Epicondylitis or tennis elbow is a tendinitis of the extensor and supinator muscles of the wrist and fingers, especially the extensor carpi radialis brevis. It is a pathology that was first described in 1873 by Runge.
Why does epicondylitis occur and how does the injury originate?
The injury mechanism, in most cases, is produced by a repetitive gesture or movement of extension and supination, something very common in sports such as paddle tennis, tennis or badminton. However, it is also frequent in different professions, such as carpenters, plumbers, lumberjacks, gardeners, mechanics or other trades that carry out repetitive movements with the forearm.
Epicondylitis is usually related to a bad sports technique: incorrect string tension, grip, center of gravity of the racket, sports initiation without technical advice…
What are the symptoms of epicondylitis or tennis elbow?
The first symptoms of epicondylitis are manifested with pain on the outer side of the elbow, backhand and lift. In advanced stages, the shoulder and the wrist may be bothered by the fact of having to change technique to defend against the pain in the elbow.
The diagnosis will be basically clinical, that is to say, when the patient manifests pain to the palpation of the epicondyle and before maneuvers of counter-resistance on the part of the specialist in Sports Medicine. It will also be able to be seen with ultrasound, when tendinitis, partial or total rupture of the tendon, and even calcifications appear. In case of doubt about tendon rupture, an MRI study should be performed.
How should epicondylitis be treated?
The treatment of epicondylitis consists of several stages:
- Oral and topical anti-inflammatory drugs, as well as cryotherapy, unloading splint and elbow rest.
- Physiotherapy (massage therapy, ultrasound, laser, electrotherapy, diathermy, stretching and shock waves).
- Corticoid infiltration with local anesthetic, mesotherapy or platelet-rich plasma (PRP).
- Correction of the sporting gesture or technique, as well as revision of the material used.
- Surgery, in less than 5%, consisting of tenotomy of the extensors.