Is lateral epicondylitis Resisted forearm movement eg tennis forearm wringing scraping out pigeon lofts Overuse musculoskeletal disorder Tennis elbow Very common 471000yr Recurrence Persistently effective treatments have resisted researchers ID: 917013
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Slide1
Tennis elbow
Slide2Tennis elbow
Is lateral
epicondylitis
Resisted forearm movement eg tennis forearm, wringing, scraping out pigeon lofts
Overuse musculoskeletal disorder
Slide3Tennis elbow
Very common
4-7/1000/yr
Recurrence
“Persistently effective treatments have resisted researchers”
ARC February 2007
Slide4Tennis elbow
Local steroid injections
Popular
Short term pain relief – 6 weeks
Little better than placebo or time over the longer term
Worse between 12 weeks and one year than wait and see
Physio
Longer term benefit form 12 weeks to 1 year
Slide5Tennis elbow
Separating the patients
Payment by volume eg bricklayer, plasterer
DIY eg 1 weekend per year wallpapering
Research so far
No evidence on how best to manage any subgroup
Outcome
Likely recurrence
Good whatever
Slide6Understanding tendon disorders
Tendinopathy
, not
tendinitis
Degeneration and inadequate repair, not inflammation
Therefore
NSAIDs for short term pain relief only
Slide7How to encourage repair and rehabilitation?
Don’t know
Currently
physios
use stretching and eccentric loading of extensor
carpi
radialis
brevis
for tennis elbow
Similar approach for
Achilles tendon
Rotator cuffPatellar tendon
Golfers elbow