Tenosynovitis, peritendinitis and the tennis elbow syndrome

Both tenosynovitis and peritendinitis of the wrist and forearm and the tennis elbow syndrome are common problems among industrial workers. Yet not much is known of the etiology of these diseases and, especially, of the role of mechanical factors in the etiology. The role of different causative factors is usually studied through comparison of the occurrence rates of the disease in differentially exposed working populations. However, not many such epidemiologic studies have been done. That repetitive movements in manual work may cause tenosynovitis or peritendinitis is generally accepted. Efforts to study further movements and the work positions at fault have, however, failed to show any single set of movements or hand positions. It is often postulated that movements such as repetitive dorsiflexions of the wrist and prosupinations of the forearm are causative for the tennis elbow syndrome, but there is no scientific proof for this argumentation. There are also several proposed mechanisms for the pathogenesis of the disease. In the treatment of the acute phase of these diseases in an occupational health setting, rest for the affected limb is essential. Prevention of the diseases and their recurrences probably requires changes in work conditions. Yet, at the moment, there is not much scientific basis for these measures.