LATERAL AND MEDIAL EPICONDYLITIS

AND ARTHRITIS

Prepared by M. Rashid Hussain

LATERAL EPICONDYLITIS:
Lateral epicondylitis, commonly known as tennis elbow, is
swelling of the tendons that bend your wrist backward away from
your palm.
 The tendon most likely involved in tennis elbow is called
the extensor carpi radialis brevis. Tennis elbow is usually
diagnosed in both men and women between the ages of 30 and
50 years.
CAUSES OF TENNIS ELBOW:
Tennis elbow may be caused by:
 Weak shoulder and wrist muscles
 Using a tennis racket that is too tightly strung or too short
 Other racquet sports, like racquetball or squash
 Painting with a brush or roller
 Operating a chain saw
 Frequent use of other hand tools on a regular basis
SYMPTOMS OF TENNIS ELBOW:

 The following are the most common symptoms of tennis

elbow.
 Pain
 Burning, or an ache along the outside of your forearm and
elbow. 
 A weak grip is another symptom of tennis elbow.
DIAGNOSIS OF TENNIS ELBOW:
Your healthcare provider can usually diagnosis your tennis elbow by
a physical exam. In some cases, you may certain tests, such as:
 X-ray
 Magnetic resonance imaging (MRI)
  Electromyography (EMG)
TENNIS ELBOW TREATMENT:
Treatment may include:
 Rest and stopping the activity that produces the symptoms
 Ice packs (to reduce inflammation)
 Strengthening and stretching exercises
 Anti-inflammatory medicines (such as ibuprofen or naproxen)
 Bracing(Tennis elbow brace) the area to keep it still for a few weeks or
use of a special brace with activities
 Steroid injections to help reduce swelling and pain
MEDIAL EPICONDYLITIS:
Golfer's elbow, also known as medial epicondylitis, is caused
by damage to the muscles (Pronator teres and the Flexor Carpi
Radialis) and tendons that control your wrist and fingers. The
damage is typically related to excess or repeated stress
especially forceful wrist and finger motions.
Golfer's elbow is a condition that causes pain where the
tendons of your forearm muscles attach to the bony bump on
the inside of the elbow. The pain might spread into your
forearm and wrist.
CAUSES OF MEDIAL EPICONDYLITIS:
Improper lifting, throwing or hitting, as well as too little warmup or poor conditioning, also can
contribute to golfer's elbow.
Besides golf, many activities and occupations can lead to golfer's elbow, including:
 Racket sports: Improper technique with tennis strokes, especially the backhand, can cause
injury to the tendon.
 Throwing sports: Improper pitching technique in baseball or softball can be another culprit.
Football, archery and javelin throwing also can cause golfer's elbow.
 Weight training: Lifting weights using improper technique, such as curling the wrists during a
biceps exercise, can overload the elbow muscles and tendons.
 Forceful, repetitive occupational movements: These occur in fields such as construction,
plumbing and carpentry
SYMPTOMS:
Golfer's elbow is characterized by:
 Pain and tenderness: Usually felt on the inner side of your elbow, the pain
sometimes extends along the inner side of your forearm.
 Stiffness: Your elbow may feel stiff, and making a fist might hurt.
 Weakness: You may have weakness in your hands and wrists.
 Numbness or tingling. These sensations might radiate into one or more
fingers usually the ring and little fingers.
DIAGNOSIS:
Golfer's elbow is usually diagnosed based on your medical history and a
physical exam. To evaluate pain and stiffness, the doctor might apply pressure
to the affected area or ask you to move your elbow, wrist and fingers in various
ways.
 An X-ray can help the doctor rule out other causes of elbow pain.
 Rarely, more comprehensive imaging studies such as MRI are performed
TREATMENT:
 Rest: Put your repetitive activities on hold until the pain is gone. If you return to activity too
soon, you can worsen your condition.
 Ice the affected area: Apply ice packs to your elbow for 15 to 20 minutes at a time, three
to four times a day for several days. To protect your skin, wrap the ice packs in a thin towel.
 Use a brace: wear a counterforce brace on your affected arm, which might reduce tendon
and muscle strain.
 Stretch and strengthen the affected area: doctor might suggest exercises for stretching
and strengthening. Other physical or occupational therapy practices can be helpful too.
ARTHRITIS:

 Arthritis is a disease that affects your joints (areas where your

bones meet and move).
 Arthritis usually involves inflammation or degeneration (breakdown)
of your joints.
 These changes can cause pain when you use the joint.
AREAS OF ARTHRITIS:

 Feet.
 Hands.
 Hips.
 Knees.
 Lower back.

OSTEO ARTHRITIS:
 With the development of OA, the cartilage at
the ends of your bones deteriorates from
wear and tear. Cartilage is a protective
cushion that helps bones in joints move and
RHEUMATOID ARTHRITIS:
 Unlike OA, rheumatoid arthritis (RA) is an
autoimmune disease. An autoimmune disease is a
disease where your body’s immune system attacks
parts of your body.
 With RA specifically, the immune system attacks the
lining of the joint capsules. This results in
inflammation and can thicken the lining of the
membranes that surround a joint. With the 
thickening of this membrane, bone cartilage can be
destroyed. Joints can even lose their shape over time.

glide smoothly.
 With the loss of this protective tissue, bone
begins to grind against bone. This leads to
pain, stiffness, tenderness, loss of range of
motion, and a grating sensation in the joint.
Common joints affected include knees, hip,
and hands.
CAUSES:
 wear and tear of a joint from overuse
 age (OA is most common in adults over age 50)
 injuries
 obesity
 autoimmune disorders
 genes or family history
 muscle weakness
SYMPTOMS:
 Pain.
 Redness.
 Stiffness.
 Swelling.
 Tenderness.
 Warmth.
DIAGNOSIS:
 X-ray. X-rays may show joint changes and bone damage found in
some types of arthritis. Other imaging tests may also be done.
 Ultrasound. Ultrasound uses sound waves (not radiation) to see the
quality of synovial tissue, tendons, ligaments, and bones.
 Magnetic resonance imaging (MRI). MRI images are more
detailed than X-rays. They may show damage to joints, including
muscles, ligaments, and cartilage.
CONT…..
Arthroscopy:
This procedure uses a thin tube containing a light and camera (arthroscope) to
look inside the joint. The arthroscope is inserted into the joint through a small
incision. Images of the inside of the joint are projected onto a screen. It is used
to evaluate any degenerative and/or arthritic changes in the joint; to detect bone
diseases and tumors; to determine the cause of bone pain and inflammation,
and to treat certain conditions.
NON SURGICAL TREATMENT:
Medication: Anti-inflammatory and pain medications may help relieve your arthritis
symptoms. Some medications, called biologics, target your immune system’s
inflammatory response.
Physical therapy: Rehabilitation can help improve strength, range of motion and
overall mobility.
Therapeutic injections: Cortisone shots may help temporarily relieve pain and
inflammation in your joints. Arthritis in certain joints, such as your knee, may improve
with a treatment called viscosupplementation. It injects lubricant to help joints move
smoothly.
SURGICAL TREATMENT:

Fusion: Two or more bones are permanently fused together. Fusion immobilizes

a joint and reduces pain caused by movement.
Joint replacement: A damaged, arthritic joint gets replaced with an artificial joint.
Joint replacement preserves joint function and movement. Examples include 
ankle replacement, hip replacement, knee replacement and 
shoulder replacement.
ORTHOTIC TREATMENT:
 Simple orthotics are used in the treatment of osteoarthritis of the knee and fingers. They do
not allow straightening the joint, but provide stabilization of the joint and can provide relief.
Thus, they can be useful for people who are inoperable and who suffer from severe
osteoarthritis.
 Elastic knee brace, dynamic splints used in sport. Mainly used in cases of osteoarthritis of
the knee, they aim to correct the joint.
 Rest or immobilization splints used for the wrist and especially the hand (osteoarthritis of the
fingers) enable placing the joint in a position that relieves stress and guards against deformity.
They seem to bring real benefits as 40% of patients using a hand orthosis wears it for another
5 years after the prescription.