A.N. CHESNAKOV^1, 2, V.V. KOKORIN^1, 2, P.E. KRAYNYUKOV^1, 3, A.A. EVTUSHENKO⁴

 ¹Central Military Clinical Hospital named after P.V. Mandryk, Moscow

²National Medical-Surgical Center named after N.I. Pirogov, Moscow

³People’ Friendship University of Russia, Moscow

⁴Military Hospital 422, Nizhniy Novgorod

 Contact details:

Chesnakov A.N. — Senior Resident of the Surgical Department

Address: 8A Bolshaya Olenyya St., Moscow, Russian Federation, 107014, tel.: +7-905-762-98-78, e-mail: Alecsei-1974@yandex.ru

 The article analyzes the issues of the clinic, diagnosis, choice of tactics for the treatment of lateral epicondylitis, as well as the positive aspects of conservative treatment by a combined use of traditional physiotherapy and the principles and methods of reflexotherapy. A new method for the treatment of lateral epicondylitis (patent for invention dated May 30, 2022) is presented, which is based on the synthesis of the classical physical method for the treatment of periarticular tissues pathology and reflexotherapy using the traditional Chinese medicine methods.

This method of treatment enables in short terms, in the outpatient conditions, to stop the inflammatory syndrome in the area of the elbow joint, restore the physiological function of the upper limb, improve microcirculation, lymphatic drainage, and stimulate the proliferative-reparative process of the lateral epicondyle of the humerus. This method of treatment makes it possible to create optimal conditions for the repair of damaged enthesis and muscle structures as part of the muscular-tendon meridians of the large intestine and «the triple heater», the relief of the pathological inflammatory process, pain syndrome, the restoration of the volume of movement and the functional and physiological state of the upper limb.

The presented method of treatment of the said pathology consists in non-drug therapy of lateral epicondylitis by using a device for vacuum-gradient therapy in local trigger zones diagnosed during ultrasound examination by a linear sensor L12-5. Diagnostics of «stress points» is performed according to the scheme of projection of the muscular-tendon meridian of the large intestine and «the triple heater» onto the skin. In the diagnosed «stress points» on the surface of the skin of the upper limb and the corresponding shoulder zone, massage is performed using vacuum-gradient suction cups with a diameter of up to 50 mm.

High negative pressure (200 mmHg) is created in the «stress points» during the first session. In each subsequent session, the pressure achieved after the second session of therapy increases by 1.5–2 times and not more. The multiplicity of pressure increases depends on the individual tolerability of the procedure by the patient. The target level of achieving negative pressure at the «trigger point» is 800–1000 mmHg with reaching a plateau till a stable clinical effect is achieved. The maximum number of procedures was nine sessions for the patient. On average, five sessions with an interval of two to three days are enough to achieve a stable clinical effect.

Key words: lateral epicondylitis, «tennis elbow», enthesis, enthesopathy, vacuum-gradient therapy, extracorporeal shock wave therapy, visual analog scale.

 (For citation: Chesnakov A.N., Kokorin V.V., Kraynyukov P.E., Evtushenko A.A. Method of treatment of lateral epicondylitis. Practical medicine. 2022. Vol. , № , P.)