Association between Epicondylitis and Cardiovascular Risk Factors in Pooled Occupational Cohorts

Abstract

BackgroundThe pathophysiology of lateral epicondylitis (LE) is unclear. Recent evidence suggests some common musculoskeletal disorders may have a basis in cardiovascular disease (CVD) risk factors. Thus, we examined CVD risks as potential LE risks.MethodsWorkers (n = 1824) were enrolled in two large prospective studies and underwent structured interviews and physical examinations at baseline. Analysis of pooled baseline data assessed the relationships separately between a modified Framingham Heart Study CVD risk score and three prevalence outcomes of: 1) lateral elbow pain, 2) positive resisted wrist or middle finger extension, and 3) a combination of both symptoms and at least one resisted maneuver. Quantified job exposures, personal and psychosocial confounders were statistically controlled. Odds ratios (ORs) and 95% Confidence Intervals (CIs) were calculated.ResultsThere was a strong relationship between CVD risk score and lateral elbow symptoms, resisted wrist or middle finger extension and LE after adjustment for confounders. The adjusted ORs for symptoms were as high as 3.81 (95% CI 2.11, 6.85), for positive examination with adjusted odds ratios as high as 2.85 (95% CI 1.59, 5.12) and for combined symptoms and physical examination 6.20 (95% CI 2.04, 18.82). Relationships trended higher with higher CVD risk scores.ConclusionsThese data suggest a potentially modifiable disease mechanism for LE.

Modern disintegration and primal connectivity

“…In their study of 1824 workers across multiple domains, Hegmann et al (2017) not only found that those with CVD risk factors had 6 times higher risk of epicondylitis, but also identified literature showing similar risk levels for other musculoskeletal conditions, such as carpal tunnel syndrome (5 times higher in those with CVD markers), median nerve entrapment (8 times higher in those with CVD risk factors) and rotator cuff tendinopathy. The presence of diabetes in workers was also found to increase likelihood of epicondylalgia.…”

“…For example, diabetes is well known to contribute to the atherosclerotic process. Since connective tissues are poorly supplied by vasculature, their tolerance for compromise is narrowed (Hegmann et al, 2017). Similarly, type 2 diabetics have an over-abundance of circulating insulin due to cellular resistance to insulin.…”

“…For many years, red meats were vilified as a primary cause of inflammation due to their higher levels of omega 6 to omega 3, compared to fish, for example, with higher levels of omega 3 to omega 6. However, it has emerged that this finger pointing was at least partially misdirected, and that grass-fed, free-ranging animal meats are actually much higher in omega 3's, while reciprocally farmed fish are higher in omega 6's (Hebeisen et al, 1993, Hegmann et al, 2017McAuliffe et al, 2018). The conclusion: when feeding an animal on foods that it did not evolve to metabolize and keeping it in close confinement (which requires high antibiotic use), the end result is a stressed, inflamed, sick animal, high in omega 6's.…”

“…Beyond a focus on just the effect of dietary increases in collagen and stretching practices on connective tissue health, there are also broader considerations of nutrition and lifestyle in the treatment and prevention of these pervasive health challenges. For example, Hegmann et al (2017) found an association between cardiovascular risk factors (CVD risks) and epicondylitis.…”

Increased Risk of Coronary Artery Disease in People with a Previous Diagnosis of Carpal Tunnel Syndrome: A Nationwide Retrospective Population-Based Case-Control Study

“…Furthermore, while this study found an increased risk of CAD in patients with a previous diagnosis of CTS, it remains unclear as to whether other neuromuscular diseases or symptoms may also be related to CAD. Previous research has confirmed that rotator cuff tendinopathy [ 42 ] and lateral epicondylitis [ 43 ] are related to the development of CAD, although it remains uncertain as to whether the mechanisms leading to the development of CAD are similar between these neuromuscular diseases and CTS. Importantly, the scope of our research is limited by the fact that some symptoms or signs cannot be diagnosed as a disease relating to a specific ICD-9-CM code.…”