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Tutorial

Tutorial. Finding information(1) 28/3/06 O.Arikawe. Tennis elbow. DEFINITION: pain and tenderness over the lateral epicondyle and pain on resisted wrist extension. INCIDENCE: 4 – 7 / 1000 per year in general practice. Peak incidence between 40 -50 years. AETIOLOGY

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Tutorial

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  1. Tutorial Finding information(1) 28/3/06 O.Arikawe

  2. Tennis elbow DEFINITION: pain and tenderness over the lateral epicondyle and pain on resisted wrist extension. INCIDENCE: 4 – 7 / 1000 per year in general practice.Peak incidence between 40 -50 years.

  3. AETIOLOGY repeated strain result in inflammation of the common extensor tendon where it inserts into the epicondyle

  4. It could also occur after minor or unrecognized trauma of the extensor muscles of the fore arm. • Tennis is a direct cause in only about 5%.

  5. PROGNOSIS: self limiting. minority of cases persist for 18 months to 2 years or longer. 10% - 20% of episodes result in 12 weeks absence from work.

  6. Sources of information • Clinical evidence • Bandolier • medline/medscape • On medica • Doctors.net.uk/pubmed • Nice guidelines • Textbooks • Journals – BMJ, BJGP

  7. Possible treatments for tennis elbow • Topical NSAIDS for short term pain relief • oral NSAIDS for short term pain relief • Corticosteroid injections • Acupuncture • Exercise and mobilization • NSAIDS for longer term pain relief • Braces(orthoses)

  8. Surgery • Extra corporeal shock wave therapy • Physiotherapy • Botulinum toxin injection • Topical nitric oxide patch • Ionotophoretic steroid delivery

  9. Best treatment option Topical NSAIDS for short term pain relief. Evidence: cochrane review abstract based on meta-analysis of controlled clinical trials Clinical evidence search and appraisal April 2003

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