LATERAL EPINCONDYLITIS – NEW THERAPEUTIC OPTIONS IN REFRACTORY AND CHRONIC CASES

Daniela Poenaru*

ABSTRACT

Lateral epicondylitis is associated with overuse from either sport activity or overuse in work and home environement. It has an incidence of 1 – 3% in general population, it is prevalent in the forth and fifth decades, in professionaly active population and has a high rate of recurrence or chronic course. Despite the actual denomination, which suppose an inflammatory substrate, the main morhopathologic process is degenerative, eith tendon microtears and angiofibrotic proliferation. For the acute stage, whose symptoms last under 3 months, conservative treatment consists in nonsteroidal antiinflammatory drugs, rest, bracing, physiotherapy and therapeutic exercise. Corticosteroids provide rapid analgesic effect but carry the risk of rupture and recidive. The chronic stage necesitates therapies oriented toward tendon regeneration. Research was performed on extracorporeal shock wave therapy, regenerative therapies, prolotherapy, botulinum toxin injection. Musculoskeletal ultrasound is largely used for diagnostic and treatment purpose, improving the injection techniques.

Keywords: lateral epincondylitis, corticosteroids, ESWT, PRP, ABI, prolotherapy, botulinum toxin.