Tendinitis in the elbow
definition
A Tendinitis (Tendinitis, from Latin tendo = the tendon, or epicondylitis from Greek epi = around and condylos = the ankle) is a inflammatory disease of the attachment fibers one or more muscles. In most cases they are age and usage related degenerative change the tendon the trigger. As well on Elbow joint, which as a composite joint consists of a hinge and a so-called pivot joint, such tendinitis can become noticeable.
However, the cause is by no means in the elbow joint itself, but in the tendons of the muscles that work on the elbow joint. Either the muscles on the inside of the arm, which are used to flex the wrist and fingers, or the muscles on the outside of the arm, which act as an opponent for the extension, can be affected. In the vernacular, the irritation of the internal tendons is known as a golfer's elbow (Epicondylitis ulnaris humeri) and those of the external tendons as tennis elbows (Radialis humeric epicondylitis). Both clinical pictures are rarely present at the same time. Depending on the type and extent of movement, different complaints and restrictions can arise.
causes
The most frequent Cause of tendinitis general is the age-related regression of the tendon. Long-term overload (or just constant exposure) leave their mark. Major risk factors for developing tendinitis of the elbow are excessive physical activity without adequate rest breaks as well as a dirty technology at that very activity. Exercising with excessive weight and neglecting proper exercise can permanently damage tendons, muscles and joints. Also one repetitive uniform load, which stresses the same structures every time, increases the risk of developing epicondylitis. Especially sports such as tennis or golfwhich have even found their way into the slang term for the disease are typical of such repetitive stresses. But even without exercising, symptoms of tendinitis can occur. Other possible triggers include both occupational exposure for example in physical work as well Leisure activities of various kinds in question.
Tendonitis on the outside of the elbow / tennis elbow
Tennis elbow is the most common disease of the elbow and manifests itself with pain in the outer elbow. Tennis elbow causes inflammation of the common forearm extensor tendon that attaches to the bone at the elbow, e.g. through overloading individual muscle groups at work or on the sports field. Relief of the corresponding muscles should definitely be brought about; for this it is usually sufficient to avoid strenuous movements. Bandages and splints can also be helpful again, in more severe cases a plaster splint can also be attached. This conservative treatment, if performed correctly and with the additional use of anti-inflammatory ointments, is usually sufficient to quickly relieve the pain and soon to use the elbow to its full extent again.
The last resort of choice is an operation to cure or prevent chronification. The chances of success of the operation are around 90% and there are already some minimally invasive surgical techniques, some of which are even possible with local anesthesia and without hospitalization. The degenerated, i.e. damaged, tendon attachments are detached from the protruding bone and separated out.
We have the topic extensively on our page below Tennis elbow described.
If you suspect you have a tennis elbow, check our topic: The typical symptoms of tennis elbow
Tendonitis of the triceps
Also the Triceps, which acts as an arm extensor and on the Back of the upper arm sits, straddles the elbow, and can be the cause of pain from tendinitis of the elbow. The tendons of the triceps start a little below the elbow joint. Since the work of the triceps plays an important role both during exercise and in everyday life, tendinitis of the tendons of this muscle is not unlikely. Symptoms, causes and therapy are essentially the same for the treatment of a golfer's and tennis elbow. The main difference is the fact that triceps tendonitis occurs among those affected more strength athletes and bodybuilders and fewer ball athletes find just that Dumbbell training with heavy weights one special burden represents for the triceps.
Tendonitis on the inside of the elbow / golfer's elbow
Not to be confused with tendinitis of the inside of the elbow (golfer's elbow) is the clinical picture, which is referred to as the sulcus ulnaris syndrome. This is understood to mean strong compression or permanent damage to the ulnar nerve, which, as one of the large nerves of the forearm, supplies important muscle groups. It runs in an indentation in the elbow (Ulnar sulcus) that can be felt on the back of the elbow. In the further course this nerve runs on the inside of the forearm up to the wrist and finally into the palm of the hand. If the nerve is injured in the aforementioned indentation, the sulcus ulnaris, a sulcus ulnaris syndrome results. Classically, this type of nerve injury manifests itself not only in pain in the elbow but also in a misalignment of the fingers known as the "claw hand", sensory disturbances and / or tingling sensations in the hand area and a weakness of several small hand muscles (particularly badly affected: M. adductor pollicis). Nonetheless, isolated pain on the inside of the elbow can indicate the onset of sulcus ulnaris syndrome and should therefore be assessed and assessed by a doctor - even if there is a strong suspicion of a golfer's elbow.
Read more about this under What is a golfer's elbow?
Symptoms
Pain is the typical leading symptom of tendinitis on the elbow.Above all, so-called exercise-related pain - pain that occurs when the muscle that belongs to the inflamed tendon is used - is complained of by almost everyone. In addition, pressure pain can also occur at rest. This is perceived as particularly strong when the tendon is on tension, i.e. under tension. Last but not least, all other symptoms are similar to those of any other inflammation. The affected area is painful, swollen, reddened, overheated and no longer fully functional. The latter in particular is often indirectly a consequence of the pain. Movements that are perceived as uncomfortable are usually not done with pleasure. The arm remains more and more in a relieving position.
Read more about the topic here: Burning in the elbow
diagnosis
Usually the diagnosis can be called tendinitis clinical diagnosis be asked. The examining doctor asks the patient and has all the complaints described. Then some Movements testedin which the patient is asked, for example, to bend the wrist against resistance. In this way, it is already possible to determine fairly precisely whether and which muscle is in his function is disturbed or where exactly Localized pain is. Furthermore, important Bone points and Muscles such as Tendons felt. If this is also uncomfortable and painful for the person concerned, the diagnosis of tendinitis is already relatively clear. To Fuse the doctor can make a diagnosis of this Ultrasound examination perform and / or magnetic resonance imaging (MRI).
Despite all the possibilities, of course, no test is infallible and always has certain restrictions. If the patient has severe pain, but the doctor has no explanation for this, a so-called diagnostic arthroscopy are used. This type of brief surgery is a Jointoscopywhich allows a small camera to look inside the joint and to find a more precise diagnosis there. Depending on the picture presented to the surgeon during this examination, therapy can be carried out directly in the same work step.
therapy
But what should you do if you have tendinitis of the elbow? It is an important and quick remedy against (almost) any kind of inflammation cold. So you should cool the affected area quickly. The ice pack or something similar should be used never directly on the skin - in the worst case, this can cause the skin to freeze. Cooling through one is pleasant and effective envelope (e.g. a pillowcase or a thin towel through) for 5 to 10 minutesfollowed by about 5 minutes break. This procedure can be repeated as long as you like. Also, the tendon that has become infected should, if possible spared become. This means that the activity or sport that causes the pain in particular should be avoided. In addition, so-called tendinitis is recommended for the treatment of tendinitis NSAIDs, i.e. non-steroidal anti-inflammatory drugs - read: Painkiller. Ibuprofen, Voltaren® or Paracetamol inhibit the pain and fight the inflammation. Taken in tablet form, they can provide short-term relief for those affected. Since these drugs are of course not a solution in the long term, you should also use them qualified physiotherapy started to target the affected muscles and tendons too strengthen. All of these measures initially apply to acute tendinitis of the elbow at least half a year Application. One speaks of conservative therapy attempt, because one tries to cure the disease without further intervention. If after this period of time the Pain persists unchanged and / or those affected in Greatly restrict everyday lifeso you can have a operative therapy of tendinitis think.
Bandage / tape
The basic idea behind treating tendinitis in the elbow with the help of bandages is uniform compression of the muscles and other structures in the area of the inflamed area. They help with a tennis elbow as well as a golfer's elbow.
A properly used bandage can reduce the risk of recurrence, especially after a tendonitis has healed. Prefabricated bandages, which can be purchased, have proven to be just as effective as individually applied tape bandages. Both support the muscles from the outside and exert pressure. Bandages can offer a quick and easy solution, especially if you do not trust yourself to do the rather complex taping yourself. This effect can be explained by the fact that the muscles themselves tense less strongly under pressure from the outside, overload less quickly and thus inflammation occurs later. Regular stretching also helps to lower the so-called resting tone of the muscles and reduces the risk of developing a tennis or golfer's elbow.
Read more on this topic at:
- Kinesio tape for a tennis elbow
- Bandages for a tennis elbow
plaster
Immobilization and rest are, as already mentioned above, elementary therapy principles in the treatment of tendinitis of the elbow. Nonetheless, one should Plastering the arm - if only tendinitis and no other diseases are present - be waived.
A protection of the joint and the muscles can be guaranteed by far less cumbersome measures. In the case of immobilization in plaster of paris, there is even a additional risk to exacerbate the existing problem. Depending on the plastered position and the length of time the plaster cast is worn, it comes to Stiffening of the joint. Tendons and muscles shorten Range of motion is reduced. Since a low muscle tone, such as that caused by regular stretching, is beneficial for recovery, permanent stiffening has the opposite effect in the worst case. After a long break in a cast, shortened and untrained muscles and tendons are even less resilient than before and that The risk of provoking a tennis or golf elbow again is much higher.
surgery
After all conservative therapy options have been exhausted and the pain persists, many patients feel the desire for one other solution loud: many want one surgerythat fixes the cause of your problem and for Freedom from pain cares. Such an intervention is quite possible after the failure of conservative therapy makes sense from a medical point of view. For example, under a minimally invasive arthroscopy part of the chronically inflamed tendon is removed and disruptive tissue removed.
Read more about the Arthroscopy of the Elbow
The muscle function can be taken over by other tendon parts or even other muscles, so that no functional impairment are to be expected. In most cases, as the inflamed, irritated tendon is removed, the pain also goes away. Unfortunately there is no guarantee for the success of this operation. Since an operation is always accompanied by risks, this step should be carefully considered and discussed with an experienced doctor become. The patient's symptoms do not always improve after an operation.
Home remedies for tendinitis in the elbow
The most effective and proven home remedy for tendinitis of the elbow is rest! Resting and taking a break - especially with monotonous activities or sports - are also prophylactically the best that you can offer your tendons. In addition, it is advisable to always pay attention to the correct technique during sporting activities and to perform movements consciously and with concentration. As mentioned above, regular, careful stretching is also an effective remedy for tendinitis.
Click here for one Overview of different stretching exercises
The home remedies for treating inflammation also classically include cooling. It is quick and easy to do with ice, for example. Special refrigerated packs that are stored in the freezer or curd wraps also serve the same purpose. For the latter, normal quark is applied in a thick layer to the affected elbow, covered and left there until all the liquid has evaporated and the quark turns into solid pieces. This procedure can be repeated several times a day. Despite all of these helpful and simple home remedies, you should never forget to consult a doctor in good time, if necessary. While both tennis and golfer's elbows can be treated well in the fresh, acute stage, therapy is much more difficult after the symptoms have persisted for a long time.
Read also: Home remedies for tendinitis
Homeopathy for tendinitis in the elbow
In the case of tendinitis of the elbow, it is best to use Arnica D12 or Rhus toxicodendron D30 in the homeopathic medicine drawer. While the former counteracts inflammation, the latter is considered a medicine for the tendons. Both can significantly improve the symptoms. Under certain circumstances, they can also be taken alternately one after the other. If there is very strong pressure pain over the elbow, Symphytum D3 can also be considered. The dose is usually five globules twice a day. However, this information can vary depending on the individual case and should never be adopted without consultation. In general, nothing speaks against supporting the therapy of tendinitis of the elbow with the help of homeopathic medicines. If sufficient rest and rest as well as good cooling of the affected side are not neglected, there is a good chance that the symptoms will improve quickly. However, if this does not occur in some time, it is advisable to consult an experienced doctor as soon as possible and not to postpone the symptoms for too long.
Read more here Homeopathy for a tennis elbow
Shock wave therapy
Shock wave therapy is now a popular treatment approach. For many, it is the last step before an operation. This should result in local tissue irritation and thus increased blood flow. Just like the release of growth factors for regeneration and new tissue formation, the relief of pain and also the acceleration of the healing process.
To achieve the effects described, the head of the shock wave device is placed on the painful area of the elbow that has been coated with gel. The shock waves are sent out as ultrasonic waves which exert pressure on the tissue. Depending on the degree of inflammation / calcification, these can now be set to be low or high in energy. Shock wave therapy is also said to promote bone growth. With this, higher energetic pressure waves are required accordingly.
Read more on this topic at:
- Shock wave therapy
- Shock wave therapy to treat tennis elbow
Duration
Tendonitis of the elbow can at best be a brief, painful warning to the body be that something is going wrong. In the worst case, they can become one chronic illness and cannot be treated properly for years. In between there are an infinite number of gradations and just as many time periods. The Healing of a one-off, mild tendinitis can be completed after about 10 to 14 days with consistent restraintso that physiotherapy exercises can then begin. If a patient ignores tendinitis in the elbow, however, and does not stop the load or continues to train too quickly, a langer chronic course of the disease start making it difficult to control the pain. In order to keep the duration of a tendinitis as short as possible, one should follow up quickly See a doctor if you notice the first signs and carefully treat the joint, including the muscles and tendons.
