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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Sebastián Trujillo

Cati Hernández Pérez

Ha sido un tratamiento muy positivo, muy atentos y profesionales, si volviese algún otro problema de esta índole no dudaría en volver, gracias por todo

Trap Pezia

Maravilloso ! Finalmente desaparecio el dolor . El dr. Duca es muy empatico y todo el personal una maravilla

Ivan Quer

Yolanda Beribos

Me ha encantado el trato tan amable, tan exquisito y siempre con una sonrisa que eso hace que incluso el dolor sea menor. Muy contenta con la atencion al paciente a la entrada como en el quirofano. Gracias.

Noemi Navarro

Muy agradecida. Levaba año y medio con un dolor intenso en la zona del sacro y con el procedimiento del doctor Duca el dolor se va minimizado muchísimo y esperemos que se vaya del todo. Muchas gracias!!

Marta Del Valle

Execelentes profesionales que dan respuesta a tu dolor

Sebastián Trujillo

Cristina Moya

Estoy encantada con el Doctor Francisco Duca y su gran profesionalidad y su trato humano. Hace que mi vida sea mucho mejor, y hace que mi día día sea mucho más llevadero. Rodeado de un gran equipo.
Lo recomiendo 100x100.