Lateral Epicondylalgia
October 4th 2007 10:39
Introduction
“Lateral epicondylalgia” as the name implies is a condition characterized by pain over the lateral epicondyle. Classically clinicians use the terms “tennis elbow” and “lateral epicondylitis” when referring to traumatic types of affectation, since these terms convey the extrinsic and intrinsic incidents that might explain the mechanical occurrence of this condition. Tennis elbow is used to denote its occurrence among tennis players caused by faulty biomechanics in a backhand stroke, observed when they flex and pronate the wrist (referring to the limb holding the racket), with inadequate forward lean of the trunk (Braddom et al, 1996). On the other hand the term lateral epicondylitis implies the presence of inflammation over the epicondyle (common origin of the wrist extensors), suspected to elicit the pain and functional limitation among persons having such condition.
In this discourse, we shall be using the term lateral epicondylalgia in discussing possible factors that can produce pain over the lateral epicondyle, since we will be focusing not only on the traumatic events that happen over the common origin of the wrist extensors, but also on the faulty biomechanics on the cervical spine causing neurological pain over the lateral epicondyle, as well as problems concerning local articular, ligamentous, and neural systems, and the incidents of malalignment of the forearm bones.
After all, the terms tennis elbow and lateral epicondylitis being used to refer to traumatic type of affectation has been recently questioned by researchers. Inappropriateness of the term tennis elbow can be highlighted if we are to closely examine the prevalence of the condition. Although many tennis players may experience this condition, most cases are associated with work-related activities or have no obvious precipitating factors. On the other hand the applicability of the term lateral epicondylitis has been contested since evidences show the absence of inflammatory cells on examined tendons but notes presence of fibroblasts and immature collagen on the area, ruling out tendonitis and instead confirming presence of tendinosis. Because of this, we can infer that even with cumulative stress that may severe the lateral epicondyle or the tendons and muscle bellies attached to it, inflammation may not be the primary cause of pain among patients.
Other literatures emphasize that pain (mechanical and degenerative type) over the lateral epicondyle could not have been necessarily produced by inflammatory mechanism. Instead researchers mention other factors like increased lactic acid and chondroitin sulfate over the degenerated tendons, acting to activate peritendinous nociceptors (Waugh, 2005).
TO BE CONTINUED...
“Lateral epicondylalgia” as the name implies is a condition characterized by pain over the lateral epicondyle. Classically clinicians use the terms “tennis elbow” and “lateral epicondylitis” when referring to traumatic types of affectation, since these terms convey the extrinsic and intrinsic incidents that might explain the mechanical occurrence of this condition. Tennis elbow is used to denote its occurrence among tennis players caused by faulty biomechanics in a backhand stroke, observed when they flex and pronate the wrist (referring to the limb holding the racket), with inadequate forward lean of the trunk (Braddom et al, 1996). On the other hand the term lateral epicondylitis implies the presence of inflammation over the epicondyle (common origin of the wrist extensors), suspected to elicit the pain and functional limitation among persons having such condition.
In this discourse, we shall be using the term lateral epicondylalgia in discussing possible factors that can produce pain over the lateral epicondyle, since we will be focusing not only on the traumatic events that happen over the common origin of the wrist extensors, but also on the faulty biomechanics on the cervical spine causing neurological pain over the lateral epicondyle, as well as problems concerning local articular, ligamentous, and neural systems, and the incidents of malalignment of the forearm bones.
After all, the terms tennis elbow and lateral epicondylitis being used to refer to traumatic type of affectation has been recently questioned by researchers. Inappropriateness of the term tennis elbow can be highlighted if we are to closely examine the prevalence of the condition. Although many tennis players may experience this condition, most cases are associated with work-related activities or have no obvious precipitating factors. On the other hand the applicability of the term lateral epicondylitis has been contested since evidences show the absence of inflammatory cells on examined tendons but notes presence of fibroblasts and immature collagen on the area, ruling out tendonitis and instead confirming presence of tendinosis. Because of this, we can infer that even with cumulative stress that may severe the lateral epicondyle or the tendons and muscle bellies attached to it, inflammation may not be the primary cause of pain among patients.
Other literatures emphasize that pain (mechanical and degenerative type) over the lateral epicondyle could not have been necessarily produced by inflammatory mechanism. Instead researchers mention other factors like increased lactic acid and chondroitin sulfate over the degenerated tendons, acting to activate peritendinous nociceptors (Waugh, 2005).
TO BE CONTINUED...
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