Golfers Elbow
What is Golfer's Elbow?
Golfer’s Elbow, also known as medial epicondylitis, is a degenerative condition affecting the tendons which insert into the bony prominence on the inside (medial) aspect of the elbow. It is almost identical to a tennis elbow however unlike a tennis elbow, it affects the inside aspect of the elbow.
Clinical Presentation
Pain over the bony prominence on the inner side of the elbow. The pain can extend down the forearm to the wrist and hand. The pain is made worse by bending the wrist and grasping objects tightly. There may be discomfort in extending (straightening) the wrist also, due to stretching of the affected flexor muscles.
Other symptoms include:
- Pain when the wrist or hand is bend (wrist flexion)
- Pain when gripping, making a fist or shaking hands
- Shooting pains from the elbow down to the forearm on the inside.
- Pins and needles in the ring and little fingers
Sometimes other conditions that are not linked to tennis elbow can cause pain in the elbow. For example, arthritis of the elbow, a pinched nerve in the neck, shoulder impingement and Carpal Tunnel Syndrome.
Diagnosis
The diagnosis of Golfer’s Elbow is clinical. This area is usually very tender to touch. Rest usually relieves the pain. Any occupational risk factors, and recreational sports participation. Other elbow pathologies may mimic as Golfer’s elbow or a trapped nerve in elbow or neck.
Investigations
You may be sent for plain radiographs / MRI / EMG studies may be required to rule out any other pathology.
Treatment of Golfer's Elbow
Approximately 80% to 95% of patients have success with non-surgical treatment.
- Rest, Activity Modification, Non-steroidal anti-inflammatory medications
The first step toward recovery is to give your arm proper rest. This means that you will have to stop participation in sports or heavy work activities for several weeks.Drugs like aspirin or ibuprofen reduce pain and swelling. - Equipment check
If you participate in a racquet sport you may have to have your equipment checked for proper fit. Check the work place for any changes / adaptation. - Physiotherapy
Specific exercises are helpful for strengthening the muscles of the forearm. Eccentric exercises programme is helpful. Your therapist may also perform ultrasound, ice massage, or muscle-stimulating techniques to improve muscle healing. - Using a brace centered over the back of your forearm may also help relieve symptoms of tennis elbow. This can reduce symptoms by resting the muscles and tendons. This needs to be used for all the time that patient is awake, especially remembering weekends.
- Blood Products/Platelet Rich Plasma (PRP)
These injections have shown promising results and have become more commonly used. There is increasing evidence for its use. - Steroid Injections
These have been used for a number of years and have shown to provide pain relief for short period of time, but there are some concerns that it makes the condition worse over longer period. - Extracorporeal Shock Wave Therapy
Shock wave therapy sends sound waves to the elbow. These sound waves create “microtrauma” that promote the body’s natural healing processes. Shock wave therapy has shown to be beneficial in cases non responding to other forms of non operative treatment. - Surgery
This is reserved for the resistant and disabling golfers elbow.
Read more about surgery for Golfer’s Elbow