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Epicondylitis, also known as tennis elbow, not only affects athletes but all those who perform repetitive activity with the upper limbs. There are different forms of epicondylitis, all characterized by pain on the lateral part of the elbow.

If not treated properly, the situation becomes increasingly severe and painful to the point that even the simple gesture of raising the arm to drink a glass of water becomes problematic. First of all, it should be pointed out that this syndrome has taken the name of epicondylalgia, and no longer epicondylitis.

This is because in the past all the problems were attributed to the inflammatory cause, while with the latest scientific evidences shared by us at Nervenia emphasize that the degenerative neurogenic process of the tendons involved is predominant.


The cause of epicondylitis is always mechanical, due to over-stressing of the affected part and to repetitive sports or work movements. The repetitive work of the hand and forearm (for example that done by on-line workers, electricians, plumbers, tennis players) is a predisposing factor.  It often begins with a small blunt trauma on the lateral part of the elbow, which in association with repetitive movements triggers the pathology. Even mechanical alterations of the elbow and arm can have the same consequences. 


Pain is the predominant symptom of epicondylitis and is localized where these fibers attach to the bone on the outer side of the elbow. Clinically, it starts with subtle onset pain, with pain during the combined use of hand, wrist and elbow. Pain may increase in the evening, after work or sports days. Usually the symptomatology becomes more intense in terms of size and duration, with greater functional difficulties  and progressive reduction of activity up to a real functional impotence. Some patients also report a glass of water as painful and extremely difficult.


Radiological examination is usually negative (although sometimes small calcifications are present). The diagnosis is mainly clinical even if a local ultrasound, better if done with color or power Doppler, allows to identify the areas of degeneration and increase of vascularization.

Cures and remedies

Until today, in acute forms (ongoing pain) epicondylitis therapy aims to eliminate inflammation and pain by interrupting or temporarily reducing sports or work, combining the use of local anti-inflammatory drugs with a subsequent immobilization of the elbow for a few weeks if the first phase of treatment does not work, associating 2-3 local infiltrations. In rebel forms to conservative therapy, surgery has been often indicated.

In recent times the use of shock waves followed by physical therapies has spread quite successfully.

What Nervenia offers, completing the classical therapies, is a deep nerve stimulation (DNS) treatment, with which our patients have obtained excellent conservative and post-surgical results, minimizing the risk of recurrence.