Risk factors in lateral epicondylitis (tennis elbow): a case-control study

Abstract

Lateral epicondylitis is a common condition, but relatively little is known about its aetiology and associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and quantify the relative contributions of some constitutional and environmental risk factors for lateral epicondylitis in the community. Our dataset included 4998 patients with lateral epicondylitis who were individually matched with a single control by age, sex, and general practice. The median age at diagnosis was 49 (interquartile range 42-56) years . Multivariate analysis showed that the risk factors associated with lateral epicondylitis were rotator cuff pathology (OR 4.95), De Quervain's disease (OR 2.48), carpal tunnel syndrome (OR 1.50), oral corticosteroid therapy (OR 1.68), and previous smoking history (OR 1.20). Diabetes mellitus, current smoking, trigger finger, rheumatoid arthritis, alcohol intake, and obesity were not found to be associated with lateral epicondylitis.

Association between Epicondylitis and Cardiovascular Risk Factors in Pooled Occupational Cohorts

“…Three studies have suggested prior smoking was a risk for LE [12, 80, 81]. Two studies reported a trend of increasing LE risk with obesity [12, 19], although another found it to not be a risk [80]. Our study failed to find BMI as a risk factor.…”

Is there an association between tendinopathy and diabetes mellitus? A systematic review with meta-analysis

“…Five reported results on different tendons (eg, elbow and shoulder) but used the same database,49 50 53 54 56 two reported different outcomes from the same patient cohort,13 55 and two shared the same cohort where the second paper was a follow-up with a slightly increased numbers 11 23. From these, four representative studies were included and the other five were excluded.…”

“…Results between studies, however, were mixed with two finding no significant association between diabetes and tendinopathy whereas three identified a positive association. Three of these studies reviewed large medical databases15 48 50 and two sampled cohorts of working populations47 57 but subgrouping in this way did not correspond to studies that reported significant associations.…”

Diagnostic guidlines for occupational epicondylitis

“…stwierdzili, że aktywne palenie jest niezależnym czynnikiem ryzyka zapalenia nadkłykcia przyśrodkowe-go kości ramiennej [9]. Z kolei Titchener podkreśla wpływ palenia tytoniu w przeszłości, czyli u obecnie niepalących, nie stwierdzając korelacji między występowaniem "łokcia tenisisty" a czynnym paleniem tytoniu [12].…”

“…ponad 3-krotnie powyżej 20 lat pracy [12]. Podobnie jak w przypadku zapalenia nadkłykcia bocznego duże znaczenie ma sposób ustawienia kończyny górnej i sposób jej użycia podczas pracy.…”