Golfer’s Elbow – Medial Epicondylitis

Introduction

Golfer’s Elbow (medial epicondylitis) is a type of cumulative trauma injury. Golfer’s Elbow results when the tendons that attach to the inner elbow degenerate. Tendons do not stretch easily and are vulnerable to degeneration during repetitive motions, such as those used during a golf swing or work activities. The pain of Golfer’s Elbow occurs where the tendons attach to the elbow bone (medial epicondyle) and can radiate down the forearm. The majority of people with Golfer’s Elbow find symptom relief with non-surgical methods. If surgery is necessary, there are open and arthroscopic methods to fix the problem.

Anatomy

Golfer’s Elbow involves the common flexor tendon that connects flexor forearm muscles to the inner (medial) side of the elbow bone (epicondyle). The forearm muscles that flex the wrist move it downward towards the palm side of the hand.

Causes

Repetitive motions and cumulative stress cause the tendons at the inner side of the elbow to deteriorate. Such motions may occur while playing golf, but also during periods of muscle overuse.

Symptoms

A main symptom of Golfer’s Elbow is pain and tenderness at the inner side of the elbow that increases during wrist flexion or grasping motions. The pain may radiate down the forearm.

Diagnosis

A physician performs an examination and reviews the individual’s medical and activity history to make a diagnosis of Golfer’s Elbow. The physician evaluates the forearm and elbow structures with simple tests. X-Rays and, more rarely, MRI imaging, are used to confirm the diagnosis and rule out other causes of elbow pain.

Treatment

Most cases of Golfer’s Elbow respond to non-surgical treatments. Treatment typically includes rest or activity restriction or alteration. Specific stretching and exercises under the guidance of a therapist are often prescribed. The therapist may use ultrasound or other modalities to promote healing. A splint, brace, or elbow wrapping may be recommended. Physicians may instruct the application of ice to the affected areas or recommend medication to relieve pain. Ultrasound Guided Cortisone injection are often used, but have little evidence that they are useful.

If conservative Treatment and Physical Therapy Failed:
Ultrasound Guided Platelet rich plasma injection or Stem Cells injection for regeneration is promising (not FDA approved) but supported by multiple Studies.