Pathogenesis (development of disease)
Epicondylitis humeri results from chronic overuse of the muscle insertion of the extensor carpi radialis brevis muscle, the extensor digitorum communis muscle, and the carpi radialis longus muscle and repetitive microtrauma (repeated microinjuries). This results in neurological irritation and metabolic changes and initiates a chronic inflammatory degenerative process.
Histopathologically, it is a tendon degeneration, i.e. a tendinopathy (tendon disease), and not an inflammation of the epicondyle (bony prominence in the immediate vicinity of the articular process or condyle).
Due to one-time or prolonged heavy overloading, e.g. at work, gardening or sports, radial “tennis elbow” occurs, especially in tennis players, and ulnar “golfer’s elbow” in golfers.
Note: Left-handed players may also develop the disease on the right side. One discusses in this context the occurrence of neutrophic (“acting on the nerves“) regulatory disorders due to a cervical syndrome (syndrome of the cervical spine with nerve compression/damage).
Etiology (Causes)
Biographic causes
- Age of life – increasing age
- Occupations – occupations that always perform the same movements (eg, craftsmen, office workers).
Behavioral causes
- Consumption of stimulants
- Tobacco (smoking)
- Physical activity
- Chronic overload due to repetitive movements of the corresponding muscle groups for at least 2 hours a day (eg, playing tennis, playing an instrument) or force (> 20 kg)By the way: occurrence in trained tennis players with about 5% rather rare.
- Overweight (BMI ≥ 25; obesity).
Disease-related causes
- Arthritis (inflammation of the joints)
- Synovitis (synovial inflammation) – inflammation of the inner layer of the joint capsule, the membrana synovialis.
- Traumatic periostitis (periosteum inflammation).
- Injury to the extensor muscles of the forearm
