The Difficulty of Establishing Effective Treatments for Lateral Elbow Tendinopathy
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 7, Issue 4
Abstract
Although the signs and symptoms of Lateral Elbow Tendinopathy (LET) are clear and its diagnosis is easy, to date, no ideal treatment has emerged. It is important to understand why it has proved difficult for previous workers to establish effective treatments for LET. This may be due to the difficulty of establishing nomenclature, pathophysiology, etiology, epidemiology, diagnosis and conservative treatment of the condition. Difficulties with Nomenclature A cursory search through existing literature reveals a plethora of terms that have been used to describe LET. These include (i) tennis elbow (TE), (ii) extensor tendonitis, (iii) extensor tendinosis, (iv) extensor tendinopathy, (v) lateral epicondylalgia, (vi) lateral epicondylitis and (vii) LET. However, it was the description of hypothetical condition by Morris of “lawn tennis arm” in 1882 that instigated the use of the term LET in medicine. LET seems to be the most appropriate term to use in clinical practice because all the other terms such as lateral epicondylitis, lateral epicondylalgia, lateral epicondylosis and/or tennis elbow make reference to inappropriate aetiological, anatomical and pathophysiological terms [1]. Difficulties with Pathophysiology Considerable confusion concerning the actual location of LET has existed since the introduction of the term about a century and a half ago. The exact location of the pathophysiological changes was unknown for decades, since many structures around the elbow- the tendons of the wrist extensor muscles and possibly the anconeous muscle, the bursae, the radial collateral and annual ligament, the radiohumeral synovial fringe, the radiohumeral joint, the radial head and radial nerve - have been described in the pathogenesis of LET based on theoretical hypotheses and mechanisms through clinical examination and diagnosis [2]. This problem seems now to have been resolved, because the structure most commonly reported as being responsible for LET is the origin of the extensor carpi radialis brevis (ECRB) tendon on the basis of surgical findings [1]. There was also some debate as to the pathogenesis of LET. At first LET was classified as an inflammatory process and physicians attributed the pain of LET to inflammation. However, great progress has been made in this area, especially in the last two decades, and it has been found that the LET condition is a degenerative process that occurs when the ECRB has failed to heal properly after an injury or after repetitive microtrauma resulting from overuse [3].
Authors and Affiliations
Stasinopoulos Dimitrios
Keywords
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- EP ID EP592904
- DOI 10.26717/BJSTR.2018.07.001520
- Views 149
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