SUMMARY
Background. Lateral Elbow Tendinopathy (aka Tennis Elbow or Lateral Elbow Pain), is characterized by a specific pain located in the lateral epicondyle and referred to the dorsal compartment of the forearm. Manual labour and forceful gripping activities can exacerbate pain, by restricting a patient’s ability to work, train and perform simple daily tasks. In the framework of an aetiopathogenic complexity, a multimodal approach based upon the exclusive involvement of the common extensor tendon seems to be rather obsolete. This method does not consider any intra-articular pain resulting from micro-instabilities requiring a different approach together with a detection performed in a limited time span, in order to avoid any impairment of the psychosocial condition following the failure of all the proposed conservative treatments.
Objectives. The primary objective of this debate was to have elaborated a decisional algorithm called Integrated Approach of Lateral Elbow Pain (I-APPLEp), which could allow the detection of a time-optimized plan for a diagnostic, therapeutic framing.
Discussion. Following the above-mentioned research proposal, this clinical approach based upon an evaluative and therapeutic management of patients with LEP allows us to draw some conclusions:
1) using the expression Lateral Elbow Pain (LEP) to refer to this musculoskeletal condition should be preferable, owing to its aetiological and pathophysiological complexity. Moreover, the expression Non-specific Lateral Elbow Pain (NSLEP) in case of suffering of the extra-articular structures (i.e. Tendinopathy) and Specific Lateral Elbow Pain (SLEP) is recommended, within the framework of arthropathy or intra-articular pathology (e.g.: Smile Symptomatic MInor Instabilities of the Lateral Elbpw); 2) an early surgical treatment can be a feasible option in the management of articular micro-instabilities, recalcitrant pathologies and psychosocial profiles with a high risk of unfavorable prognosis.
Conclusions. We recommend testing brand-new diagnostic, therapeutic proposals on sampling patients, who must be adequately chosen, in order to estimate the real impact in the short, medium and long term.
Research proposal of a new clinic model for the interpretation of Lateral Elbow Pain: is it time to change?
L. Di Filippo, D. Pennella, F. Maselli, P. Arrigoni
Original Article, 57-66
Keywords: lateral elbow pain, lateral elbow tendinopathy, tennis elbow.,
Table of Content: Vol. 10 (No. 1) 2020 January/March
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Thanks to the reviewers
Acknowledgments, 0 -
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