For many, epicondylitis causes long-lasting pain. What is commonly referred to as tennis elbow or mouse arm can affect anyone.
You don't even have to play tennis to do this.
Anyone who works with their hand and arm more or less daily can be affected by epicondylitis, which is one of the most common causes of pain in the musculoskeletal system.
Typing and working with the hand in a hyperextended position at the wrist can trigger the typical pain syndrome at the tendon origins in the elbow.
In this article you will learn:
What is epicondylitis?
Why am I the one affected by this?
You can do this yourself to alleviate the symptoms.
What effect do ointments and shock waves have on mouse arm?
When is surgery advisable for epicondylitis?
These days, we all spend a lot of time on computers, and we also use our cell phones constantly. Manual work, multitasking, and constant tension are typical triggers for high muscle and tendon tone in the arms.
One-sided work and permanently high muscle tension can lead to overload at the tendon attachments, which can cause epicondylitis.
What is epicondylitis and why am I affected?
Due to chronic overload, there is a temporary reduction in tissue blood flow.
The epicondyle is a bony protrusion at the elbow where the tendons of the wrist and finger muscles originate. Pain that occurs at the tendon origin, i.e., the epicondyle, is referred to as epicondylitis.
In the past, epicondylitis on the outer elbow protrusion was frequently observed in tennis players, which is why the term tennis elbow has become established.
The same phenomenon can also be observed on the inner side of the elbow, which is referred to as golfer's elbow. The varying stress on the arms during sport-specific movements can therefore cause overload in different areas.
If the muscles that lift the fingers and wrist are affected, the outer bony prominence of the elbow is usually affected, and this is referred to as lateral epicondylitis. Conversely, strain on the finger flexors and wrist flexors leads to problems on the inner bony prominence.
It was previously assumed that epicondylitis was caused by an inflammatory mechanism. Research now suggests that it is not inflammation, but rather that overload causes reduced blood flow to the tendon tissue.
In an advanced stage of epicondylitis, the damaged tissue at the bony origin can die.
Professions such as bakers, cooks, florists or the "desk worker" are particularly frequently affected by epicondylitis.
People who do a lot of manual work are particularly affected. Using a mouse or mouse pad for extended periods can also cause elbow pain.
At first, it feels like muscle soreness. Later, it develops into a dull, and later sharp, pain that can be triggered by any movement or pressure.
I can do that myself if I have tennis elbow.
Prevention is better than any therapy!
At the first signs of epicondylitis, you should consider the activities that are most likely to trigger your symptoms. These activities are often related to work or your favorite sport.
In many cases, it helps to check your arm position at your workstation and adjust it if necessary, or to temporarily adopt a different work routine. For persistent mouse arm, adjusting your arm position helps. However, bent wrists should not place excessive strain on the fingers.
Stretching the affected muscles and tendons has a preventative effect. This loosens the fibers and prevents them from cramping.
Eccentric stretching training of the wrist extensors is very suitable for this. In this training the hand is lifted upwards by the healthy arm and then stretched downwards using a light weight, e.g. 1 kg.
In another exercise, the arm can be stretched out and bent at the wrist by the hand of the opposite side, thereby stretching the extensor tendons at the elbow.
What other non-surgical treatment methods are there?
In addition to stretching the tendons, massages and acupuncture can reduce the symptoms.
Following the principle "whatever helps is allowed," ointments, shock wave therapy, or manual therapy can be used. Taking painkillers can be considered in the short term, but it's more important to change your behavior and the strain on your arm so that the symptoms subside even after stopping the painkillers.
Sometimes, a period of rest and abstinence from sports may be necessary to allow the pathology to heal. Mobility should be maintained.
Caution is advised when using cortisone injections. While they may work wonders in the short term, they lead to progressive tendon tissue death in the medium term and should therefore be used with caution.
Cortisone injections should not be administered more than once or twice a year, as they can cause lasting tissue damage and, in advanced stages, can cause elbow instability, which can worsen the problem.
An injection with ACP/PRP is less anti-inflammatory and tends to promote healing. In this procedure, the body's own blood components are injected into the area of the tendon injury to support the healing process.
What are the benefits of ointments for mouse arm?
For mouse arm, ointments that relieve pain or inflammation are primarily used. These usually contain medications such as diclofenac, which have little to no side effects when applied topically.
Their benefits vary from patient to patient. Since ointments carry few risks, it's worth applying them to your painful elbow for a while to see if you experience any relief.
Painkillers and anti-inflammatory medications can also be taken as tablets, for example with the active ingredients ibuprofen or paracetamol.
Does shock wave therapy only hurt,
or does it actually do something?
Shockwave therapy is a proven treatment option for chronic irritation of the tendon insertion. The electromagnetically generated waves exert pressure on the tissue, thereby promoting blood circulation. Shockwave treatment can also stimulate biological regeneration.
By altering the permeability of the cell membrane, mitochondria can be activated in the cells, promoting the production of the energy storage compound adenosine triphosphate. Furthermore, some studies have shown that growth factors can be released in increased amounts.
One disadvantage of shockwave treatment is that it can cause pain due to the waves that occur at the bone and nerve endings. But don't worry, the pulse rate and intensity are set at a low level beforehand and can be adjusted during the treatment. Patients generally tolerate shockwave treatment very well. Unfortunately, the costs of shockwave treatment on the elbow are not covered by health insurance, so patients must cover the costs themselves.
When is surgery advisable for epicondylitis?
If the condition is chronic and very painful and conservative therapy is unsuccessful despite several months of treatment, a keyhole procedure is suitable for removing the damaged and painful tissue.
This procedure is useful if the symptoms can no longer be controlled despite conservative measures over a longer period of time and there is no instability of the elbow joint.
In case of elbow instability, another procedure should be used in which a strip of the body's own tendon (e.g. triceps tendon) is transplanted to the affected area to replace the tendon tissue and restore the stability of the joint.
Conclusion:
Nowadays, constant work on the computer, mobile phone, multitasking and constant tension are typical triggers for mouse arm.
Lateral epicondylitis describes an overload syndrome of the wrist extensors at their tendon origin on the outer elbow.
As a preventative measure, it helps to stretch the affected muscles and tendons, as this loosens the fibers and prevents them from cramping as quickly.
The benefits of ointments and shock waves vary from patient to patient. It is worthwhile to combine various conservative treatment options with eccentric stretching exercises.
Surgery is only necessary in a few cases where the symptoms cannot be controlled despite several months of conservative measures, or where joint instability is present.
How does minimally invasive surgery for epicondylitis work?
Would you like to know how a minimally invasive procedure for tennis elbow is performed?
Then make an appointment with our specialist :
Specialist in orthopedics
and trauma surgery,
Sports medicine
Comments