Tendinitis of the elbow would represent approximately 22% of cases of musculoskeletal disorders (MSDs) which represent 87% of occupational diseases, indicates the Health Insurance. It occurs following repetitive and intensive movements of the arm and hand (work movements for example). It causes pain, felt on the outer side of the elbow, particularly when one flexes, extends or performs a rotation of the arm. How long does tendonitis last? How to treat it? With infiltrations? From physio?

What is the definition of elbow tendonitis?

tendinitis of the elbow or epicondylitis East “a degenerative disease caused by wear and tear of the tendons used to operate the elbow” informs Dr. Eric Noël, rheumatologist in Lyon. There are two main groups: lateral epicondylitis on the top of the elbow (called the tennis-elbow because these tendons are used; by tennis players) and medial epicondylitis on the inside of the elbow (called the golf-elbow because solicited by golfers)”. The tendon is an anchor point between bone and muscle. It undergoes the stresses and solicitations of the muscles. It is more accurate to speak of “tendinopathy” of the elbow than of “tendinitis” (inflammation of the tendon) because it is a degenerative condition and not an inflammatory one. Doctors today prefer to speak of tendinopathy or mechanical enthesopathy.

What are the possible causes of elbow tendonitis?

► Repeated movements. Epicondylitis is probably due to micro tears caused by repetitive movements that strain the tendons of the elbow, with or without charging port. “Movements repeated hundreds of times will overload these tendons” explains Dr. Eric Noël. It can be repetitive movements at work. Epicondylitis is an occupational disease. “It can also be repetitive movements, in sports practice, while gardening (use of secateurs for example), DIY (painting a ceiling, etc.).”

► Taking certain medications .Moreover “Certain medications, including some antibiotics, can cause tendon pain,” says our interlocutor.

►”An infectious focus (dental or sinusitis) can also cause tendon pain” continues the rheumatologist.

What are the symptoms of elbow tendonitis?

Tendinitis of the elbow is indicated by pain on the outer side of the elbow or pain when extending the elbow, reaching for objects or turning the forearm, to open a door handle for example. These pains can start from brutal way or be progressive. “Elbow tendinopathy pain differs from osteoarthritis pain. The pain is in the joint in osteoarthritis. In case of tendinopathy, the pain occurs during flexion, extension or prosupination movements (rotational effort) of the elbow“ explains Dr. Eric Noël.

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“For a median or lateral tendinopathy, the therapeutic solutions are the same” inform the rheumatologist. As with all tendonitis, you need rest and use the muscles concerned as little as possible. For rest your elbow, it’s necessary :

• Bend the elbow rather than straighten it during an effort
• Avoid rotations of the forearm in force (to tighten for example)
• Have the wrist in external rotation to carry or lift objects (palm up).
• In very rare cases, the elbow must be plaster to be at rest.

What medications are effective for treating elbow tendonitis?

Taking analgesics helps reduce pain, as does applying ice or anti-inflammatory gel. “Oral anti-inflammatories are not very effective in the case of tendinopathy, unlike osteoarthritis” says Dr. Eric Noël.

When to do infiltrations?

Injection of corticosteroids (injections) into the elbow can be used to relieve pain. shock waves can be performed to stimulate the healing process of the tendon. There is another, more recent treatment that is still being evaluated: “the injection of platelet concentrate (PRP) into the tendon to make it heal” inform the rheumatologist.

Is physiotherapy effective in treating elbow tendonitis?

Physical therapy sessions are also part of the treatment. “They include ultrasound, laser and ionization to relieve pain and tendon rehabilitation techniques to strengthen it and make it more resistant” informs Dr. Eric Noël. It is possible that physiotherapy shortens the evolution time of tendinitis a little.

When should you operate?

“Surgery is considered as a last resort, if all other treatments fail” says Dr. Eric Noël.

The presumed diagnosis of elbow tendinopathy is based on a clinical examination when the doctor will see that the patient has pain on palpation and when performing certain movements against resistance. “Only ultrasound or MRI confirm the diagnosis” informs Dr. Eric Noël.

How long does elbow tendonitis last?

These micro-tears eventually heal but it takes 9 to 24 months (on average, 12 months) for a cure. “When a tendinopathy is caught early and certain gestures are removed, it can heal very quickly” emphasizes Dr. Eric Noël.

Thanks to Dr Eric Noël, rheumatologist in Lyon.