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The laser Doppler flowmeter, an instrument highly sensitive to changes in blood flow velocity in the dermal microvascular bed, was used to examine a sympathetic vasomotor response (SVR) in 40 patients with lateral epicondylitis. There was a significant association between the absence of a normal SVR in the skin overlying the affected enthesis compared with the unaffected contralateral epicondyle (P < 0.01). These results suggest that local dysfunction of the sympathetic nervous system may be associated with the pathogenesis of anatomically discrete pain in the enthesopathy of epicondylitis.
Smith et al. (Sat,) studied this question.