a racket, subject their muscles and tendons to enormous stress, which causes the development of lateral epicondylitis, most often right-sided.
Tennis elbow affects not only sports enthusiasts, but also people who perform repetitive physical activity (chopping wood, working with a wrench, playing golf, hammering nails, etc.), which causes chronic tension in the tissues of the elbow area.
Sometimes such a disease, which simultaneously affects all neighboring areas: muscles, ligaments, tendons and periosteum, can be caused by an injury or bruise to the elbow. Often lateral epicondylitis is combined with osteochondrosis of the cervical and thoracic spine.
Tennis elbow affects half of tennis players and 14% of the general population. This disease affects women less often than the stronger half of humanity (in the age category of 30-50 years).
Diagnosis of elbow disease
The presence of lateral epicondylitis in the body can be determined by pain in the elbow area, the back of the forearm, the epicondyle area, the hand or fingers.
At first insignificant, the pain gradually increases, increasing with a strong fist clench, handshake, grasping certain objects with the hand, or lifting minor weights: it could even be a mug of water. Any simple movements with this progressive disease subsequently become unbearable torture.
“Tennis elbow,” the treatment of which involves the use of complex therapy, is easy to diagnose at the initial stage of development by detecting tissue swelling and muscle tears in the extensor muscles.
“Tennis Elbow”: Treatment
Treatment of tennis elbow syndrome is carried out comprehensively and is aimed at reducing the load in the elbow area, relieving pain and inflammation, completely regenerating the affected organ and strengthening it. Effective therapy and quick recovery will be ensured by timely contact with medical personnel at the first signs of the disease. How to treat tennis elbow? At the initial stage, the affected organ needs to be provided with complete rest. For mild pain, self-massage in the muscle area and application of dry heat will be required.
Non-steroidal anti-inflammatory and painkillers are effective among medications: Ibuprofen, Ortofen, Indomethacin, Butadione, Diclofenac. “Tennis elbow” can be effectively treated with physiotherapeutic procedures (laser, electrophoresis of novocaine or hydrocortisone, ultrasound. It is recommended to apply to the elbow area in the morning and evening
Fixing the sore arm
To fix the injured arm, you should definitely use an elastic bandage or orthosis applied in the form of a figure eight. “Tennis elbow” heals quickly with the use of such special bandages, which provide support, reduce the load on the arm and protect against various types of injuries. In case of acute pain, the arm is suspended on a scarf or a plaster bandage is applied to it (for a period of 3 to 5 weeks).
Traditional medicine recipes
In the treatment of this disease, traditional medicine recipes have proven themselves well, the action of which is aimed at getting rid of elbow pain and relieving inflammation. An effective remedy is a plant and fresh crushed leaves of which (1:1) must be combined with 1/4 part of melted honey and 1/4 part of vegetable oil. All this needs to be ground to a homogeneous mass and applied warm to the affected area. Apply a layer of gauze on top, bandage it and leave it for a day. The medicinal paste should be stored in the refrigerator for 2-3 weeks or in the freezer for several months. If treated correctly, after a short time you can forget about such a disease as “tennis elbow.”
Treatment with folk remedies involves relieving inflammation of the epicondyle with onions combined with tar. To prepare it, you need to cut the onion into two parts, drop two drops of pine tar into the middle of the halves. Both halves should be applied to the sore joint in the area of the epicondyle. The bandage should be fixed and left for 30 minutes. Treatment must be carried out twice a day.
Milk compress against elbow inflammation
A milk compress helps well, the preparation of which requires heating the milk to 60C⁰, dissolving crushed propolis in it: a teaspoon per 100 ml of liquid. You need to soak a gauze napkin with the warm milk mixture, wrap it around the affected joint, cover it on top and insulate it. Leave the compress for 2 hours. Treatment is carried out for 20 days twice a day.
“Tennis elbow”: exercises
As the patient heals, he can gradually begin physical therapy exercises and slowly return to normal activities, while speeding up his own recovery at home. To do this, it is recommended to spare the muscles, not make sudden movements, and perform light physical exercises, the effect of which is aimed at strengthening and stretching the muscles and tendons around the elbow area.
- Raise your arm to shoulder level and bend it at the wrist. With the other hand you need to gently pull the hand towards the elbow. Perform for half a minute five to ten times.
- Place your forearm on your knee so that your hand hangs freely. Take a load weighing 0.250-0.500 kg in your hand and slowly bend and straighten your hand at the wrist. Repeat the exercise 5-10 times.
- You need to sit down, put your forearm on your knee so that your hand is perpendicular to its surface. Squeeze the hammer handle and slowly rotate your wrist to the left, then to the right (5-10 times).
- Place a rubber band on your fingertips and stretch it 20 times, spreading your fingers apart. After a short break, repeat the exercise three times. If there is insufficient resistance, you can put two rubber bands on your fingers.
- Squeeze a tennis ball in your hand about 20 times. Do the exercise three times with short breaks.
As a rule, the prognosis for treatment of tennis elbow is favorable in 95% of cases.
In rare cases, conservative treatment is powerless and surgical intervention has to be resorted to.
Preventive methods
- effective warm-up and regular strength training: carried out wisely, they are aimed at improving the strength qualities of muscle groups, strengthening the tendons of the elbow area, and counteracting fatigue when playing tennis;
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- the use of warming gels and ointments;
- visiting a sauna is a method that effectively affects injured tendons; elevated temperature causes the appearance of new capillaries, increasing metabolic processes in the injured elbow;
- vitaminization of the body, required to activate metabolic processes at the tissue and cellular levels; Such vitamin complexes as “Unicap”, “Centrum”, “Vitrum” are effective.
Hardening procedures for tendon diseases are extremely contraindicated. This can cause prolonged vasospasm, which can delay healing for an indefinite period.
Epicondylitis or tennis elbow syndrome is a disease that causes degenerative and inflammatory disorders in the area of the elbow joint. The inflammatory process occurs in the area of attachment of muscle tissue to the humerus. The name of the disease is explained simply - damage to a joint of this kind is more often diagnosed in tennis players due to the characteristics of the sport, which require characteristic movements of the limb.
Why does the disease occur?
Doctors to this day cannot give an exact answer as to what provokes the appearance of epicondylitis. However, it is known that prolonged and monotonous movements in the elbow joint, which involve constant flexion and extension, subsequently lead to the development of tennis elbow. The pathology mainly affects athletes, but can also be diagnosed in ordinary people. The following risk factors are identified:
- constant lifting of heavy objects;
- excessive activity of the elbow joint;
- frequent movements in the elbow joint.
What symptoms does the pathological condition have?
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The main symptom that indicates tennis elbow is pain. At the same time, it has characteristic features that make it possible to distinguish the disease from other pathologies affecting the joints. Pain occurs when certain loads. Patients note undesirable symptoms during rotational movements in the forearm. In other words, if movements of the upper limb occur without involving muscle tissue, then pain does not appear. Pain develops only in a situation where physical activity affects a muscle that is affected by the inflammatory process.
In addition, the disease can be distinguished by the location of the pain syndrome. Pain occurs in the lateral surface of the humerus, which makes it possible to determine the exact location of the inflammation. In this case, a strong load on the elbow is not required; sometimes a handshake is enough for the disease to respond with pain. In medical practice, the symptoms of the disease are usually grouped as follows:
- dull pain that may radiate to the shoulder;
- sharp pain during rotational movements;
- pain when feeling the elbow area;
- redness of the skin in the area of inflammation;
- stiffness of movements.
Diagnostic measures
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If a patient suspects that an inflammatory process has developed in the elbow joint, it is important to contact a medical facility as soon as possible. First, the doctor conducts a survey, during which he finds out whether the person is engaged in professional activities that involve a powerful load on the elbow joint. Then he begins visual inspection and palpation, which makes it possible to determine pain in the elbow area. The person is then sent for the following examinations:
- ultrasonography;
- magnetic resonance imaging;
- electromyography.
How is tennis elbow treated?
Conservative methods: medications, physiotherapy and exercise therapy
Tennis elbow is predominantly treated with pharmaceuticals. In most cases, they make it possible to cure the disease, however, in severe cases of the disease, an integrated approach is required, which includes physical therapy and physiotherapy. If a person experiences severe pain, they initially resort to painkillers and immobilize the joint. For these purposes, an orthosis or plaster cast is used. During therapy, patients will need to eliminate the load on the elbow joint. In addition, it is important to keep your elbow warm and systematically massage it, which will improve blood circulation.
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The patient is most often prescribed non-steroidal anti-inflammatory drugs, with the help of which it is possible not only to eliminate pain, but also to stop the inflammatory process.
- Mostly they resort to the following medications:
- "Diclofenac";
"Ibuprofen";
Medicines are used not only in tablet form; they also prescribe the use of ointment or gel for external use. Several times a day, a medicine is applied to the affected area of the elbow, which reduces inflammation and relieves pain. On average, therapy with non-steroidal anti-inflammatory pharmaceuticals takes about 2 weeks. If treatment of tennis elbow with these medications does not bring the required therapeutic effect, they resort to steroid medications, the most common of which are corticosteroids. These medications are injected into the joint area.
You can treat tennis elbow at home using recipes from traditional healers. However, this can only be done after consultation with the attending physician. In combination with the use of medications and traditional medicine, patients are prescribed special exercises that will help develop the shoulder and elbow, improve muscle tone. In addition, physiotherapy is also prescribed, which includes the following procedures:
The treatment regimen can be supplemented with electrophoresis procedures.
- ultrasound treatment;
- phonophoresis;
- diadynamic therapy;
- electrophoresis.
Surgical intervention
If conservative therapy methods do not help get rid of inflammation and pain, surgery is resorted to. Its essence is to remove the inflamed area of tissue. During surgery, the doctor separates the muscle, removes the affected area, and places the muscle tissue back on the bone. After surgical intervention the patient faces a rehabilitation period, during which an orthosis or tape is applied to the affected limb (tennis elbow taping).