A new integrative model of lateral epicondylalgia: Figure 1

Abstract

Tennis elbow or lateral epicondylalgia is a diagnosis familiar to many within the general community and presents with an uncomplicated clinical picture in most cases. However, the underlying pathophysiology presents a more complex state and its management has not been conclusively determined. Research on this topic extends across anatomical, biomechanical and clinical literature; however, integration of findings is lacking. We propose that the current understanding of the underlying pathophysiology of lateral epicondylalgia can be conceptualised as encompassing three interrelated components: (i) the local tendon pathology, (ii) changes in the pain system, and (iii) motor system impairments. This paper presents a model that integrates these components on the basis of a literature review with the express aim of assisting in the targeting of specific treatments or combinations thereof to individual patients.

Lateral Epicondylitis: Impact on Demographic Variables

“…This might be because the dominant hand is always used extensively in all the occupational, household and activities of daily living leading to overuse, overstress and over-exertion of the wrist extensors of the forearm as seen in lateral epicondylitis. This makes the dominant hand more susceptible to degenerative changes occurring in lateral epicondylitis than the nondominant hand [23].…”

Effect of taping techniques on pain and grip strength in patients with lateral epicondylitis

“…Also, KT reduced over stretching of the muscle, leading to overall increase in muscle performance. Moreover, the reduction in pain increased grip strength [6].…”

“…Different treatment modalities have been described, including orthotics, non-steroidal anti-inflammatory drugs, steroid injections, manual therapy, ultrasound therapy, laser therapy, extracorporeal shockwave therapy, acupuncture and taping [5,6].…”

Lateral Epicondylitis Injection Therapy: A Safety and Efficacy Analysis of Hyaluronate versus Corticosteroid Injections

“…There is evidence that the tendon degeneration involves both apoptotic and autophagy mechanisms [5]. A proposed mechanism involves tendon pathology, changes in neuromuscular function as well as changes in pain threshold [3]. Neurochemicals including glutamate, substance P, and calcitonin gene-related peptide have been identified in patients with chronic tennis elbow and in animal models of tendinopathy [16].…”

“…It can be responsible for substantial pain and loss of function of the affected limb for over 1 year in up to 20% of people [3,4]. Tennis elbow is considered an overload injury of the ECRB at the point of attachment at the lateral epicondyle.…”