Epicondylitis – a disease affecting people in specific professions: the key is to notice it early

If you do monotonous manual work and feel a dull, low-intensity pain around the elbow, and soon you can no longer lift even a cup of coffee without pain, you should promptly consult a doctor. According to Justinas Vaičiulis, an orthopedic traumatologist at the Orthopedics and Traumatology Center of Vilnius “Kardiolita Clinics,” you may be suspected of having epicondylitis—often called “tennis elbow”—which is caused by repetitive movements of the wrist and elbow joints. While early symptoms of the disease can be treated with exercise, delaying treatment may eventually require surgery.

Affects more than just athletes

Epicondylitis does not affect only tennis players, and neither gender nor age has a significant impact on developing the condition. One of the few specialists who consistently treats this disease, orthopedic traumatologist J. Vaičiulis, says that people seeking consultations for elbow pain include both athletes and representatives of other professions—construction workers, chefs, and even tailors.

“This is an occupational disease of people who constantly perform hand movements within an incomplete range of motion. The inflammation does not appear overnight. Most often, patients are those who always perform the same actions with tense forearm muscles. For a long time, these muscles remain overly contracted and do not relax. Then inflammation develops in the elbow tendon where it attaches to the bone, a scar forms, becomes inelastic, and as a result, the person feels pain,” explains the orthopedic traumatologist.

Pain caused by epicondylitis increases individually— for some it may take a week, for others severe symptoms can appear the same day. Athletes tend to endure it the longest, adds J. Vaičiulis: “Tennis players sometimes come in complaining of pain that has been bothering them for half a year or even a year.”

Pain in the elbow area is usually sharp and becomes more pronounced during forearm movement—when straightening, bending, or rotating the arm at the elbow joint. The pain may spread to the upper arm or wrist and may be accompanied by swelling.

The earlier the diagnosis, the easier the treatment

According to the doctor, one should not delay when experiencing pain of this nature—the longer epicondylitis goes undiagnosed and untreated, the more difficult the treatment process becomes.

“The most important thing is to see a doctor in time. The sooner a patient consults specialists, the greater the chance that treatment will be limited to exercises alone, without additional costs. If the disease is left untreated for a year, surgeons usually have to intervene and perform surgery, because other conservative measures are ineffective,” warns J. Vaičiulis.

Treatment of epicondylitis follows a general algorithm when detected early, it is initially treated with conservative methods. One of these is stretching exercises, designed to stretch the scarred area of the tendon and improve blood circulation in that area.

“At first, physiotherapy is applied. The patient must correctly perform the exercises on their own 5–6 times a day for a few minutes, continuing for one or two weeks. If there is no effect after a few weeks, other treatment methods should be considered,” says the doctor.

The final stage of treatment

If exercises are ineffective, injections are administered, and for patients who delay and no longer respond to previously mentioned measures, surgery is performed to remove the inelastic part of the tendon.

“Surgery is only the final stage of treatment. It carries a certain risk of complications and is an invasive intervention. It is best if the patient visits a doctor before surgical intervention becomes necessary—ideally within the first three months after the onset of pain. Then the disease can truly be treated with exercises alone. A condition delayed from four months up to about a year can be treated with medication, but after that, most often only surgery helps,” the physician cautions.

According to J. Vaičiulis, athletes can help prevent this inflammation by doing a proper warm-up before training. Those whose jobs involve repetitive, monotonous hand movements within a limited range of motion are advised to warm up their hands before work and regularly perform stretching exercises. If pain is noticed, the best course of action is to consult an orthopedic traumatology specialist.

Dr. Justinas Vaičiulis

Orthopedic traumatologist at Meliva | Kardiolitos Clinics