title: Diagnosis and Management Pattern of Lateral Epicondylitis in a Tertiary Care Center.
abstract: BACKGROUND
  Lateral Epicondylitis has been found to be the second most frequently diagnosed musculoskeletal disorder. A wide range of symptomatic treatments are available such as use of anti-inflammatory analgesic drugs, steroids, physiotherapy. This study aims to know about the diagnosis, prescription pattern and current practice on management of tennis elbow in Nepal.
  
  
  METHODS
  This is a hospital based observational study carried out at Bir Hospital, Kathmandu, Nepal. Patients diagnosed with tennis elbow were purposively selected through prospective sampling technique from Orthopedic Department. Questionnaire and patient medication files were used as tools for data collection.
  
  
  RESULTS
  A total of 97 patients were found to be suffering from tennis elbow affecting mostly 41-50 years of age group and seen mostly in female (62%). Further, it was found that housewives (31%) were mostly affected. Diagnosis of tennis elbow was done commonly by clinical evaluation (61%) and X-ray (39%). Both Pharmacological and Non-Pharmacological approaches were in practice. Pharmacological treatment include NSAIDS (59% Aceclofenac, 19% Naproxen, 18% Indomethacin, 16% Diclofenac, 6% Piroxicam) and Steroids (23% methylprednisolone acetate and 21% oral prednisolone). Non-Pharmacological treatment was done by lifestyle modification (100%), 78% application of heat, 63% use of tennis elbow band, 29% exercise and 28% physiotherapy. Surgical intervention (3%) was also done when the conservative management failed.
  
  
  CONCLUSIONS
  There is professional risk of tennis elbow for housewives, farmers and shopkeepers in context of Nepal. Only one treatment approach is not effective in management of tennis elbow for long term effect.
authors.affiliation: Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Nayabazar, Kathmandu, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Dhakal
authors.affiliation: Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Nayabazar, Kathmandu, Nepal, Nepal Health Research Council (NHRC), Ramshah Path, Kathmandu, Nepal.
authors.forename: T
authors.initials: T
authors.lastname: Acharya
authors.affiliation: Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Nayabazar, Kathmandu, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Gautam
authors.affiliation: Department of Pharmacy, National Model College for Advanced Learning, Tribhuvan University, Nayabazar, Kathmandu, Nepal.
authors.forename: N
authors.initials: N
authors.lastname: Upadhyay
authors.affiliation: Manmohan Cardiothoracic, Vascular and Transplant Center, TUTH, IOM, Maharajgung, Kathmandu, Nepal.
authors.forename: S
authors.initials: S
authors.lastname: Dhakal
keywords: lateral epicondylitis; NSAIDs; physiotherapy; steroid; tennis elbow.