External epicondylitis of the humerus (tennis elbow)
(Painful site: lateral elbow joint) Wang Tao, Department of Orthopedics, Affiliated Hospital of Qinghai University
I Overview
Abnormal or repeated lifting, pulling, pounding, clenching, rotating the forearm or wrist
II Symptoms (according to the patient)
“My elbow hurts so much that I can’t even hold a glass of water”
“I screwed something with a screwdriver and had elbow pain for a while”
“Last week, I developed elbow pain after driving a nail”
III Treatment
Phase I (short duration, mild symptoms): 1 Restriction of inappropriate activities
2 Oral painkillers
3 Cold compresses
Phase 2 (symptoms lasting 1 month): forearm brace or cast on top of phase 1 treatment
Stage 3 (2 months): Based on the first stage of treatment, the addition of a forearm brace or cast and local closure is highly recommended.
Stage 4 (more than 3 months): 1 Start palm-up lifting after the pain disappears
2 Surgery may be considered for manual laborers with persistent symptoms
IV. Closure therapy (local injection)
1 Success depends on whether the treatment drug is injected accurately into the junction between the subcutaneous fat and the tendon, either too deep or too shallow will not achieve the best results, and a doctor with more experience in this area is needed.
2 Post-injection treatment: rest for 3 days, cold compresses, continuous application of braces or casts for 3-4 weeks, avoiding inappropriate activities; if the symptoms are reduced by <50%, the injection can be repeated once after 6 weeks.
V Surgery
Patients with significantly impaired grip function and forearm strength should be operated, as surgery can restore 90% of the tendon strength.
VI Prognosis
95% of patients can be cured with the above treatment