EFFECTIVENESS OF TREATMENT IN PATIENTS WITH LATERAL AND MEDIAL EPICONDYLITIS

Abstract

Epicondylitis is a condition characterized by inflammation of the epicondyles of the elbow joint. There are Ulnar and Medial epicondylitis. The epicondyle is the outer convex part of the elbow to which all the extensor muscles of the arm attach. The disease usually occurs after overloading the extensor muscles of the joint. Lateral epicondylitis is a condition characterized by inflammation of the lateral epicondyle of the elbow joint. The incidence of the disease is approximately 1-3% of the world's population. Causes of lateral epicondylitis include repeated contraction of the forearm muscles during extension of the arm at the wrist. These repetitive movements lead to damage to the tendon with multiple microscopic tears, localized to the point where the forearm muscles attach to the bony prominence on the outside of the elbow (the lateral epicondyle). The disease was first described in tennis players, hence the popular name "tennis elbow". Lateral epicondylitis occurs 10 times more often than medial epicondylitis. Symptoms of lateral epicondylitis: Pain radiates down the fingers and up to the shoulder joint. It increases during activity and subsides with rest. Dysfunction occurs in the affected hand and patients find it difficult to perform many daily activities. Medial epicondylitis is characterized by inflammation in the area of the medial epicondyle of the elbow joint in the forearm area, where the muscles involved in flexion of the fingers and wrist are located. The tendons of these muscles merge into one common tendon that starts from the medial epicondyle of the humerus (shoulder bone) in the elbow joint, causing damage to the tendons at their insertion on the medial epicondyle, which causes medial epicondylitis. Medial epicondylitis is generally much more common on the lateral epicondyle than on the medial epicondyle. Medial epicondylitis as a disease is almost analogous to lateral epicondylitis, but occurs on the outside of the elbow. Symptoms of medial epicondylitis: In most patients, the onset of symptoms is gradual and sometimes weeks pass before patients seek medical attention. In medial epicondylitis, the pain usually worsens with flexion and pronation of the wrist. Diagnosis of lateral and medial epicondylitis: The diagnosis of the disease is made after taking a detailed history, conducting a thorough physical examination and, if necessary, visual examinations such as radiography, computed tomography, magnetic resonance imaging and others. Research methods: The research was conducted at the PHI "General Hospital" - Strumica, in the departments of Physical Medicine and Kinesitherapy. The research included 14 patients with diagnosed epicondylitis, of which 9 patients (5 males and 4 females) with lateral epicondylitis and 5 patients (3 males and 2 females) with medial epicondylitis. The patients were divided into a Control and Experimental group. Treatment of lateral and medial epicondylitis includes: rest of the affected limb, and in some cases even immobilization for 2-3 weeks with a bandage, splint or cast. Iontophoresis with nonsteroidal anti-inflammatory drugs, isometric exercises to maintain muscle strength are also used. Results: Physical therapy affects the inflammatory process and improves blood supply to the tissues in the affected areas and causes improvement in the condition. Discussion: Resting the sprained limb, maintaining physical fitness, strengthening the forearm muscles, isometric stretching exercises, the use of nonsteroidal anti-inflammatory drugs and the injection of corticosteroid injections reduce swelling, pain and inflammation. Conclusion: Physical medicine, with the application of magnetic therapy, ultrasound therapy and shock wave therapy, has a particularly important role and contributes to the rapid and complete recovery of patients with lateral and medial epicondylitis