Die Therapie der Epicondylitis – eine aktuelle Übersicht

Zusammenfassung

Die Epicondylitis radialis humeri oder auch Tennisellbogen ist eine sehr häufige Erkrankung, die nicht nur bei Tennisspielern, sondern im Zusammenhang mit vielerlei Aktivitäten auftritt und ein Überlastungssyndrom der Unterarmextensoren darstellt. Bereits bei der Differenzialdiagnose sind dennoch viele andere Erkrankungen abzugrenzen. Die Auswahl an Therapieoptionen ist unüberschaubar und es existieren nur wenige gute klinische Studien, die ein Therapiekonzept evidenzbasiert hinsichtlich Wirksamkeit unterstützen. Im akuten Stadium erweist sich die lokale Anwendung von NSAIR, Steroidinjektionen, Ultraschall oder Akupunktur als hilfreich. Hinsichtlich der Wirksamkeit von Krankengymnastik, Orthesen, Lasertherapie, Elektrotherapie oder Botulinumtoxininjektion besteht zurzeit kein Konsens. Im chronischen Stadium der Erkrankung erweist sich gemäß Evidenzkriterien bisher keine Therapie als wirksam. Ob Patienten in dieser Phase von Krankengymnastik, Orthesen, Stoßwellentherapie oder einer Operation profitieren, ist nicht bewiesen. Ob in Zukunft orthobiologische Verfahren eine Rolle spielen werden, ist gegenwärtig noch ungewiss.

Abstract

Lateral epicondylitis or tennis elbow is a common injury, which affects not only people who play tennis but occurs with many different activities. It reflects overuse of the extensor muscles of the forearm. There are some other pathologies which have to be separated from epicondylitis. The choice of different treatments is hard to overlook and there are only a few good clinical trials which support one treatment option by means of evidence based medicine. During the acute phase topical NSAIR, steroid injections, ultrasound and acupuncture are helpful. There is no consensus about the effectiveness of physiotherapy, orthoses, laser, electrotherapy or botulinumtoxininjections. During the chronic phase none of the different treatment modalities is effective according to criterias of evidence based medicine. By now, it has not been proven whether patients profit during that time of physiotherapy, orthoses, extracorporeal shock wave therapy or an operation. Whether orthobiological treatment options may play a role in the future is presently uncertain.

Schlüsselwörter

Epicondylitis - Tennisellbogen - evidenzbasierte Therapie

Key words

epicondylitis - tennis elbow - evidence based medicine

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