Epicondylitis is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Tendinopathy of the elbow characterized by pain and tenderness at the origins of the wrist flexors/extensors at the humeral epicondyles
  • May be acute (traumatic) or chronic (overuse)
  • Two types
    • Medial epicondylitis (“golfer’s elbow”)
      • Involves the wrist flexors and pronators, which originate at the medial epicondyle
    • Lateral epicondylitis (“tennis elbow”)
      • Involves the wrist extensors and supinators, which originate at the lateral epicondyle
  • May be caused by many different athletic or occupational activities
  • Common in carpenters, plumbers, gardeners, and athletes
  • Usually involves the dominant arm
  • Lateral epicondylitis is more common.

Epidemiology

  • Predominant age: >40 years
  • Predominant sex: male = female

Incidence
  • Common overuse injury
  • Lateral > medial
  • Estimated between 1% and 3%
Prevalence
  • Lateral epicondylitis: 1.3%
  • Medial epicondylitis: 0.4%

Etiology and Pathophysiology

  • Acute (tendonitis)
    • Inflammatory response to injury
  • Chronic (tendinosis)
    • Overuse injury
    • Tendon degeneration, fibroblast proliferation, microvascular proliferation, lack of inflammatory response
  • Repetitive wrist flexion or extension places strain across enthesis of flexor/extensor group.
  • Tool/racquet gripping
  • Shaking hands
  • Sudden maximal muscle contraction
  • Direct blow

Risk Factors

  • Repetitive wrist motions
    • Flexion/pronation: medial
    • Extension/supination: lateral
  • Smoking
  • Obesity
  • Upper extremity forceful activities

General Prevention

  • Limit overuse of the wrist flexors, extensors, pronators, and supinators.
  • Use proper techniques when working with hand tools or playing racquet sports.
  • Use lighter tools and smaller grips.

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Citation

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TY - ELEC T1 - Epicondylitis ID - 116210 ED - Baldor,Robert A, ED - Domino,Frank J, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116210/all/Epicondylitis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -