Prevalence and Determinants of Lateral and Medial Epicondylitis: A Population Study

Abstract

Epicondylitis is a common disorder of the arm, yet the role of individual- and work-related factors has not been addressed in a population study. The aims of this study were to estimate the prevalence of lateral and medial epicondylitis and to investigate their risk factors. The target population of this study comprised a representative sample of people aged 30-64 years residing in Finland during 2000-2001. Of the 5,871 subjects, 4,783 (81.5%) were included in this study. The prevalence of definite lateral epicondylitis was 1.3%, and that of medial epicondylitis was 0.4%. The prevalence did not differ between men and women and was highest in subjects aged 45-54 years. Current smoking (adjusted odds ratio (OR) = 3.4, 95% confidence interval (CI): 1.4, 8.3) and former smoking (OR = 3.0, 95% CI: 1.3, 6.6) were associated with definite lateral epicondylitis. An interaction (p = 0.002) was found between repetitive movements of the arms and forceful activities for the risk of possible or definite lateral epicondylitis (for both repetitive and forceful activities vs. no such activity: OR = 5.6, 95% CI: 1.9, 16.5). Smoking, obesity, repetitive movements, and forceful activities independently of each other showed significant associations with medial epicondylitis. Epicondylitis is relatively common among working-age individuals in the general population. Physical load factors, smoking, and obesity are strong determinants of epicondylitis.

Humeral Lateral Epicondylitis Complicated by Hydroxyapatite Dihydrite Deposition Disease: A Case Report

“…10 There is evidence of an association between epicondylitis and forceful work tasks of the upper extremity, a combination of forceful and repetitive activities, and a combination of either forceful or repetitive activities with an extreme nonneutral posture of the hand and arm. 1 Correlations of LE with specific repetitive movements 2 hours per day, handling tools greater than 1 kg, handling loads greater than 20 kg at least 10 times a day, low job control, and low social support at work have also been identified. 11 Although the pathogenesis of epicondylitis is unclear, repeated microtrauma localized at the origin of common extensor is thought to initiate the disease.…”

“…1 The incidence of lateral epicondylitis (LE) is reported to be 3 to 11/1000 patients per year in general practice 2 ; the prevalence varies between 1% and 3% in the general population and can reach up to 23% among workers. 1,3,4 The peak prevalence has been estimated to 1.3% in subjects aged between 45 and 54 years. 1 There is no clear association between sex and epicondylitis 3,5,6 ; however, a few studies report a higher risk in women.…”

“…1,3,4 The peak prevalence has been estimated to 1.3% in subjects aged between 45 and 54 years. 1 There is no clear association between sex and epicondylitis 3,5,6 ; however, a few studies report a higher risk in women. 7,8 Despite the fact that it is often referred to as tennis elbow, this condition occurs more commonly in nonathletes.…”

“…12 Although the exact nature of the biomechanical events leading to it is unknown, the natural repair response from repetitive mechanical stress leads to an accumulation of connective tissue that may account for the clinical and pathologic manifestations. 1 A common pathologic finding seen during operative procedures includes chronic tears with formation of granulation tissue in the origin of the ECRB. 13 Despite being a common condition, LE may represent a clinical challenge when becoming chronic or recurrent.…”

Sonoelastography of the Common Flexor Tendon of the Elbow with Histologic Agreement: A Cadaveric Study

“…Therefore, we decided to include in this study only cadavers that could be examined within 30 hours after death to reduce divergence from in vivo imaging results. In addition, we did not have information on the medical history of the body donors, and because of the advanced age of the donors, we found a much higher prevalence of alterations of the common flexor tendon than that described in the literature (13). A cadaver model also does not allow for color Doppler imaging, although the applicability of this method has already been shown (10).…”