Epicondylitis

Description:

It is the dystrophic process in places of an attachment of muscles to epicondyles of a humeral bone which is followed by a reactive inflammation of the next fabrics. Distinguish an outside epicondylitis of a shoulder (a so-called tennis elbow) which meets more often, and an internal epicondylitis of a shoulder.

Epicondylitis symptoms:

In a clinical picture of an outside epicondylitis the leading place is taken by local pain in the field of an outside epicondyle which can irradiate up the outer edge of a hand and down to the middle of a forearm. At rest pain is absent and develops at a palpation or certain movements — extension and forearm supinations, and especially at a combination of these movements. The passive movements of a forearm are painful only when rendering resistance of Bol amplifies at compression of a brush in a fist and simultaneous bending in a radiocarpal joint. Pain usually has the progressing character, it develops even at a small muscle tension, for example deduction in a hand of any thing. Outward of an elbow joint at an epicondylitis not. it is changed, the passive movements are, as a rule, not limited. At a palpation it is possible to find a point of the greatest morbidity. It can be located both in sinews of razgibatel, and in muscles. More often it is an instep support, but maybe one of beam razgibatel of a brush. Depending on it allocate tendinous and periosteal, muscular, tendinous and epicondylic forms of an epicondylitis. In certain cases as a result of a prelum of a deep branch of a beam nerve an instep support, note paresis of muscles of a razgibately brush and fingers. Make ultrasonic, electrophysiologic and radiological researches for specification of the diagnosis.

Current of an outside epicondylitis chronic. In several weeks after rest creation to the corresponding muscles pain abates, sometimes on it several months leave. When resuming loading often celebrate a pain recurrence.
Unlike outside the internal epicondylitis is usually observed at persons of preferential easy physical work — typists, seamstresses, mounters, etc., is more often at women. Clinically it is shown by pains when pressing on an internal epicondyle, and also during the bending and pronation of a forearm. Pain irradiates along an inner edge of a forearm. Current of an internal epicondylitis, as well as outside, chronic.

Epicondylitis reasons:

The outside epicondylitis arises preferential at the persons making often repeating, stereotypic movements (extension and supination of a forearm), for example massage therapists, painters, carpenters, players in tennis and happens usually right-hand. Sometimes it is a consequence of a direct injury of an elbow. Men suffer more often than women.

Treatment of the Epicondylitis:

Treatment of an epicondylitis in most cases conservative. Appoint rest for muscles which tension of sinews is followed by emergence or strengthening of pain. At the expressed pain syndrome apply a plaster bandage 3 — 4 weeks. Appoint the antiinflammatory and anesthetizing medicines (Butadionum, Ortophenum, indometacin, etc.). Conduct a course of physiotherapeutic treatment — a novocaine solution electrophoresis, amplipulsetherapy, фонофорез a hydrocortisone, etc. For stopping of pain use laser therapy, cryotherapy (including cryomassage). In some cases the reflexotherapy is effective. The good therapeutic effect gives a combination of local cooling (irrigation of painful area coolant, for example Aether chloratus) with introduction to a point of the maximum morbidity of local anesthetic (novocaine, lidocaine, etc.) or a hydrocortisone. After that carry out slow passive extension of the muscles which are attached to outside (at an outside epicondylitis) or internal (at an internal epicondylitis) to an epicondyle. In certain cases, for example at inefficient conservative treatment or the accruing compression of the nerves passing a row, make operation — cutting off of a beam razgibatel of a brush in the place of its proximal attachment, a deep section to a bone in a painful zone, a section of the fascia covering extensor muscles, distalny an epicondyle, excision of tendinous and okolosukhozhilny fabrics in a painful zone, etc.

At a vertebrogenny syndrome of an epicondylitis carry out treatment of a basic disease — massage of a collar zone, remedial gymnastics, according to indications traction therapy, etc.