Epicondylitis: An Ergonomics Issue that Begins With Pain – A Commentary

Epicondylitis is a common cause of pain in the elbow and arm [1]. Generally, epicondylitis is observed in middle-aged patients with no predication for either gender. This disease state was first described in 1873 by Runge as a chronic degeneration condition associated with the wrist/arm. There are two basic forms of Epicondylitis, lateral and medial, when evaluated from an anatomical prospective. Medial epicondylitis (ME) (Golfer’s elbow) is the least common form observed and is a result of movement occurring in the wrist through “twisting” toward the palm. This can occur due to golf swings along with activities like chopping wood, repetitive hand movements that employ a tool or use of a chain saw [1]. ME is associated with the superficialis flexor digitorum and medial epicondyle. The more common form of injury involves the lateral epicondylitis (LE) which has an incidence rate of around 1 to 3 percent in the general population [1]. Higher incidence rates have been observed in occupational populations. LE is seen more frequently in workers that undertake forceful and repetitive activities that usually include awkward postures associated with movement of the elbow [2]. Recently, Descatha et al. [3] reported an association of LE with tasks that are strenuous in nature and support previous findings of activities that are repetitive more than 2 hours a day for hand tools greater than one kilogram. LE is associated with the extensor carpi radialis and lateral epicondyle. Both of these forms have been suggested to result in irritation and inflammation of the associated tendons (e.g. LE Extensor Carpi Radialis Brevis) and muscles/structures [1,2]. However, actual pathophysiological mechanisms have not been fully elucidated.