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World J Orthop. Apr 18, 2022; 13(4): 354-364
Published online Apr 18, 2022. doi: 10.5312/wjo.v13.i4.354
Lateral epicondylitis: New trends and challenges in treatment
Vesselin Karabinov, Georgi P Georgiev
Vesselin Karabinov, Clinic of Neurology, National Cardiology Hospital, Sofia 1000, Bulgaria
Georgi P Georgiev, Department of Orthopedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, Sofia 1527, Bulgaria
Author contributions: All authors made significant contributions to the preparation of this manuscript; Karabinov V participated in the review of the literature and selection of appropriate materials, wrote the article, and critically revised the article; Georgiev GP created the concept of this manuscript, wrote the article, critically revised the article, and participated in the final approval.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Georgi P Georgiev, MD, PhD, Assistant Professor, Department of Orthopedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, Byalo More Str., Sofia 1527, Bulgaria. georgievgp@yahoo.com
Received: October 2, 2021
Peer-review started: October 2, 2021
First decision: December 9, 2021
Revised: December 14, 2021
Accepted: April 3, 2022
Article in press: April 3, 2022
Published online: April 18, 2022
Processing time: 191 Days and 13.6 Hours
Abstract

Lateral epicondylitis (LE) is a chronic aseptic inflammatory condition caused by repetitive microtrauma and excessive overload of the extensor carpi radialis brevis muscle. This is the most common cause of musculoskeletal pain syndrome in the elbow, inducing significant pain and limitation of the function of the upper limb. It affects approximately 1-3% of the population and is frequently seen in racquet sports and sports associated with functional overload of the elbow, such as tennis, squash, gymnastics, acrobatics, fitness, and weight lifting. Typewriters, artists, musicians, electricians, mechanics, and other professions requiring frequent repetitive movements in the elbow and wrists are also affected. LE is a leading causation for absence from work and lower sport results in athletes. The treatment includes a variety of conservative measures, but if those fail, surgery is indicated. This review summarizes the knowledge about this disease, focusing on risk factors, expected course, prognosis, and conservative and surgical treatment approaches.

Keywords: Diagnosis; Lateral epicondylitis; Tennis elbow; Treatment; Review

Core Tip: Lateral epicondylitis (LE) is the most common cause of musculoskeletal pain in the elbow. LE is a leading causation for absence from work and lower sport results in athletes and has a negative impact on the job and social life of patients. Despite extensive research in the last few decades and the plenty of different articles concerning the causes, pathogenesis, and treatment, LE remains a challenge. In this article, we summarize the knowledge about this condition, emphasizing the risk factors, the development of symptoms and the prognostic value of individual factors, and the treatment approaches.