Epicondylitis of the elbow joint

Epicondylitis of the elbow joint is a pathology that affects the muscle tissue of the elbow. Let's consider the main causes of the disease, diagnostic methods and symptoms, as well as treatment methods and prognosis for recovery.

Epicondylitis affects the area of the elbow where the muscles attach to the forearm bone. Depending on the location of the inflammatory process, the disease has two forms - external and internal. External inflammation is most often diagnosed, as it is the most common disease of the musculoskeletal system.

1. External (lateral) epicondylitis - this form of the disease is called "tennis elbow". Since the inflammatory process occurs in the place where the muscle fibers are attached to the epicondyle. Most often, the disease is diagnosed in athletes. The pathology occurs due to overstraining of the shoulder muscles. This happens when playing tennis, monotonous physical work (painting walls, sawing wood, etc.). The main category of patients is patients from 30 to 50 years old.
2. Medial epicondylitis - the disease is called "golfer's elbow". Constantly repetitive movements lead to an inflammatory process. This can be work with various hand tools, sports injuries. Any long-term work that involves the muscles of the forearm can cause medial inflammation of the elbow.

Causes of epicondylitis of the elbow joint

The causes of epicondylitis of the elbow joint are varied, but they are all associated with the active functioning of the elbow muscular system. As a rule, the disease develops unilaterally, that is, on the dominant hand. Depending on the pain when pressing on the affected area, there are several forms of inflammation: muscular, tendon, supracondylar and tendon-periosteal. Very often, epicondylitis occurs due to an unsuccessful hand movement, improper lifting of weights or throwing a heavy object.

At the moment of injury, a person feels immediate pain, which quickly passes. But the first signs of the disease appear after several hours, or even days, as the swelling and inflammation grow. One-time loads on the hands can also cause epicondylitis of the elbow joint. Very often, patients involved in arm wrestling, working with a wrench or screwdriver suffer from such injuries. Chronic load on the tendons is another factor that increases the risk of developing inflammation of the elbow joint. Epicondylitis appears due to inflammation of the tendons and in this case is a secondary disease.

People who constantly repeat the same type of movements suffer from the pathology: painters, athletes, massage therapists, seamstresses, masons and others. Elderly patients are also at risk, which is prone to injuries and joint inflammation. Another possible cause of the disease is osteochondrosis of the spine. A direct connection between these ailments has not been found, but it has been established that after surgery on the spine, elbow pain suddenly stopped.

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Symptoms of Elbow Epicondylitis

Symptoms of epicondylitis of the elbow joint depend on the form of the disease. In the medial form, the area of painful symptoms is the inner surface of the arm, and in the lateral form, the outer surface. The symptoms characteristic of epicondylitis allow us to differentiate it from other diseases of the elbow joint, such as arthritis.

• Painful sensations appear when there is a load on the elbow. For example, when trying to move the limb inward, that is, during flexion-extension movements.
• Discomfort occurs when shaking hands and increases when trying to bend the elbow.
• The disease causes a decrease in muscle tone, which affects the ability to hold any objects.
• The inflammatory process does not affect the external condition of the elbow tissue. The only thing that can indicate pathology is slight redness and swelling.
• Another characteristic symptom of epicondylitis is the absence of pain at night.

If such symptoms accompany you for several months, this indicates the progression of the disease. Without medical assistance, inflammation of the elbow joint becomes chronic.

Elbow pain with epicondylitis

Elbow joint pain with epicondylitis is the only pronounced symptom of the disease. The pain syndrome has a number of features that help to distinguish it from similar joint diseases.

Pain sensations can be acute and subacute:

• In acute epicondylitis, the pain is localized in the area of the supracondylar bone of the humerus and is constant and intense. In some cases, the pain radiates to the forearm and impairs the mobility of the elbow. It is very difficult to keep the limb in an extended position; discomfort occurs when trying to squeeze the hand.
• The subacute form of inflammation is accompanied by a dull pain, which manifests itself with slight pressure on the external or internal epicondyle. Unpleasant sensations arise with slight loads on the elbow. At rest or with flexion-extension movements, pain in the elbow joint does not occur.

Inflammation of the elbow joint with epicondylitis

Inflammation of the elbow joint with epicondylitis occurs at the point where the elbow muscles attach to the forearm bone. The severity of the inflammatory process depends entirely on the form of the disease, the cause and localization of the pathology. Despite the fact that epicondylitis is considered an occupational disease, patients with diseases of the musculoskeletal system increasingly suffer from this disease.

Due to the poor symptoms, the inflammatory process is not always detected in time. At first, tendon inflammation causes discomfort, but as the disease progresses, the pain becomes aching and sharp, and is localized. The inflammatory process intensifies with loads on the affected limb, with flexion and extension of the elbow. The danger of the latent form is that epicondylitis can last for months, acquiring a chronic stage. In this case, the patient will have to undergo surgery and a long rehabilitation period.

Lateral epicondylitis of the elbow joint

Lateral epicondylitis of the elbow joint is a common pathology that most often affects tennis players. The thing is that when playing tennis, the movements are of an extension nature, involving the hand and forearm. This leads to tension in the extensor muscles and tendons that hold onto the lateral epicondyle of the humerus. But many other types of activity can also cause epicondylitis of the elbow joint.

The main causes of lateral epicondylitis are:

• Increased loads on the tendons and muscles of the forearm, constantly repetitive movements of the hand. All this can lead to inflammation of the tendons and extensor muscles of the hand.
• The disease is caused not only by the inflammatory process, in some cases the cause of epicondylitis is damage to tendon tissue, i.e. tendinitis. Tissue wear entails degenerative changes in the tendons.

The characteristic symptoms of the disease are pain sensations localized in the area of the lateral epicondyle of the humerus. The pain penetrates the entire forearm and intensifies with extension movements of the hand or when trying to hold something heavy in the hand. In some cases, the pain manifests itself at night when the patient falls asleep, which negatively affects his well-being in everyday life. Lateral inflammation of the elbow causes slight swelling and fever, which indicates an inflammatory process.

To diagnose the disease, the doctor collects anamnesis and asks the patient in detail about the nature of the pain, its duration and intensity. To confirm the diagnosis, the elbow joint is carefully examined and a series of functional tests are carried out. Based on the results of the studies, a final diagnosis is made, an effective treatment is selected, as a rule, a combination of drugs and exercises for recovery.

Medial epicondylitis of the elbow joint

Medial epicondylitis of the elbow or "golfer's elbow" is an inflammatory condition that affects the muscles and tendons of the elbow. Frequently repetitive movements, playing certain sports, various elbow injuries, or work involving the use of hand tools can lead to epicondylitis. That is, any activity that uses the muscles of the forearm can cause a serious inflammatory process.

Medial epicondylitis is localized on the inner bone of the elbow, that is, in the medial epicondyle. The muscles responsible for flexion of the limbs are associated with tendons that can experience heavy loads during professional or sports activities. Even a small inflammation entails pain and swelling. Symptoms appear several days after the injury. The pain is localized in the epicondyle area and spreads along the forearm. Attempts to bend the fingers or the hand at the wrist cause severe pain. The grip strength is significantly reduced when lifting weights or trying to clench the hand into a fist.

But in some cases, the medial form of the disease does not develop due to physical exertion or inflammation. We are talking about fibroblast cells, their action negatively affects collagen, which loses its strength. Collagen becomes fragile and easily destroyed, the body reacts to this with scars in the tendon tissues. Scarred tissues do not have the same strength as healthy ones, so they cannot fully restore the structure of the elbow joint tendons.

Medial epicondylitis of the elbow joint

Internal epicondylitis of the elbow joint manifests itself as an inflammatory process in muscle tissue. The pathology occurs in the muscles responsible for flexion and extension movements of the hand. The muscles are located on the inner side of the elbow joint. This form occurs more often than the external one and is considered one of the most common dysfunctions of the musculoskeletal system of the body.

Today, it is difficult to establish the exact cause of the disease, since there are many factors that provoke the development of the disease. Long monotonous flexion-extension movements cause microtrauma and inflammation. Athletes, agricultural and construction workers are especially susceptible to this pathology. Increased physical activity and carrying heavy objects can also provoke epicondylitis of the elbow joint.

Lateral epicondylitis of the elbow joint

External epicondylitis of the elbow joint occurs against the background of an acute inflammatory process in the ligamentous and tendon tissues. Since the tissues of the ligamentous apparatus are on the outside of the joint, this has become the main factor for calling this form of inflammation external epicondylitis. Inflammation in the tendon tissues does not appear on its own; there are many reasons that influence the formation of pathology. Doctors are unanimous in their opinion that epicondylitis is a secondary disease. That is, its appearance is influenced by hereditary predisposition and a congenital factor.

There are three main categories of professions that are at risk for developing lateral epicondylitis. This applies to athletes, builders and all others whose work involves active movement of the elbow area. The joint consists of ligamentous and cartilaginous tissue, which differ in elasticity. Due to heavy loads, the elasticity of the tissues does not withstand, and microtraumas appear, which entail inflammation. In some cases, even a minor dislocation of the hand can cause lateral epicondylitis of the elbow joint.

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Chronic epicondylitis of the elbow joint

Chronic epicondylitis of the elbow joint indicates that the initial form of the disease is neglected. As a rule, if you seek medical help for elbow pain in a timely manner, treatment is quick and diagnosis is not difficult. But sometimes the pain persists for several weeks or even months, and the patient is in no hurry to see a doctor and performs his usual activities, repeatedly injuring the damaged joint and tendon. As a result, epicondylitis becomes chronic.

Treatment of the chronic form of the inflammatory process is long and requires significant efforts from both the doctor and the patient. In particularly difficult cases, in addition to drug therapy, that is, conservative treatment, the patient will undergo surgery and a long rehabilitation period to fully restore the functions of the elbow joint.

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Diagnosis of epicondylitis of the elbow joint

Diagnosis of elbow epicondylitis begins with anamnesis and physical examination. The doctor asks the patient about the history of the disease, the nature of pain, injuries and work that causes trauma to the elbow joint. After this, the patient undergoes functional and motor tests to confirm pain in the elbow area. To clarify the diagnosis and differentiate it from other inflammatory joint lesions, additional studies are conducted.

• Radiograph – an X-ray of the elbow joint is necessary to confirm epicondylitis. The image can show damage to the humeral epicondyle or calcium deposits in the area of the medial epicondyle.
• Magnetic resonance imaging – using magnetic waves, it is possible to visualize the condition of soft tissue and bone sections. Thanks to this, it is possible to determine the degree of damage and the form of the inflammatory process.
• Ultrasound examination – this examination reveals signs of degeneration of the connective tissue of the tendons and visualizes the condition of the soft tissues and the epicondyle of the humerus.

One of the most reliable diagnostic methods that allows confirming the presence of an inflammatory process is functional tests for joint mobility. Thus, unlike arthrosis or arthritis, with epicondylitis, flexion and extension of the elbow joint causes minor pain. In this case, special attention is paid to the load on the joint and the localization of pain. Attempts to turn the hand as much as possible clockwise or counterclockwise without preliminary fixation of the joint cause painful sensations, which significantly increase when the hand returns to its original position. In this case, this is almost 100% confirmation of epicondylitis of the elbow joint or a sign of damage to the tendons in the elbow area.

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Treatment of epicondylitis of the elbow joint

Treatment of epicondylitis of the elbow joint depends on the form of the disease, the stage of its development, the presence of concomitant pathologies of the musculoskeletal system and other diseases of the joints and bones. Often, people consult a doctor when the inflammatory process progresses and epicondylitis has become chronic. But if the disease is at an early stage, the main treatment is limited to limiting the activity that provoked the pathology. This will allow the damaged muscles and tendons of the joint to be restored naturally.

To relieve pain, immobilization of the affected limb is necessary. A splint or fixing bandage is applied to the arm to prevent tendon tension and joint fixation. Today, a special bandage or elbow pad is increasingly used for these purposes. The period of wearing a fixing bandage can be up to one month, depending on the severity of the pain. Treatment of epicondylitis can be both conservative and surgical.

Conservative treatment:

• External therapy – ointments with NSAIDs and drugs for cooling the site of pain.
• Nonsteroidal anti-inflammatory drugs – help reduce pain and inflammation. Ibuprofen, Ortofen, Ketorolac, Indomethacin and others are used for these purposes.
• Electrophoresis of the elbow joint with analgesics and anesthetics.
• Physiotherapy – reflexology, magnetic therapy, cryotherapy, laser therapy and other methods.

Drug therapy is carefully selected by the attending physician. The doctor prescribes anti-inflammatory and pain-relieving ointments and tablets that speed up the recovery process. In acute forms of inflammation, the patient is prescribed a blockade, that is, an intramuscular injection of a pain-relieving drug into the epicenter of pain. The blockade is carried out once and only when ointments are ineffective. If such treatment does not relieve pain, the patient is prescribed shock wave therapy.

Shock wave therapy is recognized as one of the most progressive methods of treating joint inflammation. With the help of sound impulses, the body starts natural processes to restore damaged muscles, tendons and tissues. If in this case there is no positive dynamics, then this is a direct indication for surgical intervention. The operation is the excision of the extensor muscles and removal of part of the tendons affected by the inflammatory process. The operation is performed using an incision or puncture of tissues. After such treatment, the patient has a long rehabilitation period.

Treatment of lateral epicondylitis of the elbow joint

Treatment of lateral epicondylitis of the elbow joint can be both conservative and surgical. The main goal of therapy is to speed up the process of restoration of damaged tendons. Let's consider the main methods and drugs for the treatment of the lateral form of inflammation.

• Immobilization of the injured limb - taping or an elbow brace is used for these purposes. Due to the restriction of movements, inflamed tissues heal and recover. This method prevents repeated injury to the extensor muscles.
• Nonsteroidal anti-inflammatory drugs – used to eliminate pain syndrome and inflammation. The active components of the drugs act on blood cells and stop the inflammatory process. Due to this, the process of destruction of tendon tissue comes to naught, pain and swelling are reduced.
• Use of hormonal anti-inflammatory drugs – used to reduce the inflammatory process. Hormonal drugs are injected into the affected area to restore the affected structures.
• Surgical treatment – used when conservative therapy has not yielded the desired result. The operation allows you to relieve tension from the extensor tendons of the hand. The surgeon makes an incision above the lateral epicondyle and cuts off the inflamed tendons. The cut tissues are sutured to the muscle fascia and the skin is sutured. The operation is performed on an outpatient basis.

Treatment of medial epicondylitis of the elbow joint

Treatment of medial epicondylitis of the elbow joint is aimed at complete restoration of the affected structures. Conservative therapy gives a positive result after 2-3 weeks of treatment. The essence of such treatment is to preserve collagen from further destruction. For these purposes, NSAIDs (Nise, Nurofen, Nimisil) are used for 5-7 days. If taking medications is ineffective, then the patient is prescribed steroids.

Steroid injections with anti-inflammatory drugs are administered to the site of inflammation. Sometimes 2-3 injections are enough to completely eliminate pain, inflammation and swelling. But such treatment is risky. Since repeated administration of drugs significantly reduces the strength of collagen fibers and can cause tendon rupture.

But the most important method of treating medial epicondylitis of the elbow joint is physiotherapy. For these purposes, pulsed magnetic therapy, diadynamic therapy, cryotherapy, hydrocortisone ultrasound or shock wave therapy are used.

Treatment of epicondylitis of the elbow joint with tablets

Treatment of epicondylitis of the elbow joint with tablets is a conservative method of therapy. Medicinal fight against the inflammatory process helps to eliminate pain and destruction of joint tissues.

• If the pain is minor, then Analgin, Ketanov or Renalgan are taken to eliminate it. In addition to tablets for the treatment of pain syndrome, ointments with an analgesic and anti-inflammatory effect are excellent.
• Many patients are prescribed Diclofenac and Ibuprofen to treat recurrent epicondylitis and relieve acute pain attacks. In addition, single injections of glucocorticosteroids or painkillers are given to the site of pain. Such therapy is effective in acute elbow joint inflammation.
• In the case when the disease takes a chronic advanced form, tablets with analgesic action and non-steroidal anti-inflammatory drugs are used for treatment. The following drugs are especially effective: Nimesil, Ibuprofen, Aspirin, Nimesulide. These medications are taken for both medial and lateral forms of epicondylitis.
• If the above-described drugs do not eliminate the painful sensations, then the patient is prescribed stronger drugs. As a rule, the arthrologist uses injections with lidocaine. The drug is administered intramuscularly, since such treatment is considered radical and is used only in case of ineffectiveness of less strong drugs.
• If even the blockade does not help relieve the pain, the patient will undergo shock wave therapy. In addition, advanced and particularly complex cases of inflammation are treated surgically, completely removing the source of pain and inflammation.

Treatment of epicondylitis of the elbow joint with folk remedies

Treatment of epicondylitis of the elbow joint with folk remedies is still popular today. As a rule, folk therapy is used simultaneously with conservative treatment, since some folk recipes are really effective for epicondylitis. But you should not rely entirely on such treatment, since without medical help the inflammatory process can take on very serious proportions. Let's consider the most popular methods of treating epicondylitis with folk remedies.

1. To eliminate pain, massage oil made from bay leaf is suitable. Take a couple of bay leaves, grind them into powder and mix with slightly warmed olive or vegetable oil. Before use, the product should be infused for 7-10 days. The medicine can be used as a compress or rubbed into the elbow joint.
2. Take a liter jar and fill it ½ full with chopped horse sorrel roots. Add 500 ml of vodka to the plant, mix thoroughly and put in a dark and warm place for 10-15 days. Use the remedy as a compress, carefully wrapping the affected limb for 1.5-2 hours. The course of treatment is 10-14 days.
3. If epicondylitis has become chronic and often recurs, green tea can help relieve the pain. Pour boiling water over a spoonful of tea and let it brew for 30-40 minutes. Pour the finished drink into a container with ice cubes and freeze. It is recommended to apply green tea ice to the painful area for 5-10 minutes.
4. A good pain-relieving and restorative compress can be made from fragrant violets. Pour 200 ml of vodka over 200 g of flowers and leave in a dark place for 10-14 days. The resulting remedy should be applied to the joint for 2 hours, every day for a month.
5. Pour boiling water over the leaves and flowers of black elderberry for 5-10 minutes. Squeeze the herbal mixture thoroughly and apply to the elbow joint, wrapping it with film on top. After 15-20 minutes, the compress can be removed and the skin washed. Treatment should be carried out every 3-4 days for 1-2 months.
6. In order to relieve acute inflammation, you can use hot clay. Take blue clay and mix it with hot water 1:1. Carefully spread the product on a two-layer gauze and apply to the elbow, fixing the compress with a bandage and wrapping it with a scarf or shawl. Keep the compress for 30 minutes and replace it with a new one. The procedure should be carried out 2-3 times a day for 7-10 days.

Exercises for epicondylitis of the elbow joint

Exercises for epicondylitis of the elbow joint are included in the rehabilitation program for restoring normal functioning of the limb. All exercises are prescribed only by the attending physician. The main goal of the exercises is to normalize regional microcirculation, completely eliminate discomfort in the affected area, restore the ability to fully move the joints and prevent forearm muscle atrophy.

But doing the exercises has a number of prescriptions and restrictions. Physical activity should be gradual, that is, from small to large. At first, the exercises should not last long, but as the elbow joint strengthens, the duration of the exercises can be increased. If acute pain occurs during the exercises, it is better to consult a doctor. In general, physical therapy improves blood flow, normalizes the secretion of synovial fluid, strengthens muscles and increases the elasticity of ligaments. Attention should be paid to both passive and active loads using a healthy hand.

• Bend your arms at the elbows, gradually clench and unclench your fists.
• Slowly bend and straighten your elbows, keeping your hands together.
• Keep your shoulders still and bend and straighten your forearm area in a circular motion outward and inward.
• Make "mill" and "scissors" with your hands.
• In addition to the above exercises, there are others with strength loads on the arms. But they are not always used for recovery after epicondylitis.

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Elbow Epicondylitis Brace

A bandage for epicondylitis of the elbow joint is used to immobilize the limb and prevent further injury to the ligaments and tissues of the joint. The advantage of the bandage is that this device is not too expensive and will always come in handy. Such bandages should be used by athletes and people who have suffered elbow joint injuries and those whose work is associated with the active functioning of the flexor-extensor muscles.

It is better to use a bandage for epicondylitis according to the doctor's technology, that is, wear it during the allotted time, for example, 1-2 hours a day. The bandage is recommended to be used in cases where the elbow joint is subject to the greatest impact. In this case, it acts as a kind of preventive method to prevent injury and rupture of the ligaments and tendons of the joint.

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Blockade for epicondylitis of the elbow joint

Blockade for epicondylitis of the elbow joint is a means used to treat severe pain, as well as for the treatment of advanced and chronic inflammation. Let's consider two options for performing a blockade, for lateral and medial epicondylitis.

1. Lateral epicondylitis occurs due to monotonous repetitive flexion-extension movements. Moreover, not only the elbow joint is involved, but also the forearm.
   • The blockade is placed in the area of muscle attachment to the lateral epicondyle, at the point of localization of maximum pain (determined by palpation).
   • The skin is carefully treated with antiseptic solutions to infiltrate the subcutaneous fat.
   • The needle is inserted at an angle of 40° until it contacts the bone and is pulled up a couple of millimeters. 5-7 ml of the medicinal mixture or antiseptic solution is injected into the limb. If blockades with glucocorticosteroids are performed, then repeated administration of the drugs is mandatory after 10-14 days.
   • After blocking the elbow joint, a bandage or other means of immobilization is applied to the affected limb for 2-3 days.
2. Medial epicondylitis occurs due to overload of the forearm muscles, i.e. the radial and ulnar flexor of the wrist, the superficial flexor of the fingers and the long palmar muscle. The inflammatory process is localized in the places of attachment of muscle fibers and tendons. In some cases, pain syndrome localized in the area of the medial epicondyle manifests itself against the background of vertebrogenic syndrome.
   • To perform the blockade, the skin is treated with an antiseptic and the point of increased pain is determined, which is located a couple of centimeters distal to the medial epicondyle.
   • The needle is inserted at an angle of 30° relative to the skin. Medicinal mixtures or antiseptic are injected into the affected limb.
   • The difficulty of the medial epicondylitis block is that the ulnar nerve passes behind the medial epicondyle. Therefore, all manipulations must be performed by an experienced surgeon.

Despite the effectiveness of this treatment method, blockade for epicondylitis of the elbow joint can lead to puncture damage to the ulnar nerve, which is very dangerous.

Surgery for epicondylitis of the elbow joint

Surgery for elbow epicondylitis is an extreme treatment method. Surgical intervention is justified when conservative drug treatment is ineffective. Surgery is also performed for patients whose activities are directly related to regular loads on the forearm muscles. That is, with constant trauma to the elbow joint.

There are several surgical intervention techniques:

• Removal, i.e. tendoperiostetomy of the tendon with part of the muscular system.
• Dissection of the tendon of the short extensor of the hand.
• Arthroscopic therapy.
• Lengthening of the tendon of the short extensor of the hand.

Recently, arthroscopic therapy of elbow epicondylitis has become very popular. This type of surgical intervention is less traumatic, unlike skin incision. At the same time, after an arthroscopic operation, you can start light work in 10-14 days, since the restoration of joint tissues occurs very quickly and effectively.

Prevention of epicondylitis of the elbow joint

Prevention of epicondylitis of the elbow joint is aimed at eliminating the factors of trauma to the forearm and elbow joint. Thus, with frequent monotonous movements during sports or profession, it is necessary to alternate the work and rest regime. To relieve tension from the muscular system, you can do a warm-up, a light massage or special exercises from a course of therapeutic physical training.

If the disease is in a chronic stage, but as a preventive measure against the inflammatory process, the following procedures can be used:

• Local cryotherapy on the affected area. This method uses dry cold air, with a temperature below 30 degrees.
• Ultraphonophoresis using anesthetic and anti-inflammatory mixtures in the area of pain localization.
• Extracorporeal shock wave therapy is considered an extreme preventive method. It is used when other measures do not bring relief from pain and do not promote natural restoration of muscle tissue of the elbow joint.
• Paraffin-ozokerite and naphthalene applications.

Prevention involves reducing the risk of injury to the elbow joints when carrying heavy objects, using hand tools at work or in sports. Do not forget about protecting your elbows with elastic bandages or special elbow pads.

Prognosis of elbow epicondylitis

The prognosis for epicondylitis of the elbow joint is usually favorable, since the disease does not lead to death or fatal damage to the body. If you seek medical help in a timely manner, you can avoid surgical intervention by quickly restoring damaged muscle tissue. But if the disease is advanced, then, most likely, you will have to perform surgery and make blockades to eliminate pain. In this case, the prognosis for recovery depends on the nature of the inflammatory process and the degree of damage to the tissues of the limb.

Epicondylitis of the elbow joint responds well to therapy, so even the chronic form of the pathology can be transferred to the stage of long-term remission. But do not forget about the observance of preventive measures to protect the joints from damage and prevent inflammation, which will cause not only discomfort, but also significant inconvenience when working or playing sports associated with regular loads on the elbow joint area.