The mechanism of disease development
Professor Jack Harvey notes that the problem"Tennis" elbow is extremely complex and currently poorly soluble. She, in turn, is associated with a very broad problem of connective tissue adaptation to the modern household and industrial loads.
Before sports medicine is very difficulttask - to help the ligaments and muscles athlete withstand the overload, without which it can not do none of the competition. The mechanism of the disease is quite clear. In the very early part of the tendons of the extensor muscles and arch support (arch support - arm, rotating the hand outwards-pronator muscle rotates the hand inside) due to significant stresses and vibrations at impact the ball with the racket there is inflammation and slight swelling. Inflammation muscle attachments to bone is the cause of acute and chronic pain, and inability to produce full strokes.
There is also an opinion that at the time of reductionmuscle tendon infringed on bony prominences condyle aponeurosis surrounding them, which leads to disruption of the circulation and the development of degenerative changes in the tendon. At rest, the pain is absent and appears only when probing the outer epicondyle and certain movements - extension and supination of the forearm, especially when combinations of these movements (positive symptom Welch). Flexion and pronation of the forearm is usually painless. Passive movement (extension and supination) forearm painful only in providing resistance. Pain increases when compressing the hand into a fist, and while bending at the wrist joint (Tompsena symptom). The pain usually is progressive in nature, painful are the lightest movement, produced with the participation of the affected tendon (for example, when an athlete is holding something in his hand bent).
The main symptom of lateral epicondylitispain is localized on the outer side of the elbow. The pain may spread across the back surface of the forearm and hand, and even reach the fingers. It may also be marked tenderness and stiffness of the forearm muscles. The pain is worse when the brush back extension, and when turning the forearm, palm up. Holding in his hand heavy objects also increases the pain. For some patients, due to increased pain even from the refrigerator carton of milk is enough challenge.
Initially, the doctor find out the details of storiesyour disease. You will answer questions about the nature of pain, possible injuries elbow region in the past, as well as professional sports and loads. Physical examination is a very important step in the diagnosis of epicondylitis. For the diagnosis of this disease and specific diagnostic tests can be performed physician.
You may be scheduled X-ray study of the elbow joint. This will rule out other diseases manifested by pain in the elbow.
The symptoms of lateral epicondylitis are very similarsymptoms of another disease, called radial tunnel syndrome. This disease is caused by compression of the radial nerve at the elbow. If the pain does not decrease in the conservative treatment of epicondylitis, the doctor may prescribe diagnostic tests to rule out the tunnel neuropathy.
When an obscure diagnosis appointed specialresearch methods. Magnetic resonance imaging - a method of research of bone and soft tissue using magnetic waves. Ultrasound examination is based on the difference in the reflection of tissues with different density and structure of the ultrasonic signals generated by a specific sensor. These methods are highly informative studies, completely safe and painless.
Current chronic epicondylitis. After a few weeks, and sometimes months, the pain subsided and recovery occurs, but with proper treatment and relative calm. However, when returning to the intensive lessons disease can be resumed. In some cases, the disease can last for several years.