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
