Free Lateral Epicondylitis Research Paper Example

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Abstract

The Lateral Epicondylitis disease, often known as the tennis elbow disease, is becoming quite common in the sports the world, so I decided to investigate the causes and treatment. The main cause of the disease is a sudden and forceful pull or shock hat ruptures one’s extensor carpi radial Brevis. This causes intense pain in the elbow, wrist and arm and often limits the movement of the entire arm, especially movements that strain the wrist. MRI scans and X-rays can help determine the disease, and while physiotherapy and medications work well, surgery is the quickest way to get rid of the disease.
Lateral Epicondylitis is “also commonly known as the Tennis Elbow disease, and it mostly occurs when the outer part of one’s elbow becomes tender and swollen.” (Smidtet al, 2002).Basically, the tendons get inflamed as a result of overuse and over-exercise as well. This mostly happens when the elbow has to perform the same functions over and over again constantly, and since they are not given a chance to rest, they end up getting inflamed.
The reason, I have chosen the topic, is the fact that it recently has been springing up quite commonly in international sports. The most famous recent case was when sports entertainer and wrestler John Cena suffered from the disease. Since I am an acute follower of almost all kinds of world sports, I decided to further investigate the disease to see why it was so common in sports and in other activities that require intense exertion as well.

Symptoms

There are many varying symptoms of the said disease, and the way, they manifest in every person, depends highly on each person’s body type. To begin with, there is a high amount of pain in the outer part of the elbow which is sometimes radiated out to one’s forearm as well. Sometimes, when the disease is extremely intense, it will move on to one’s wrist as well, especially when the wrist suffers from an extension. There is also a point of tenderness on the lateral epicondylitis which is a very dominant bone part on one’s elbow. One will also suffer from pain when they lift heavy objects, grab things in general, and when it gets extremely intense, people will also experience pain in simple movements as well. If one carries out movements that extend their wrists, they are likely to suffer from pain as well. These movements can include pouring out liquids and any other movement that involves the wrists to function. In the morning, people will suffer from stiffness as well on the arm that has the tennis elbow. “The symptoms may be similar to what one may go through if they suffer from golfer’s elbow, but the position of the swelling is relatively different.” (Smidtet al, 2002)

Causes

In the early stages of research on the disease, most people believed that the disease was mostly caused simply by overexertion of one’s elbow and by tiring it out too much. However, later research disproved this was always the case as a new reason or cause was discovered soon. Research carried out later on showed that more than fifty percent of tennis elbow diseases were caused by a sudden shock or hit on one’s epicondyle. “Other causes were classified as a sudden and forceful pull on the arm or forceful use of one’s arm (which put strain on the elbow) when one is in pain. Some studies shows that the shock caused by misplaying a tennis shot may also cause tennis elbow.” (Gruchow, 1979).
Cyriax has a certain hypothesis on how the disease actually occurs. He states that there are tears between both the internal and external tendons and on the periosteum of one’s lateral epicondyle as well. There are also certain researchers that show a deep connection between one’s radial nerve and tennis elbow. Therefore, disorders that are caused or effect the radial nerve, like carpal tunnel syndrome and rotator cuff, may increase the chances of tennis elbow. There is no common census on the actual cause of the disease.

Diagnosis

Now that we have established how the disease is caused and what the signs and symptoms are, we must learn how one can establish the disease as tennis elbow.
In order to determine if painful elbows are actually tennis elbow, Battery tests are conducted where the tester will exert pressure on the affected area and ask the sufferer to move the elbow, wrist and arm systematically. If the pain is actually being caused by something other than tennis elbow, X-ray results will reveal that quite easily. MRI tests can also be conducted although it is highly expensive. However, they are usually better at determining the point where the excess fluids and inflammation has taken place. Characteristic signs help in a systematic diagnosis of the tennis elbow injury. Most importantly, the patient will feel pain on the tender points when they stretch their arm to the full extent. Passive and resistive wrist extension tests are also conducted along with the middle finger extension tests. All the tests help determine how severe the disease actually is.
“The actual body part that is greatly affected is known as the extensor carpi radialis Brevis – this is where the swelling and liquid accumulation takes place. Depending on the severity of the pain and the disease, one’s extensor carpi radialis Brevis may never be properly cured by simply going for conservative treatment.” (Gurchow, 1979). If there are inflammatory changes taking place in the extensor carpi radialis Brevis, the condition can easily be reversed. If, however, the origin of the extensor carpi radialis Brevis's muscle is ruptured, if nonreversible pathologic variations to source of the ECRB muscle is caused or if secondary changes occur, the disease will never be fully and completely cured.

Treatment

There are many ways to cure the tennis elbow disease including natural methods, surgery and conservative medicine although due to the intensity of the disease, it is highly likely that no one method can be used to fully cures the disease in the short-term. The disease may eventually heal itself, but that will take several weeks or even months.
Physiotherapy is extremely important if one wants to completely cure the disease. Massage and manipulation are common ways to restore movement to the affected areas. They also people how to cure the disease through mobile exercises.
However, medication is the most important part of the disease. NSAIDS will temporarily relieve the pain although their effectiveness are less commonly agreed upon (there are mixed views about it). Injections are no more effective than the NSAIDS. “Botulinum toxin type A is a better option than anything else available. Surgery, at the end of the day, is better than most other options since it quickly removes the inflammation.” (Lo, 2007).

References

NynkeSmidt, Daniëlle A W M van der Windt, Willem J JAssendelft, Walter L J M Devillé, Ingeborg B C Korthals-de Bos, Lex M Bouter, (2002). Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomised controlled trial. The Lancet. 359 (e.g. 2), pp.657-662
Gruchow, William, and Douglas Pelletier., (1979). An epidemiologic study of tennis elbow: Incidence, recurrence, and effectiveness of prevention strategies.. American Journal of Sports Medicine..7 (4), pp.234-238.
Lo, MY; Safran, MR, (2007). Surgical treatment of lateral epicondylitis: a systematic review. Clinical Orthopaedics and Related research. 463 (), pp.98–106