Lateral epicondylitis is a common overuse syndrome that affects the extensor tendons of the forearm. If left untreated, it can lead to subsequent micro-tears, besides degeneration of collagn, and even angiofibroblastic proliferation.
Treatment Through A Watchful-Waiting Approach
This line of treatment can be comparable with physical therapy. It is superior to treatment through corticosteroid injection. In the watchful-waiting approach, patient will visit their primary care physician once a week. There will be a six-week intervention period. During this time aggravating activities are to be avoided. Various practical solutions are recommended. Patients will receive acetaminophen or some other kind of non-steroidal anti-inflammatory drug (NSAID), if required. Basically patients are encouraged to wait for improvement to happen by itself.
NSAIDS For Treatment
Topical NSAIDs are used for providing short-term pain relief. Their long-term effectiveness besides any other kind of advantages over other forms of conservative treatments are still quite uncertain.
Extracorporeal Shock Wave Therapy
This therapy is also beneficial for the condition.
Using an inelastic and nonarticular strap on the proximal forearm strap can help to decrease pain and to increase the grip strength. It can also help in improving the patient’s ability while performing daily activities.
Laser therapy is also used by many for the treatment of lateral epicondylitis. It is recommended to use it in conjunction with some other form of conservative modalities.
Doing stretching and strengthening exercises one or more times daily is recommended. This should be done at least three days a week for six weeks or more. This can help to reduce pain. The focus must be on eccentric rather than concentric phases.
Electrotherapy is often employed for treating lateral epicondylitis. It leads to pain reduction after two to four weeks. Ultrasonography is believed to have thermal as well as mechanical effects on the target tissue. This can lead to an increase in metabolism and circulation. It can also aid in extensibility of connective tissue as well as tissue regeneration.
Acupuncture can be considered as another option for treating this condition. However, it is known to lead to pain reduction for a short term only.
In case all these options fail, people are opting for autologous blood injections. These are able to trigger off an inflammatory cascade. This tends to initiate the repair of degenerative tissue which takes place because of mediators in the blood. It can also happen due to localized trauma that can happen due to the injection itself. One injection may be enough while some patients may require multiple injections.
Botulinum toxin type A injection or Botox can also facilitate healing as it will paralyze the common extensor origin, but only temporarily. There will be decrease in pain and a better quality of life in addition to improved grip strength. But it is better to consult a doctor before taking any of these injections.
Nitric oxide is able to stimulate synthesis of collagen by wound fibroblasts. Thus it can be used for healing extensor tendons. This is why topical nitrate patches can have an impact on patients suffering from lateral epicondylitis.
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