網球肘──病因及現行保守治療

Lateral Epicondylitis-Review of Causes and Non-Surgical Treatments

肱骨外上髁炎俗稱網球肘，於1873年由Runge等人提出，起因於前臂伸肌腱連接於肱骨骨外髁之退化性肌腱炎。大多個案中網球肘在藥物及復健等保守治療下獲得良好疼癒。在少數嚴重個案中，藥物治療無效。在門診中當藥物治療無效下醫師還能提供患者什麼其他選項，我們回顧目前國外發表的文章統合目前保守治療的選項包含藥物、針炎、震波治療、硝酸鹽塗抹、類固醇注射及血小板生長因子注射等，包含治療成效之回顧，希望提供門診中治療之參考。

Lateral epicondylitis is commonly called tennis elbow and was firstly mention by Runge et al. Instead of an inflammatory process, the recent pathologic studies indicate a degenerative change of the common origin of the extensor tendon over lateral epicondyle. In most of the cases, the symptoms recovered well with medical treatment. However, in severe cases, it may be refractory to NSAID treatment. We aimed at providing physicians in the out-patient department other choices aside from the oral NSAID treatment. This paper reviewed the recent published papers regarding the pathogenesis and treatment results about medical treatment, acupuncture, shock wave treatment, topical nitrate, injection of steroid, whole blood or PRP. Although recent published results fail to provide any conclusive evidence for one preferred method of non-surgical treatment for this condition, this review reminds us about the various treatment choices in cases of failed oral NSAID treatment.