Central Sensitization and Ultrasound in Lateral Epicondylitis

Lateral epicondylitis (LE) is a common musculoskeletal disorder characterized by pain and tenderness over the lateral elbow and may become chronic despite conservative treatment. Although LE is primarily associated with local tendon pathology, central sensitization, radial nerve involvement, and psychosocial factors may contribute to persistent pain and disability. This cross-sectional case-control study aims primarily to compare remote pressure pain thresholds between individuals with chronic LE and healthy controls. Secondary objectives are to compare clinical, functional, psychosocial, and ultrasonographic findings between the groups and to investigate the factors associated with functional impairment in individuals with chronic LE.

1. CASE GROUP Inclusion Criteria: Have unilateral lateral elbow pain persisting for at least 3 months Have a visual analog scale score of 4/10 or higher Have tenderness upon palpation of the common extensor tendon and/or lateral epicondyle region Experience elbow pain that occurs or worsens with hand grip or lateral elbow pain that occurs with resistant static contraction or stretching of the wrist extensors Have read and signed the volunteer consent form (VCF) Exclusion Criteria: * Having undergone surgery on the upper extremity or cervical region before * Presence of cervical or shoulder pathology * Mechanical symptoms in the elbow (locking, limited range of motion) and other elbow pathologies * History of trauma to the elbow * Presence of upper extremity neurological deficit * History of fibromyalgia, central nervous system disease, or rheumatic disease * Last 1 month history of physical therapy or injection for lateral epicondylitis * Pregnancy 2. HEALTHY GROUP Inclusion Criteria: * Not having experienced elbow pain before * Having read and signed the volunteer agreement form (BGOF) 2.Exclusion criteria * Presence of upper extremity, shoulder, or neck pain within the last year * History of upper extremity fractures * Presence of neurological deficits