scholarly journals AGNIKARMA USING HONEY IN TENNIS ELBOW

2021 ◽  
Vol 9 (11) ◽  
pp. 2659-2664
Author(s):  
Sreelatha K ◽  
George M. J ◽  
Rejani H
Keyword(s):  
Statistical Analysis ◽  
Tennis Elbow ◽  
Extensor Tendon ◽  
Repetitive Strain Injury ◽  
Exclusion Criteria ◽  
Lateral Epicondyle ◽  
Clinical Assessments ◽  
Repetitive Strain ◽  
The Common

Tennis elbow is a condition in which there is pain on the lateral epicondyle. It is a type of repetitive strain injury due to overexertion of the common extensor tendon (snayu), micro-traumas, or its failed healing. Tennis elbow may be correlated with snāyugata vāta in kūrpara sandhi (elbow) which has symptoms of pain, stiffness and restriction of movements. Ācārya Suśruta has mentioned snigdha agnikarma (thermal cautery) in the management of snayugata vata. 16 participants satisfying the diagnostic, inclusion and exclusion criteria were selected for the study. Agnikarma using honey (madhu) was done on the 1st and 8th days. Clinical assessments were done on the 1st, 8th, 15th, 22nd, 29th days. On statistical analysis, it was found that agnikarma using madhu shows 68.22% of effect in the management of tennis elbow. Keywords: Tennis elbow, agnikarma, honey

ANATOMIC AND CLINICAL STUDY OF A NEUROVASCULAR CAUSE OF LATERAL EPICONDYLITIS

2009 ◽  
Vol 12 (01) ◽  
pp. 11-19
Author(s):  
Xin-Ru Du ◽  
Ling-Xiu Zhao
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Extensor Tendon ◽  
Triceps Brachii ◽  
Tissue Samples ◽  
Lateral Epicondyle ◽  
The Common ◽  
Pass Through ◽  
The Right ◽  
Neurovascular Bundles

Because of few anatomic reports investigating the mechanism of lateral epicondylitis (tennis elbow), we performed cadaveric and clinical studies to investigate the involvement of neurovascular bundles passing through the common extensor origin. We dissected and observed under a light microscope tissue samples of neurovascular bundles passing through the common extensor tendon from 40 upper left and right limbs from cadavers. Tissue samples were prepared by hematoxylin & eosin and Weil's myelin staining. We also investigated the records of 20 patients who had been treated for lateral epicondylitis between 1991 and 2004. From cadavers, we found 60 bundles in the common extensor tendon, each 0.5 to 1.0 mm in diameter, with more bundles in the right than left limbs. Twenty-four of these bundles passed over the vertex of the lateral epicondyle of the humerus, and most of the bundles contained only one artery each. The bundles mostly originated from the radial recurrent artery, passing through the aponeurosis of the extensor corpi radialis brevis, but in some cases originated from the radial collateral artery, passing through the aponeurosis of the triceps brachii muscle. The bundles had a membranous covering when passing through the aponeurosis and produced a hiatus. Histological analysis of resected common extensor tendon tissue, 1 cm in diameter, of patients showed hyaline degeneration and fibrosis formation infiltration. Neurovascular bundles passed through the common extensor tendon in nine cases; six cases showed pulsing bleeding. After a mean follow-up of two years (6–48 months), 16 cases showed excellent results, two showed good results and two showed reliefs. Lateral epicondylitis could be caused by damage to neurovascular bundles when they pass through the common extensor origin; one cause of pain is the neurovascular bundle being compressed when passing through the common extensor tendon, secondary to the pathologic degeneration of the origin of the common extensor tendon.

The Role of Supinator in the Pathogenesis of Chronic Lateral Elbow Pain: A Biomechanical Study

2004 ◽  
Vol 29 (5) ◽  
pp. 461-464 ◽  
Author(s):  
S. ERAK ◽  
R. DAY ◽  
A. WANG
Keyword(s):  
Tensile Force ◽  
Balloon Catheter ◽  
Extensor Tendon ◽  
Biomechanical Study ◽  
Extensor Digitorum ◽  
Moderate Increase ◽  
Extensor Digitorum Communis ◽  
Lateral Epicondyle ◽  
The Common ◽  
Extensor Carpi Radialis

The relative contributions of the forearm extensors to the tensile force at the lateral epicondyle were examined by implanting a force transducer in the common extensor tendon of four soft fixed cadaver elbows and sequentially stretching each muscle arising from the lateral epicondye. Extensor carpi radialis brevis and extensor digitorum communis produced the largest increases while the superficial head of supinator produced a moderate increase in tensile force in the common extensor tendon. Extensor carpi radialis longus and extensor carpi ulnaris had no significant effect. Radial tunnel pressure was measured using a balloon catheter in a separate study of five cadaver elbows. Radial tunnel pressure increased on moving the wrist from neutral to a flexion–pronation position. This positional rise in pressure was reduced by supinator musculotendinous lengthening (77%) while lengthening of the extensor carpi radialis brevis and extensor digitorum communis had no effect. This study demonstrates a biomechanical basis for the superficial head of supinator in the aetiology of both lateral epicondylitis and radial tunnel syndrome.

scholarly journals The three-portal technique in arthroscopic lateral epicondylitis release

2017 ◽  
Vol 8 (4) ◽  
Author(s):  
Ashok Gowda ◽  
Gannon Kennedy ◽  
Stacey Gallacher ◽  
Jennie Garver ◽  
Theodore Blaine
Keyword(s):  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Arthroscopic Technique ◽  
Lateral Epicondyle ◽  
Extensor Muscles ◽  
The Common ◽  
One Year ◽  
Extensor Carpi Radialis ◽  
Portal Technique ◽  
Lower Morbidity

Lateral epicondylitis, commonly referred to as tennis elbow, is a syndrome characterized by pain over the origin of the common extensor muscles of the fingers, hand and wrist at the lateral epicondyle. Reports of 70-90% response to conservative treatment at one year have been documented in the literature though refractory cases often require surgical management. Arthroscopic treatment of lateral epicondylitis allows for intra-articular visualization for concomitant pathology and localization of the Extensor Carpi Radialis Brevis tendon. Additionally, compared to the open technique, the arthroscopic technique has a lower morbidity and an earlier return to work and activity. Here we describe a three portal technique for improved visualization in arthroscopic lateral epicondylitis release.

scholarly journals Thermal and Current Flow Effects of a Capacitive–Resistive Electric Transfer Application Protocol on Chronic Elbow Tendinopathy. A Cadaveric Study

2021 ◽  
Vol 18 (3) ◽  
pp. 1012
Author(s):  
Carlos López-de-Celis ◽  
Jacobo Rodríguez-Sanz ◽  
César Hidalgo-García ◽  
Simón A. Cedeño-Bermúdez ◽  
Daniel Zegarra-Chávez ◽  
...  
Keyword(s):  
Cell Proliferation ◽  
Current Flow ◽  
Tennis Elbow ◽  
Treatment Protocol ◽  
Extensor Tendon ◽  
Cross Sectional ◽  
Lateral Elbow ◽  
The Common ◽  
Lateral Elbow Tendinopathy ◽  
A Current

Lateral elbow tendinopathy, or “tennis elbow,” is a pathology that affects around 1.3% of the general population. Capacitive–resistive electric transfer therapy aims to provoke temperature and current flow changes in superficial and deep tissues. The aim of this in vitro study was to analyze the thermal behavior and transmission of electric current on the superficial and deep tissues of the elbow during the application of different modalities of a capacitive–resistive electric transfer treatment protocol for chronic elbow tendinopathy. A cross-sectional study was designed; five fresh cryopreserved cadavers (10 elbows) were included in this study. A 30 min intervention was performed based on a protocol commonly used in clinics for the treatment of chronic lateral elbow tendinopathy by diathermy using the “T-Plus.” Common extensor tendon, radiohumeral capsule, and superficial temperatures were registered after each application for the duration of the 30 min treatment protocol. During all applications, we observed a current flow of over 0.03 A. The protocol showed a statistically significant increase in superficial temperature by 24% (5.02°) (p < 0.005), the common extensor tendon by 19.7% (4.36°) (p < 0.007), and the radiohumeral joint capsule by 17.5% (3.41°) (p < 0.005) at the end of the 30 min protocol compared with the baseline temperature. The different applications of the protocol showed specific effects on the temperature and current flow in the common extensor tendon and radiohumeral capsule. All applications of the protocol produced a current flow that is associated with the generation of cell proliferation. These results strengthen the hypothesis of cell proliferation and thermal changes in deep and distal structures. More studies are needed to confirm these results.

INTER-TESTER RELIABILITY OF SONOGRAPHERS IN DETECTING PATHOLOGICAL LESIONS IN THE ELBOW OF INDIVIDUALS WITH LATERAL EPICONDYLAR PAIN

2011 ◽  
Vol 14 (02) ◽  
pp. 1250001
Author(s):  
Valentin C. Dones ◽  
Karen Grimmer-Somers ◽  
Kerry Thoirs ◽  
Consuelo B. Gonzalez-Suarez
Keyword(s):  
Radial Nerve ◽  
Healthcare Professionals ◽  
Biceps Tendon ◽  
Lateral Collateral Ligament ◽  
Extensor Tendon ◽  
Perfect Agreement ◽  
Lateral Epicondyle ◽  
Standardized Protocol ◽  
The Common ◽  
Strong Agreement

Purpose: This research aims to determine the inter-tester reliability of sonographers in detecting presence of lesions in the elbows of participants with Lateral Epicondylar Pain (LEP) using the Musculoskeletal Ultrasound (MSUS) and in measuring the internal dimensions of the Radial Nerve at various points in the upper extremities. Methods: Two healthcare professionals who are experienced in MSUS and a musculoskeletal researcher agreed on the diagnostic sonographic features of LEP. Evidence of lesions was sought on the common extensor tendon (CET), lateral epicondyle, lateral collateral ligament, and distal biceps tendon. Measurements on the internal widest dimensions of the radial nerve at specified points were gathered. Results: There was perfect agreement between the two healthcare professionals in detecting bony irregularities on the lateral epicondyle and strong agreement on the presence of neovascularity in CET. The inter-tester reliability in assessing the internal architecture of the common extensor tendon ranged from poor (CET's margin and fibrillar pattern) to fair (for adjacent fluid and intratendinous calcifications). There were no significant differences between sonographers in measuring the Radial Nerve except for the Posterior Interosseous Nerve. Conclusions: Differences in MSUS assessment on CET's tendon margin and fibrillar pattern and the measurement of PIN between experienced healthcare professionals in MSUS scanning and interpretation highlight the need for standardized protocol.

scholarly journals Incidence of tennis elbow and association of hand grip strength among college students

2020 ◽  
Vol 9 (1) ◽  
pp. 177
Author(s):  
Riyas Basheer K. B. ◽  
Subhashchandra Rai ◽  
Irshana Balkies A. M. ◽  
Jasim Junaid N. P.
Keyword(s):  
College Students ◽  
Grip Strength ◽  
Incidence Rate ◽  
Tennis Elbow ◽  
Lateral Epicondylitis ◽  
Extensor Tendon ◽  
Lateral Epicondyle ◽  
Hand Grip ◽  
Local Tenderness ◽  
Left And Right

Background: Lateral epicondylitis is an overuse injury involving the origin of common extensor tendon at elbow joint. Among the college students there is more complaint on wrist and elbow. Objective was to find out the incidence of tennis elbow & grip strength among the students during the entire academic year.Methods: Three hundred and seventy subjects fulfilled the inclusion criteria with age respondents between seventeen to twenty four years. This study is done in those students who have local tenderness on palpation over the lateral epicondyle (grade 2). NPRS was used for measuring the pain intensity. Mill’s test and Cozen’s test was performed to confirm the tennis elbow. The subject is asked to squeeze the dynamometer three times with left and right hand respectively. There was one minute resting period between each squeeze were taken into account.Results: The incidence of confirmed tennis elbow was 4.05% & 2.70% in right and left respectively. Among those participants Mill’s test was positive in 16.2% on right and left side and Cozen’s test was positive in 8.1% on right side and 5.4% on left side. The mean rank of left and right grip strength for the students who are confirmed as tennis elbow were 52.75 Kg and 50.67 Kg and for not-confirmed were 36.56 Kg and 36.41 Kg respectively.Conclusions: The study concluded that 6.7% incidence rate of tennis elbow was observed in college students during the entire academic year. And also concluded there is no much significance correlation between grip strength and tennis elbow incidence rate.

Ultrastructure of the common extensor tendon in tennis elbow

1980 ◽  
Vol 386 (3) ◽  
pp. 317-330 ◽  
Author(s):  
Kiriti Sarkar ◽  
Hans K. Uhthoff
Keyword(s):  
Tennis Elbow ◽  
Extensor Tendon ◽  
The Common

Ultrasonic Percutaneous Tenotomy for Recalcitrant Lateral Elbow Tendinopathy: Clinical and Sonographic Results at 90 Months

2021 ◽  
pp. 036354652110101
Author(s):  
Benjamin F.H. Ang ◽  
P. Chandra Mohan ◽  
Meng Ai Png ◽  
John Carson Allen ◽  
Tet Sen Howe ◽  
...  
Keyword(s):  
Pain Relief ◽  
Extensor Tendon ◽  
Tissue Healing ◽  
Lateral Elbow ◽  
Percutaneous Tenotomy ◽  
Vas Scores ◽  
The Common ◽  
Lateral Elbow Tendinopathy

Background: In a study from our institution, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon for recalcitrant lateral elbow tendinopathy showed excellent safety profiles, high tolerability, efficiency, sustained pain relief, functional improvement, and sonographic evidence of tissue healing in 20 patients at 3 years’ follow-up. Purpose: To explore the long-term clinical and sonographic results of ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon. Study Design: Case series; Level of evidence, 4. Methods: The same cohort of 20 patients was recalled after 7 years, and visual analog scale (VAS) for pain and Disabilities of the Arm, Shoulder and Hand (DASH) scores, need for secondary intervention, and overall satisfaction were assessed. They were also reassessed using ultrasound imaging of the brevis and the common extensor tendon to evaluate tendon hypervascularity, tendon thickness, and the progress or the recurrence of the hypoechoic scar tissue. Results: We successfully scored 19 patients and performed ultrasound on 16 patients with a median follow-up of 90 months (range, 86-102 months). There were no adverse outcomes and satisfaction remained at 100% (6 patients, satisfied; 13 patients, very satisfied). No patient developed a recurrence of symptoms and signs of lateral elbow tendinopathy, and therefore no secondary intervention was required. The improvement from baseline and early term scores was sustained ( P < .001 for all). At 90 months, there was a significant improvement in VAS scores and DASH–Compulsory scores compared with preprocedure scores and all follow-up times until 3 months. There was no difference in VAS scores and DASH–Compulsory scores at 90 months compared with 6 and 36 months. For DASH–Work scores, there was a significant improvement at 90 months compared with preprocedure scores, but there was no difference between DASH–Work scores at 90 months and scores at all other points of follow-up. At 90 months, hypervascularity remained resolved in 79% of patients, while all patients had reduced tendon swelling and sustained resolution or reduction of the hypoechoic lesion. Conclusion: At the long-term follow-up of 90 months, ultrasonic percutaneous tenotomy of the brevis and the common extensor tendon, previously shown to enhance recovery of lateral elbow tendinopathy, demonstrated good durability of pain relief and functional recovery that was previously achieved. This was accompanied by sustained sonographic tissue healing with no significant deterioration.

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