A Comprehensive Guide to Epicondylitis Treatment

Often athletes such as golfers, cricketers, and tennis players, among others, develop a painful inflammation in their elbow muscles as a result of excessive stress in the arm tendons. The musculoskeletal disorder is also known as Epicondylitis and one of the most common muscular disorders. Epicondylitis is classified into two categories - Medial Epicondylitis (also known as golfer's elbow) and Lateral Epicondylitis (otherwise known as tennis elbow). Indulging in repetitive hand movement activities such as throwing a ball, using an ax to chop wood, using hand tools and using a chain-saw can lead to these conditions. Let us delve deeper into this condition, through this blog post, and develop an understanding of the various aspects of Epicondylitis.

Anatomy

First up, we have the Golfer's elbow, otherwise known as the medial epicondyle. The condition is identifiable through the discomforting pain caused on the inside part of the elbow. Primarily, golfer’s elbow develops in the wrist flexor muscles of the forearm that pull the hands forward and the flexor tendon on the medial epicondyle. On the other hand, tennis elbow causes severe pain on the outer part of the elbow, in the forearm extensor muscles that bend the wrist back, and the single tendon on the lateral epicondyle.

Causes

Any inflammation in the tendon muscle is known as tendonitis. Inflammation around the medial epicondyle is referred to as the medial epicondylitis, whereas those around the lateral epicondyle is known as lateral epicondylitis. Both of these conditions occur due to wear and tear of the cells in the tendons, resulting in tissue degeneration. Any degenerated tendon has an unnatural arrangement of collagen fibers, which are further injured due to the production of fibroblasts in the body. Eventually, due to excessive tearing of the muscle tissues in the tendon, and lack of recovery time, the resultant scar tissue formed by the body stops healing, leaving the injured areas weak, with symptoms of pain and inflammation.

Surgical treatment

Surgical treatment of medial epicondylitis and lateral epicondylitis is often the viable option to remediate chronic case of epicondylitis.

Tendon Debridement

First up, we have the tendon debridement, wherein the surgeons remediate the contingencies caused by tendonosis, by debriding (taking out) the affected tissues within the tendon. The surgeons create a small incision in the affected area and remove only the damaged tissue while cleaning up the tendon.

Tendon Release

One of the most common arthroscopic surgical treatments of medial epicondylitis is known as a medial epicondyle release. The surgical treatment for the lateral epicondylitis treatment is known as lateral epicondyle release. Medial epicondylitis releases tension off the flexor tendon. The surgery begins by the creation of an incision over the medial epicondyle along the arm. Subsequently, the surgeon exposes the point where the flexor tendon attaches itself to the medial epicondyle. The flexor tendon is severed and split to remove any scar tissue, while the loose end of the tendon is sutured to the fascia tissue nearby. In the arthroscopic treatment for lateral epicondylitis, surgeons resort to the similar procedure. The surgeons furbish an incision over the lateral epicondyle to expose the point where the extensor tendon attaches itself to the lateral epicondyle. Subsequently, the surgeon splits the tendon, removes any scar tissue and suture the loose end to fascia tissue nearby. The surgery concludes by stitching up of the skin.

Wrapping Up

Arthroscopic surgical treatments medial epicondylitis and lateral epicondylitis are an outpatient process wherein patients do not have to stay overnight in the hospital. Additionally, surgeons use a general anesthetic or a regional anesthetic, as per the severity of the condition. Surgeons also prefer using an axillary block to numb the patient’s arm.