Download PDF
J Wrist Surg 2019; 08(04): 295-299
DOI: 10.1055/s-0039-1685451
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Depression and Anxiety among Patients with Atraumatic Lateral Epicondylitis and Ulnar-Sided Wrist Pain

Michael J. Pensak
1   Department of Orthopedics, University of Colorado School of Medicine; University of Colorado Hospital, Aurora, Colorado
,
Patrick M. Carry
2   Children's Hospital Colorado, Musculoskeletal Research Center, Department of Orthopedic Surgery, Aurora, Colorado
,
Jacob M. Entin
1   Department of Orthopedics, University of Colorado School of Medicine; University of Colorado Hospital, Aurora, Colorado
,
Andy Lalka
2   Children's Hospital Colorado, Musculoskeletal Research Center, Department of Orthopedic Surgery, Aurora, Colorado
3   Department of Orthopedics, University of Colorado School of Medicine Aurora, Colorado
,
Nader A. Shourbaji
1   Department of Orthopedics, University of Colorado School of Medicine; University of Colorado Hospital, Aurora, Colorado
,
Frank A. Scott
1   Department of Orthopedics, University of Colorado School of Medicine; University of Colorado Hospital, Aurora, Colorado
› Author Affiliations
Further Information

Publication History

24 July 2018

27 February 2019

Publication Date:
17 April 2019 (online)

    Permissions and Reprints

Abstract

Background Ulnar-sided wrist pain (UWP) and lateral epicondylitis (LE) are common disorders that can be difficult to treat. Depression and anxiety have been shown to modify patient symptoms, disability and pain.

Questions/Purposes The purpose of our study was to quantify the prevalence of depression and anxiety among patients with LE or UWP. A secondary aim was to determine if these patients report higher levels of pain upon presentation and if they are more likely to require occupational therapy.

Patients and Methods A retrospective chart review was conducted, and patients included those with LE or UWP, atraumatic in origin, ages 18 and over, and ongoing use of noninvasive treatment of LE or UWP.

Results Our final analysis included 97 patients of which 57 had LE, 34 had UWP, and 6 had both. The prevalence of a mood disorder was 34.0%. Anxiety and/or depression was more prevalent in patients with LE compared to UWP. The most common medication was alprazolam. Pain scores averaged 1.2 points higher in subjects with a history of a mental health disorder. After adjusting for age and sex, there was no significant association between prevalence of depression and/or anxiety and utilization of physical or occupational therapy.

Conclusions Patients with either LE, UWP or both along with depression and/or anxiety may be less likely to improve with traditional treatments. Future investigations are warranted focusing on the value of a multidisciplinary team consisting of a hand surgeon, behavioral therapist, or psychologist to optimize treatment response.

Level of Evidence This is a Level IV, case series study.

Keywords

anxiety - depression - lateral epicondylitis - mental disorder - upper extremity

Note

This study was approved by the Colorado Multiple Institutional Review Board.