Elbow tendinopathies: epicondylitis and epitrochleitis

What is

Tendinopathies in the elbow joint are caused by the deterioration of the tendons that join the different muscles with the bones that form part of this joint. Its development is usually slow and the pain progressive; it is not rare that partial or total tendon ruptures occur, so it is important to act as soon as possible on the factors that lead to the deterioration and subsequent possible rupture of the tendon.

Type

Epicondylitis (Tennis Elbow)

Epicondylitis or tennis elbow is caused by wear and inflammation of the tendons that join the forearm muscles on the outside of the elbow and are involved in the extension of the wrist and fingers.
This injury is usually caused by overuse of these muscles in racquet sports such as tennis, paddle tennis and squash. This causes pain and tenderness to pressure on the outside of the elbow.

Epitrochleitis (Golfer's Elbow)

Epitrocleitis is the inflammation and degeneration of the tendons that attach the forearm muscles to the inside of the elbow.
It is one of the most common causes of elbow pain and is usually related to activities and sports such as golf, climbing or volleyball.
It is caused by wear and tear of the insertion in the bone of the muscles that allow flexion of the wrist.

Symptoms

Symptoms usually appear gradually, i.e. the pain increases slowly with increasing wear and tear. The pain appears on the outside (epicondylitis) or inside of the elbow (epitrochleitis) and as it progresses, there is a decrease in grip strength.

Approach protocol

Diagnosis and assessment

A correct medical evaluation will be necessary by means of a good anamnesis, physical examination and, if necessary, with the support of imaging tests. Focusing especially on identifying the factors that lead to tendon overload (in this phase the biomechanics and the physical trainer will be fundamental) and assessing whether the injury is exclusively a tendinopathy, if there is a rupture or if there are associated calcifications. This will allow to select the best treatment.

Complementary tests

X-ray and/or MRI.

Treatment

The treatment will depend on the doctor’s diagnosis and the degree of deterioration of the tendon, depending on it may be applied:

Drugs for pain relief
Physiotherapy: methodology based on knowledge and clinical reasoning in which we combine a series of techniques and treatments both manual therapy and invasive techniques, always associated or complementing them with cutting-edge technology that allows us to accelerate the recovery process. Among other high-tech devices include Magnetolith, SIS, focal shock waves, Indiba, among others. This therapeutic combination allows us to activate the patient early to begin with a routine and a process of specific therapeutic exercises that allow us to enhance and strengthen the lost functional patterns.
Interventional treatments:
- Regenerative medicine treatments
  - Platelet-rich plasma: the compound extracted from the patient’s own blood has a concentrate of anti-inflammatory factors and cytokines that make it very useful for this pathology.
  - Cytokine-rich serum: this is a different process to platelet-rich plasma in which a compound rich in anti-inflammatory cytokines is also obtained from the blood.
  - Stem cells: originating from the patient’s bone or fat, they have a regenerative and anti-inflammatory power that makes them a unique treatment for pain relief.
- Hyaluronic acid treatment
- Nerve blocks

Here begins your life without pain

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Isaac June

Me a devuelto mi vida rutinaria después de un año.

Teresa Collado MUñoz

El doctor Joege Manuel Orduña calls es un excelente profesional, me ha solucionado rápidamente y sin ir pasando de diagnóstico en diagnóstico las migrañas despues de 2 años por la seguridad social y cansada de que me subieran la medicacion sin otro tipo de tratamiento, y también me está tratando una lesión de hace casi 2 años que por la seguridad social no me han hecho casi nada y lo poco que han hecho era incorrecto por no usar el equipamiento recomendable.

Recomiendo mucho que si necesitáis ir a la unidad del dolor por algun motivo pidáis consulta con el doctor Jorge, con el y con todo su equipo estoy muy agradecida.

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