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  • Writer's pictureÁlvaro García-Donas

Epicondylalgia, The importance of differential diagnosis for its treatment

Updated: Apr 7

Epicondylalgia is an injury that affects the tendons in the elbow region, commonly known as tennis elbow due to the frequency with which it occurs in this sport and in paddle tennis. Differential diagnosis is crucial to determine the exact cause of the pain and design an optimal treatment plan.

In the case of epicondylalgia, it should not be confused with olecranial bursitis, triceps tendinopathy, radial nerve injuries or cervical injuries among others that may present similar symptoms. It is important to perform a thorough evaluation of the patient's history, examine the affected area and perform several specific tests (such as ULTTC, neurodynamic tests or loading of the tendon structure).

In our work, ultrasound is a fundamental tool that adds value to the evaluation of epicondylalgia. It can help identify changes in the tendons and rule out other possible causes of pain, such as the presence of calcifications or partial ruptures, in addition to monitoring their evolution during the readaptation process.

As for the treatment of epicondylalgia, it is usually divided into several phases:

  • Acute phase: During this stage, the main objective is to relieve and control pain and reduce possible inflammation. This can be achieved through the application of cold, appropriate bandaging, diathermy, electrotherapy, manual therapy and of course start performing the first strength stimuli.

  • Subacute phase: In this stage, the focus is on restoring function and strengthening the muscles and tendons involved.

  • Readaptation phase: Once the pain and possible inflammation have subsided and function has improved, the patient's goal will be pursued. This can range from going about daily life, such as picking up a bottle of water or carrying a heavy bag, to returning to sports such as paddle tennis, tennis or golf.

  • Relapse prevention: It is essential to identify and intervene in extrinsic risk factors that may contribute to the onset of epicondylalgia. It is also important to maintain an adequate exercise routine to strengthen and stabilize the elbow. This will help prevent possible relapses, among others. This may include ergonomic changes in the workplace and proper training techniques in the sport we are practicing.

Remember that the specific treatment may vary from one patient to another, so it is essential to have a complete evaluation by a health professional to establish an individualized plan tailored to each person's needs.

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