Tag Archives: Tendon

Trigger finger

Alternative Name : Stenosing tenosynovitis, trigger thumb, or trigger digit,

Definition:
Trigger finger is a common disorder of later adulthood characterized by catching, snapping or locking of the involved finger flexor tendon, associated with dysfunction and pain. A disparity in size between the flexor tendon and the surrounding retinacular pulley system, most commonly at the level of the first annular (A1) pulley, results in difficulty flexing or extending the finger and the “triggering” phenomenon. The label of trigger finger is used because when the finger unlocks, it pops back suddenly, as if releasing a trigger on a gun.
.Click to see the picture..>..(0)...(1)…...(2).

One of your fingers or your thumb gets stuck in a bent position and then straightens with a snap — like a trigger being pulled and released. If trigger finger is severe, the finger may become locked in a bent position.

Often painful, trigger finger is caused by a narrowing of the sheath that surrounds the tendon in the affected finger. People whose work or hobbies require repetitive gripping actions are more susceptible. Trigger finger is also more common in women and in anyone with diabetes.

Symptoms:
Signs and symptoms of trigger finger may get progressed from mild to severe and include:

*Finger stiffness, particularly in the morning

*A popping or clicking sensation as you move your finger

*Tenderness or a bump (nodule) at the base of the affected finger

*Finger catching or locking in a bent position, which suddenly pops straight

*Finger locked in a bent position, which you are unable to straighten

Trigger finger more commonly occurs in your dominant hand, and most often affects your thumb or your middle or ring finger. More than one finger may be affected at a time, and both hands might be involved. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger.

Trigger finger is not the same as Dupuytren’s contracture — a condition that causes thickening and shortening of the connective tissue in the palm of the hand — though it may occur in conjunction with this disorder.

Causes:
The cause of trigger finger is a narrowing of the sheath that surrounds the tendon in the affected finger. Tendons are fibrous cords that attach muscle to bone. Each tendon is surrounded by a protective sheath — which, in turn, is lined with a substance called tenosynovium. The tenosynovium releases lubricating fluid that allows the tendon to glide smoothly within its protective sheath as you bend and straighten your finger — like a cord through a lubricated pipe.

But if the tenosynovium becomes inflamed frequently or for long periods, the space within the tendon sheath can become narrow and constricting. The tendon can’t glide through the sheath easily, at times catching the finger in a bent position before popping straight. With each catch, the tendon itself becomes more irritated and inflamed, worsening the problem. With prolonged inflammation, scarring and thickening (fibrosis) can occur and bumps (nodules) can form.

More than one potential causes have been described but the etiology remains idiopathic. It has also been called stenosing tenosynovitis (specifically digital tenovaginitis stenosans), but this may be a misnomer, as inflammation is not a predominant feature.

It has been speculated that repetitive forceful use of a digit leads to narrowing of the fibrous digital sheath in which it runs, but there is little scientific data to support this theory. The relationship of trigger finger to work activities is debatable and scientific evidence for and against hand use as a cause exist.

Risk Factors:
Risk Factors  developing trigger finger include:

Repeated gripping. If one routinely grips an item — such as a power tool or musical instrument — for extended periods of time, one may be more prone to developing a trigger finger.

Certain health problems. One is also at greater risk if he or she has certain medical conditions, including rheumatoid arthritis, diabetes, hypothyroidism, amyloidosis and certain infections, such as tuberculosis.Your sex. Trigger finger is more common in women.

Diagnosis:
Diagnosis is made almost exclusively by history and physical examination alone. More than one finger may be affected at a time, though it usually affects the thumb, middle, or ring finger. The triggering is usually more pronounced in the morning, or while gripping an object firmly.

Treatment:
Injection of the tendon sheath with a corticosteroid is effective over weeks to months in more than half of patients.

When corticosteroid injection fails, the problem is predictably resolved by a relatively simple surgical procedure (usually outpatient, under local anesthesia). The surgeon will cut the sheath that is restricting the tendon.

One recent study in the Journal of Hand Surgery suggests that the most cost-effective treatment is two trials of corticosteroid injection, followed by open release of the first annular pulley.  Choosing surgery immediately is the most expensive option and is often not necessary for resolution of symptoms.  More recently, a randomized controlled trial comparing corticosteroid injection with needle release and open release of the A1 pulley reported that only 57% of patients responded to corticosteroid injection (defined as being free of triggering symptoms for greater than 6 months). This is compared to a percutaneous needle release (100% success rate) and open release (100% success rate).  This is somewhat consistent with the most recent Cochrane Systematic Review of corticosteroid injection for trigger finger which found only 2 pseudo-randomized controlled trials for a total pooled success rate of only 37%.  However, this systematic review has not been updated since 2009.

There is a theoretical greater risk of nerve damage associated with the percutaneous needle release as the technique is performed without seeing the A1 pulley.

Investigative treatment options with limited scientific support include: non-steroidal anti-inflammatory drugs; occupational or physical therapy; steroid iontophoresis treatment; splinting; therapeutic ultrasound, phonophoresis (ultrasound with an anti-inflammatory dexamethasone cream); and Acupuncture.

Prognosis:
The natural history of disease for trigger finger remains uncertain.

There is some evidence that idiopathic trigger finger behaves differently in people with diabetes.

Recurrent triggering is unusual after successful injection and rare after successful surgery.

While difficulty extending the proximal interphalangeal joint may persist for months, it benefits from exercises to stretch the finger straighter.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Trigger_finger
http://www.mayoclinic.com/health/trigger-finger/DS00155
http://assets.sbnation.com/imported_assets/71765/trigger_finger_2.jpg
http://www.trigger-finger.com/
http://www.drmomeni.com/hand/trigger.html

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Bursitis

Definition:
A bursa is a fluid-filled sac that usually overlays a bone or a joint and acts as a shock absorber. There are two types:

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Anatomical bursae normally occur around the body where tendons cross bones or joints. The complex knee joint has 15 bursae, for example.

•Adventitious bursae are not part of the normal body structure but develop when the soft tissue overlying a bone suffers repeated friction or trauma. An example of this type is over the pelvic bone in the buttock muscles because someone has been sitting on a hard chair for several hours a day.

Bursitis is inflammation of the fluid-filled sac (bursa) that lies between a tendon and skin, or between a tendon and bone. Certain occupations predispose people to this. The condition may be acute or chronic.
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Causes:
The most common causes of bursitis are trauma, infection, and crystal deposits.

Trauma
Trauma causes inflammatory bursitis from repetitive injury, which results in widening of the blood vessels. This allows proteins and extracellular fluid into the bursae and the bursae react against these “foreign” substances by becoming swollen.

•Chronic: The most common cause of chronic bursitis is minor trauma that may occur to the shoulder (subdeltoid) bursa from repetitive motion, for example, throwing a baseball. Another example is prepatellar bursitis (in front of the knee) from prolonged or repetitive kneeling on a hard surface to scrub a floor or lay carpet.

Acute brusits: A direct blow (let’s say you accidentally bang your knee into a table) can cause blood to leak into the bursa. This rapid collection usually causes marked pain and swelling, most often in the knee.

Infections:
Bursae close to the surface of the skin are the most likely to get infected with common organisms; this is called septic bursitis. These bursitis-causing bacteria are normally found on the skin: Staphylococcus aureus or Staphylococcus epidermis. People with diabetes or alcoholism and those undergoing steroid treatments or with certain kidney conditions, or who may have experienced trauma may be higher risks for this type of bursitis. About 85% of septic bursitis occurs in men.

Crystal deposits
People with certain diseases such as gout, rheumato:id arthritis, or scleroderma, for example, may develop bursitis from crystal deposits. Little is known about how this process happens. Uric acid is a normal byproduct of daily metabolism. People who have gout are unable to properly break down the uric acid, which crystalizes and deposits in joints-a mechanism for causing bursitis.
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Symptoms:
Bursitis causes pain and tenderness around the affected bone or tendon. The bursae sacs may swell, often making movement difficult. The most commonly affected joints are the shoulder, elbow, wrist and hand, knee, and foot.

Shoulder…...click & see

The subacromial (subdeltoid bursa) separates the major tendon (known as the supraspinatus tendon) from the overlying bone and deltoid muscle. Inflammation of this bursa is usually a result of injury to surrounding structures-most commonly the rotator cuff. This is often referred to as “impingement syndrome.” It is often difficult to tell the difference between this type of bursitis pain and a rotator cuff injury. Both cause pain in the side or front of the shoulder.

•Overhead lifting or reaching activities are uncomfortable.

•Pain is often worse at night.

•The shoulder will usually have decreased range of active motion and be tender at specific spots.

Elbow. click & see

Olecranon bursitis is the most common form of bursitis. Goose-egg-like, tender red swelling may appears just behind the elbow. This area is at the top of one of the forearm bones called the ulna and is known as the olecranon process.

•The pain may increase if the elbow is bent because tension increases over the bursa.

•This bursa is frequently exposed to direct trauma (bumping your arm) or repeated motions from bending and extending the elbow (while painting, for example).

•Infection is common in this bursa.

Knee....click & see

•Kneecap (prepatellar) bursitis: Swelling on the front of the kneecap is usually associated with either chronic trauma (from kneeling) or an acute blow to the knee. Swelling may occur as late as 7-10 days after a single blow to the area, usually from a fall.

•Anserine bursitis: The anserine bursa is fan shaped and lies among 3 of the major tendons at the knee. The name anserine (gooselike) comes from the shape of the swollen bursa. When restrained by the 3 tendons, the bursa looks like a goose’s foot.

This type of bursitis is most often seen in people with arthritis, especially overweight middle-aged women with osteoarthritis.

*The pain is typically produced when the knee is bent and is particularly troublesome at night. People often seek comfort by sleeping with a pillow between their thighs.

*The pain can radiate to the inner thigh and midcalf and usually increases on climbing stairs and at extremes of bending and extending.

*The area of tenderness is on the middle part of the knee.

*Anserine bursitis also occurs as an overuse or traumatic injury among athletes, particularly long-distance runners.
Ankle.click & see

Retrocalcaneal bursitis occurs when the bursa near the Achilles tendon in the ankle becomes inflamed. This is commonly caused by local trauma associated with wearing a poorly designed shoe (often high heels) or prolonged walking. It can also occur with Achilles tendonitis.

Bursitis in this part of the body often occurs as an overuse injury in young athletes, ice skaters, and female adolescents transitioning to higher heels. The pain is usually on the back of the heel and increases with passive extension or resisted flexion.

Buttocks....click & see

Ischiogluteal bursitis causes inflammation of the ischial bursa, which lies between the bottom of the pelvic bone and the overlying gluteus maximus muscle (one side of the buttocks). Inflammation can come from sitting for a long time on a hard surface or from bicycling.

•The pain occurs when sitting and walking.

•There will be tenderness over the pubic bone, which may be made worse by bending and extending the leg.

•The pain may radiate down the back of the thigh.

•Direct pressure over the area causes sharp pain.

•The person may hold the painful buttock elevated when sitting.

•The pain is worse when person is lying down and the hip is passively bent.

•The person may have difficulty standing on tiptoe on the affected side.

Hip click & see

The iliopsoas bursa is the largest in the body and lies in front of, and deep to, the hip joint. Bursitis here is usually associated with hip problems such as arthritis or injury (especially from running).

•The pain of iliopsoas bursitis radiates down the front and middle areas of the thigh to the knee and is increased when the hip is extended and rotated.

•Extension of the hip during walking causes pain so the person may limit the stride on the affected side and take a shorter step.

•There may be tenderness in the groin area.

•Sometimes a mass may be felt resembling a hernia. The person may also feel numbness or tingling if adjacent nerves are compressed by the inflamed bursa.

Thigh click & see

The trochanteric bursa, part of the thigh, can be associated trochanteric bursitis, which occurs most frequently in overweight, middle-aged women.

•It causes deep, aching hip pain along the side of the hip that may extend into the buttocks or to the side of the knee.

•Pain is aggravated by activity, local pressure, or stretching.

•Pain is often worse at night.
Diagnosis:
Exams and Tests:

•History: The doctor will usually take a detailed history about the onset of symptoms and will want to know what movement or activity makes you feel more or less pain. You will need to report other medical problems you may have.

•Fluid removal: The doctor may remove synovial fluid from the joint with a needle (aspiration) and send it to the lab for analysis for possible infection. Bursitis in the knee and elbow are especially prone to infection.

•X-rays: They are usually not helpful, but the doctor may get them if any other disease process is suspected such as a fracture or dislocation. MRI and CT scans are obtained only to exclude other causes.

•Blood testing: The doctor may take blood from your arm for lab testing to rule out infection or other conditions such as rheumatoid arthritis or hyperthyroidism.
Treatment:
The doctor will probably recommend home care with P-R-I-C-E-M: protection, rest, ice, compression, elevation, and medications .

At first  doctor may recommend temporary rest or immobilization of the affected joint.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may relieve pain and inflammation. Formal physical therapy may be helpful as well.

If the inflammation does not respond to the initial treatment, it may be necessary to draw out fluid from the bursa and inject corticosteroids. Surgery is rarely required….

Exercises for the affected area should be started as the pain resolves. If muscle atrophy (weakness or decrease in size) has occurred. Your health care provider may suggest exercises to build strength and increase mobility.

Bursitis caused by infection is treated with antibiotics. Sometimes the infected bursa must be drained surgically.

Prognosis:
The condition may respond well to treatment, or it may develop into a chronic condition if the underlying cause cannot be corrected.

Complications:
Chronic bursitis may occur.
Too many steroid injections over a short period of time can cause injury to the surrounding tendons.

Prevention:
Avoid activities that include repetitive movements of any body parts whenever possible.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/bursitis.shtml
http://healthtools.aarp.org/adamcontent/bursitis?CMP=KNC-360I-GOOGLE-HEA&HBX_PK=bursitis&utm_source=Google&utm_medium=cpc&utm_term=bursitis&utm_campaign=G_Diseases%2Band%2BConditions&360cid=SI_148893841_6495451981_1
http://www.emedicinehealth.com/bursitis/article_em.htm
http://www.medicalook.com/Joint_pain/Bursitis.html
http://activemotionphysio.ca/article.php?aid=246
http://www.bursitisinshoulder.com/
http://www.bursitis.ws/Knee-Bursitis.html

http://www.aidmybursa.com/foot-ankle-bursitis.php

http://www.sportlink.co.uk/hip_bursitis.php

http://www.bursitistreatment.info/ischial-bursitis_8.html

http://www.steadyhealth.com/articles/Hip_Bursitis___Trochanteric_Bursitis_a246.html

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Achilles Tendon Inflammation

Definition :
The Achilles is the tendonous extension of two muscles in the lower leg: gastrocnemius and soleus . In humans, the tendon passes behind the ankle. It is the thickest and strongest tendon in the body. It is about 15 centimetres (6 in) long, and begins near the middle of the calf, but receives fleshy fibers on its anterior surface, almost to its lower end. Gradually becoming contracted below, it is inserted into the middle part of the posterior surface of the calcaneus, a bursa being interposed between the tendon and the upper part of this surface. The tendon spreads out somewhat at its lower end, so that its narrowest part is about 4 centimetres (1.6 in) above its insertion. It is covered by the fascia and the integument, and stands out prominently behind the bone; the gap is filled up with areolar and adipose tissue. Along its lateral side, but superficial to it, is the small saphenous vein. The Achilles’ muscle reflex tests the integrity of the S1 spinal root. The tendon can receive a load stress 3.9 times body weight during walking and 7.7 times body weight when running.
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Although it’s the largest tendon in the body and can withstand immense force, the Achilles is surprisingly vulnerable. And the most common Achilles tendon injuries are Achilles tendinosis and Achilles tendon rupture. Achilles tendinosis is the soreness or stiffness of the tendon, generally due to overuse. Achilles tendinitis (inflammation of the tendon) was thought to be the cause of most tendon pain, until the late 90s when scientists discovered no evidence of inflammation. Partial and full Achilles tendon ruptures are most likely to occur in sports requiring sudden eccentric stretching, such as sprinting. Maffulli et al. suggested that the clinical label of tendinopathy should be given to the combination of tendon pain, swelling and impaired performance. Achilles tendon rupture is a partial or complete break in the tendon; it requires immobilization or surgery. Xanthoma can develop in the Achilles tendon in patients with familial hypercholesterolemia.
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Achilles tendon, which feels like a very painful sudden kick in the back of the ankle and needs urgent repair. Inflammation of the tendon, or Achilles tendonitis, is more common.

Symptoms:
•Mild pain after exercise or running that gradually gets worse
•Localised pain along the tendon during or a few hours after running, which may be quite severe
•Localised tenderness of the tendon about 3cm above the point where it joins the heel bone, especially first thing in the morning
•Stiffness of the lower leg, again particularly first thing in the morning
•Swelling or thickening around the tendon
There are several conditions that can cause similar symptoms, such as inflammation of a heel bursa (or fluid sac) or a partial tear of the tendon. You should see your doctor to confirm what’s causing your symptoms

Causes and risk factors:
To help prevent another attack, it’s important to know what triggers Achilles tendonitis in the first place.

Triggers may include:
•Overuse of the tendon – the result of a natural lack of flexibility in the calf muscles. Ask your coach about exercises specifically to improve calf muscle flexibility, and ensure your running shoes cushion the heel fully
•Starting up too quickly, especially after a long period of rest from sport – always warm up thoroughly
•Rapidly increasing running speeds or mileage – build your activity slowly, by no more than ten per cent a week
•Adding stair climbing or hill running to a training programme too quickly

•Sudden extra exertion, such as a final sprint

•Calf pain

Diagnosis & Tests:
The doctor will perform a physical exam and look for tenderness along the tendon and for pain in the area of the tendon when you stand on your toes.

Imaging studies can also be helpful. X-rays can help diagnose arthritis, and an MRI will show inflammation in the tendon.

Treatment :

Treatment of Achilles tendonitis depends on the severity of the injury and whether you’re a professional sportsperson. Treatment includes:

•Rest, to allow the inflammation to settle. Any sport that aggravates the tendon should be sped for at least a week, although exercise that doesn’t stress the tendon, such as swimming, may be possible
•Regular pain relief with non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
•Steroid injections
•Bandaging and orthotic devices, such as shoe inserts and heel lifts, to take the stress off the tendon
•Physiotherapy to strengthen the weak muscle group in the front of the leg and the upward foot flexors
•Surgery (rarely needed) to remove fibrous tissue and repair tears

According to reports by Hakan Alfredson, M.D., and associates of clinical trials in Sweden, the pain in Achilles tendinopathy arises from the nerves associated with neovascularization and can be effectively treated with 1–4 small injections of a sclerosant. In a cross-over trial, 19 of 20 of his patients were successfully treated with this sclerotherapy.


Prognosis :

Conservative therapy usually helps improve symptoms. However, symptoms may return if activities that cause the pain are not limited, or if the strength and flexibility of the tendon is not maintained.
Depending on the severity of the injury, recovery from an Achilles injury can take up to 12–16 months.

Prevention:
Prevention is very important in this disease. Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/achilles.shtml
http://en.wikipedia.org/wiki/Achilles_tendon
http://www.umm.edu/ency/article/001072all.htm

Simple and New Solution for Athletic Injuries

Pittsburgh Steelers Hines Ward and Troy Polamalu used their own blood in an innovative injury treatment before winning the Super Bowl. Major league pitchers, professional soccer players and hundreds of recreational athletes have also undergone the procedure, which is called platelet-rich plasma therapy.
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Experts in sports medicine say that it could eventually improve the treatment of stubborn injuries like tennis elbow and knee tendonitis.

The technique involves injecting portions of a patient’s blood directly into the injured area, which catalyzes the body’s instincts to repair muscle, bone and other tissue. It even appears to help regenerate ligament and tendon fibers, which could shorten rehabilitation time and possibly eliminate the need for surgery.

Sources: New York Times February 16, 2009

Tennis Elbow

Definition:
Tennis elbow is a condition where the outer part of the elbow becomes painful and tender, usually as a result of a specific strain or overuse. Although it is called “tennis elbow”, it is not restricted to tennis players –hyperextensions of the elbow, from whatever cause, can be classified as tennis elbow. Anyone who does a lot of work involving lifting at the elbow or repetitive movements at the wrist is susceptible to tennis elbow. The condition was first described in 1883.. The medical term is lateral epicondylitis.

Doctors first identified Tennis Elbow (or lateral epicondylitis) more than 100 years ago. Today nearly half of all tennis players will suffer from this disorder at some point. Interestingly though, tennis players actually account for less than 5 percent of all reported cases making the term for this condition something of a misnomer.

There are 2 additional strain related conditions which are often mistaken for Tennis Elbow. These being Golfer’s Elbow & Bursitis. Before we delve into the details of what Tennis Elbow actually is and options that are available for relieving & preventing the pain…let’s look at the distinguishing characteristics of each of these 3 ailments.


Tennis Elbow(lateral epicondylitis) Outside of Elbow:-
The onset of pain, on the outside (lateral) of the elbow, is usually gradual with tenderness felt on or below the joint’s bony prominence. Movements such as gripping, lifting and carrying tend to be troublesome.

..Click to see the picture...

Golfer’s Elbow: (medial epicondylitis) Inside of Elbow
The causes of golfers elbow are similar to tennis elbow but pain and tenderness are felt on the inside (medial) of the elbow, on or around the joint’s bony prominence.

The condition is called Golfer’s elbow because in making a golf swing this tendon is stressed; many people, however, who develop the condition have never handled a golf club. It is also sometimes called Pitcher’s elbow due to the same tendon being stressed by the throwing of objects such as a baseball, but this usage is much less frequent. Apparently you can also get golfer’s elbow from serving in tennis.

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Bursitis: Back of Elbow
Often due to excessive leaning on the joint or a direct blow or fall onto the tip of the elbow.A lump can often be seen and the elbow is painful at the back of the joint.

Bursitis is the inflammation of one or more bursae, or small sacs of synovial fluid, in the body. Bursae rest at the points where internal functionaries, like muscles and tendons, slide across bone. Healthy bursae create a smooth and almost frictionless gliding surface. With hundreds of them throughout the body they provide this surface for all motion, making movement normally painless. When bursitis takes hold, however, movement that relies on the inflamed bursa becomes rough and painful. Movement of tendons and muscles over the inflamed bursa causes it to become more inflamed, perpetuating the problem.

Symptoms of Tennis Elbow:-

*Pain on the outer part of elbow (lateral epicondyle).

*Gripping and movements of the wrist hurt, especially wrist extension and lifting movements.

*Tenderness to touch, and elbow pain on simple actions such as lifting up a cup of coffee or throwing a baseball.

*Pain usually subsides overnight.

*Recurring pain on the outside of the upper forearm just below the bend of the elbow; occasionally, pain radiates down the arm toward the wrist.

*Pain caused by lifting or bending the arm or grasping even light objects such as a coffee cup.

*Difficulty extending the forearm fully (because of inflamed muscles, tendons and ligaments).

*Pain that typically lasts for 6 to 12 weeks; the discomfort can continue for as little as 3 weeks or as long as several years.

The damage that tennis elbow incurs consists of tiny tears in a part of the tendon and in muscle coverings. After the initial injury heals, these areas often tear again, which leads to hemorrhaging and the formation of rough, granulated tissue and calcium deposits within the surrounding tissues. Collagen, a protein, leaks out from around the injured areas, causing inflammation. The resulting pressure can cut off the blood flow and pinch the radial nerve, one of the major nerves controlling muscles in the arm and hand.

Tendons, which attach muscles to bones, do not receive the same amount of oxygen and blood that muscles do, so they heal more slowly. In fact, some cases of tennis elbow can last for years, though the inflammation usually subsides in 6 to 12 weeks.

Many medical textbooks treat tennis elbow as a form of tendonitis, which is often the case, but if the muscles and bones of the elbow joint are also involved, then the condition is called epicondylitis. However, if you feel pain directly on the back of your elbow joint, rather than down the outside of your arm, you may have bursitis, which is caused when lubricating sacs in the joint become inflamed. If you see swelling, which is almost never a symptom of tennis elbow, you may want to investigate other possible conditions, such as arthritis, infection, gout or a tumor.

If no treatment given, can become chronic and more difficult to eradicate.

Exams and Tests:-
The diagnosis is made by clinical signs and symptoms, since x-rays usually show no abnormality. Often there will be pain or tenderness when the tendon is gently pressed near where it attaches to the upper arm bone, over the outside of the elbow.

There is also pain near the elbow when the wrist is extended (bent backwards, as when applying a motorcycle’s throttle) against resistance.

Treatment:
The goal of treatment is to relieve pain and swelling. Treatment may include:

Nonsteroidal anti-inflammatory medications (such as ibuprofen, naproxen or aspirin)
Local injection of cortisone and an numbing medicine
Using a splint to keep the forearm and elbow still for 2 to 3 weeks
Heat therapy
Physical therapy
Pulsed ultrasound to break up scar tissue, promote healing, and increase blood flow in the area
To prevent the injury from happening again during aggravating activities either a splint may be worn or only limited participation in the activity undertaken. If the pain persists despite non-surgical treatments, surgery may be necessary.

Although not founded in clinical research , the tennis player’s treatment of choice is frequent icing and compression (Cold compression therapy) for inflammation, and taking anti-inflammatory pain-killers, such as ibuprofen. In general the evidence base for intervention measures is poor. A brace might also be recommended by a doctor to reduce the range of movement in the elbow and thus reduce the use and pain. Also, ergonomic considerations are important to help with the successful relief of lateral elbow pain.

Relief Of Tennis Elbow:-

Initial measures
Rest, ice, and compression are the treatments of choice. There are many excellent cold compression therapy products available. Nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain and inflammation.

The best way to relieve tennis elbow is to stop doing anything that irritates your arm — a simple step for the weekend tennis player, but not as easy for the manual laborer, office worker, or professional athlete.

The most effective conventional and alternative treatments for tennis elbow have the same basic premise: Rest the arm until the pain disappears, then massage to relieve stress and tension in the muscles, and exercise to strengthen the area and prevent re-injury. If you must go back to whatever caused the problem in the first place, be sure to warm up your arm for at least 5 to 10 minutes with gentle stretching and movement before starting any activity. Take frequent breaks.

Conventional medicine offers an assortment of treatments for tennis elbow, from drug injections to surgery, but the pain will never go away completely unless you stop stressing the joint. Re-injury is inevitable without adequate rest.

For most mild to moderate cases of tennis elbow, aspirin or ibuprofen will help address the inflammation and the pain while you are resting the injury, and then you can follow up with exercise and massage to speed healing.

For stubborn cases of tennis elbow your doctor may advise corticosteroid injections, which dramatically reduce inflammation, but they cannot be used long-term because of potentially damaging side effects.

Another attractive option for many sufferers, especially those who prefer to not ingest medication orally, is the application of an appropriate and effective topical anti-inflammatory. CT Cream with A.C.P. was specifically designed to reduce inflammation and does so by taking advantage of well known elements Arnica, Choline, Pyridoxine and Vitamin B6. Researched, formulated and introduced recently by Dr. Ying Lee, CT Cream has proven to be extremely successful in treating inflammation related ailments such as epicondylitis, tendonitis, bursitis & carpal tunnel syndrome.

If rest, anti-inflammatory medications, and a stretching routine fail to cure your tennis elbow, you may have to consider surgery, though this form of treatment is rare (fewer than 3 percent of patients). One procedure is for the tendon to be cut loose from the epicondyle, the rounded bump at the end of the bone, which eliminates stress on the tendon but renders the muscle useless. Another surgical technique involves removing so-called granulated tissue in the tendon and repairing tears.

Even after you feel you have overcome a case of tennis elbow, be sure to continue babying your arm. Always warm up your arm for 5 to 10 minutes before starting any activity involving your elbow. And if you develop severe pain after use anyway, pack your arm in ice for 15 to 20 minutes and call your doctor.
Alternative treatments:-
Laser Therapy
The Use of Laser Therapy (Low Power or Low Intensity Laser Therapy) is a currently used treatment. The approach was spun off of research on how light affects cells. The findings, that light stimulates and accelerates normal healing, sparked the creation of several devices. The dosage often determines the extent of the success with this treatment, so it is generally recommended that experienced clinicians apply the therapy with a device that can be ‘customized.’ Professional athletes have used the therapy and it has gained attention in the media lately, on shows like the Canadian health program “Balance” on CTV. However, studies evaluating the efficacy of laser therapy for tennis elbow are currently contradictory.

One study has alleged that electrical erin stimulation combined with Acupuncture is beneficial but evaluation studies are inconclusive .

Click for Home Remedies Of Tennis Elbow-> .(1).…...(2).……(3)……..(4)

Prognosis :-
Most people improve with non-surgical treatment. The majority of those that do have surgery show an improvement in symptoms.

Prevention:-
To prevent tennis elbow:
*Lift objects with your palm facing your body.

*Try strengthening exercises with hand weights. With your elbow cocked and your palm down, repeatedly bend your wrist. Stop if you feel any pain.

*Stretch relevant muscles before beginning a possibly stressful activity by grasping the top part of your fingers and gently but firmly pulling them back toward your body. Keep your arm fully extended and your palm facing outward.

CAUTION!
To prevent a relapse:
Discontinue or modify the action that is causing the strain on your elbow joint. If you must continue, be sure to warm up for 10 minutes or more before any activity involving your arm, and apply ice to it afterward. Take more frequent breaks.
Try strapping a band around your forearm just below your elbow. If the support seems to help you lift objects such as heavy books, then continue with it. Be aware that such bands can cut off circulation and impede healing, so they are best used once tennis elbow has disappeared.

Call Your Doctor If….
The pain persists for more than a few days; chronic inflammation of the tendons can lead to permanent disability.
The elbow joint begins to swell; tennis elbow rarely causes swelling, so you may have another condition such as arthritis, gout, infection or even a tumor.

Possible Complications:-
Recurrence of the injury with overuse
Rupture of the tendon with repeated steroid injections
Failure to improve with nonoperative or operative treatment; these may be due to nerve entrapment in the forearm.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://www.tennis-elbow.net/tenniselbow.htm
http://en.wikipedia.org/wiki/Tennis_elbow

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