Diseases & Conditions Archive

Tennis elbow is the common term for lateral epicondylitis, an inflammatory condition of the tendon that connects the extensor muscles of the lower arm to a bony prominence on the outside of the elbow called the lateral epicondyle. The condition causes pain at the point where the tendon attaches to the epicondyle. The pain may radiate to the forearm and wrist, and in severe cases, grip strength may lessen. It can become difficult to perform simple actions like lifting a cup, turning a key, or shaking hands.

As many as half of all people who play racket sports have the condition, but most people who have tennis elbow didn't acquire it by playing tennis, squash, or racquetball. It can result from any activity that involves twisting or gripping motions in which the forearm muscles are repeatedly contracted against resistance, such as pruning bushes or pulling weeds, using a screwdriver, or playing a violin. Tennis elbow is an occupational hazard for professional gardeners, dentists, and carpenters.

Research we're watching

An increasing number of Americans have a blood abnormality that indicates autoimmunity, which means their immune system has created antibodies that could work against the body's own cells, according to a study published April 7, 2020, in Arthritis and Rheumatology. Autoimmunity can lead to autoimmune diseases such as rheumatoid arthritis or lupus, although the study authors said they didn't look to see whether the prevalence of diagnosed autoimmune diseases also rose during the same period of time.

The researchers found a rise over two decades in the number of people who had positive antinuclear antibody (ANA) blood tests, a signal of autoimmunity. They used blood samples taken from 14,211 people ages 12 and older, as part of the U.S. National Health and Nutrition Examination Survey. In samples taken in the period 1988 to 1991, ANA prevalence was 11%. It rose slightly to 11.5% for the 1999–2004 time period, and to 15.9% in the 2011–2012 period. Comparing differences in gender, race and age, the largest increases in positive ANA tests occurred in men, non-Hispanic whites, adolescents, and adults ages 50 and older.

On call

Q. I occasionally get an excruciating leg cramp that wakes me from sleep. What causes leg cramps, and how can I prevent them?

A. Although nocturnal leg cramps can strike people at any time of life, they become more frequent with age. Among people older than age 50, about half report having leg cramps, a third say they are awakened at night by them, and 15% report having cramps about once per week.

Men need to manage their bone health as much as women do.

Most people think of osteoporosis as a women-only health problem, but older men also need protection from this bone-weakening disease.

About one in four men older than 50 will break a bone because of osteoporosis during his lifetime, according to the National Osteoporosis Foundation. And research has found that compared with women, older men are more likely to die following a fracture related to osteoporosis.

Ask the doctor

Q. I know doctors and scientists are very busy dealing with COVID-19. Is the need to care for, and do research on, COVID-19 affecting the care of and research on other important diseases?

A. You're right: the COVID-19 pandemic has consumed and disrupted medical care and medical research in the United States and around the world.

Ask the doctors

Q. A friend told me that I should be screened for hepatitis C. I'm not in a high-risk group. Is this really necessary?

A. If you're an adult younger than 80 years old, the answer is yes. In March, a government health advisory group, the U.S. Preventive Services Task Force (USPSTF), revised its earlier position and now recommends that all people ages 18 to 79 be screened for this "silent" virus. Prior to this change, the USPSTF recommended only that only high-risk individuals or adults born between the years 1945 and 1965 be screened. Hepatitis C can attack the liver and lead to serious liver damage and liver cancer. The condition is curable if detected. But people often don't consider themselves at risk and are unaware that they are infected, because they typically don't have symptoms.

The easiest way to protect your eyes from the sun's hazardous radiation is to wear sunglasses, not only in the summer months, but year-round. Ultraviolet (UV) light can damage the iris, retina, lens, and cornea, leading to permanent vision loss. It's a good idea to request UV protection (an invisible coating) on all of your prescription glasses.

UV light has three wavelengths:

UVA is long, looks almost blue in the visible spectrum, and is responsible for skin tanning and aging. It may also contribute to skin cancer risk.

Obstructive sleep apnea affects an estimated 20% of the population, and if untreated it has negative effects on cardiac and metabolic health as well as quality of life. If the condition is moderate or severe, a CPAP machine is the first-line treatment, but there is less consensus about treatment of mild OSA.

Research we're watching

Could a single blood test one day enable doctors to diagnose Alzheimer's disease? Researchers writing in the March 2 issue of Nature Medicine say they've made advances in this area. The blood test they developed measures the concentration of pTau181 — a form of the tau protein associated with brain changes in Alzheimer's disease — in the body's blood plasma. They used the test on samples collected from more than 400 people who were part of an ongoing -memory study.

The researchers found that the blood test was able to accurately detect which patients had Alzheimer's, which were healthy, and which had a different type of dementia caused by a neurodegenerative disease. Today, doctors typically diagnose Alzheimer's using a series of tests designed to rule out other causes, but the process is time-consuming and costly. The researchers are now aiming to refine the test further, in hopes that it will someday make it easier to detect Alzheimer's at an early stage, when the disease may be easier to treat.

New information may affect your approach to treatment.

Millions of people turn to prescription and over-the-counter medications to cope with heartburn from gastroesophageal reflux disease or other stomach conditions. But navigating the risks of heartburn remedies can leave a sour taste in your mouth, since some have been tied to health concerns. Here's what you need to know about two mainstays of treatment, and how the latest developments may affect you.

H2 blockers

Histamine₂-receptor antagonists, better known as H2 blockers — such as famotidine (Pepcid) and cimetidine (Tagamet) — are available over the counter or by prescription. They block a chemical that signals the stomach to produce acid, and are the go-to drugs when an antacid like calcium carbonate (Tums) or aluminum hydroxide (Maalox) isn't strong enough.