Cargando…

Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow

Tennis elbow symptoms are reportedly most severe in the morning, which prompted a search for a pathological process while asleep. A “pathological sleep position” was hypothesized that repetitively aggravates an elbow lesion if the arm is overhead and pressure is on the lateral elbow. This hypothesis...

Descripción completa

Detalles Bibliográficos
Autor principal: Gorski, Jerrold M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754212/
https://www.ncbi.nlm.nih.gov/pubmed/31592507
http://dx.doi.org/10.5435/JAAOSGlobal-D-19-00082
_version_ 1783453042314575872
author Gorski, Jerrold M.
author_facet Gorski, Jerrold M.
author_sort Gorski, Jerrold M.
collection PubMed
description Tennis elbow symptoms are reportedly most severe in the morning, which prompted a search for a pathological process while asleep. A “pathological sleep position” was hypothesized that repetitively aggravates an elbow lesion if the arm is overhead and pressure is on the lateral elbow. This hypothesis was tested by using a restraint to keep the arm down while asleep. METHODS: This study was a retrospective review. All patients were advised to use a restraint to keep the arm down at night. The presence of the restraint in the morning was correlated with the subjective report. The control group consisted of the noncompliant patients. RESULTS: Compliance and subjective improvement was documented in 33 of 39 patients (85%). Subjective improvement was reported by 66% of the compliant patients after 1 month. Pain continued after the first 3 months only in 6 of 39 noncompliant patients (15%). DISCUSSION: In this pilot study, patients who kept the arm down at night improved, whereas patients who were noncompliant continued to be symptomatic. Sleep position should be considered as a possible aggravating factor that delays healing of an acute injury and results in chronic pain. If validated, keeping the arm down at night can be recommended for tennis elbow.
format Online
Article
Text
id pubmed-6754212
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Wolters Kluwer
record_format MEDLINE/PubMed
spelling pubmed-67542122019-10-07 Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow Gorski, Jerrold M. J Am Acad Orthop Surg Glob Res Rev Research Article Tennis elbow symptoms are reportedly most severe in the morning, which prompted a search for a pathological process while asleep. A “pathological sleep position” was hypothesized that repetitively aggravates an elbow lesion if the arm is overhead and pressure is on the lateral elbow. This hypothesis was tested by using a restraint to keep the arm down while asleep. METHODS: This study was a retrospective review. All patients were advised to use a restraint to keep the arm down at night. The presence of the restraint in the morning was correlated with the subjective report. The control group consisted of the noncompliant patients. RESULTS: Compliance and subjective improvement was documented in 33 of 39 patients (85%). Subjective improvement was reported by 66% of the compliant patients after 1 month. Pain continued after the first 3 months only in 6 of 39 noncompliant patients (15%). DISCUSSION: In this pilot study, patients who kept the arm down at night improved, whereas patients who were noncompliant continued to be symptomatic. Sleep position should be considered as a possible aggravating factor that delays healing of an acute injury and results in chronic pain. If validated, keeping the arm down at night can be recommended for tennis elbow. Wolters Kluwer 2019-08-02 /pmc/articles/PMC6754212/ /pubmed/31592507 http://dx.doi.org/10.5435/JAAOSGlobal-D-19-00082 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Research Article
Gorski, Jerrold M.
Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow
title Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow
title_full Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow
title_fullStr Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow
title_full_unstemmed Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow
title_short Evaluation of Sleep Position for Possible Nightly Aggravation and Delay of Healing in Tennis Elbow
title_sort evaluation of sleep position for possible nightly aggravation and delay of healing in tennis elbow
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754212/
https://www.ncbi.nlm.nih.gov/pubmed/31592507
http://dx.doi.org/10.5435/JAAOSGlobal-D-19-00082
work_keys_str_mv AT gorskijerroldm evaluationofsleeppositionforpossiblenightlyaggravationanddelayofhealingintenniselbow