Via practica 1/2017

Lateral epicondylitis – chronic enthesopathies related not only to athletes

Lateral epicondylitis is one of the most common in human body. Ethiopathogenesis is multifactorial with overuse and micro trauma being the most common causes. It is enthesopathies of the middle age. Detailed history, clinical examination and X-ray examination are important in the differential diagnosis; ultrasound, thermography and scintigraphy can assist in ambiguous cases. Goal of therapy is pain reduction and return to full activity. We suggest starting therapy with conservative treatment including rest, topical and systemic use of non-steroidal anti-inflammatory medication and injection therapy. Braces, tapes, rehabilitation and physical therapy are part of treatment too, however, their use was not associated with significant improvement in majority of the studies. Required aspect of the therapy is patient understanding with the nature and character of the disease and treatment duration. Failure of conservative therapy after 12 months or recurrences is indications for surgery. Early surgery can prevent structural changes in the humeroradial joint and in soft tissues. Type of surgery depends on experience of the surgeon. Open, percutaneous and arthroscopic techniques show similar results with faster return to work with arthroscopic procedure.

Keywords: lateral epicondylitis, tennis elbow, enthesopathy