What is it?
Medial epicondylitis (golfers elbow) is a painful condition that affects the inside of the elbow. It commonly occurs in active people after the third decade of life. The condition can be related to a sports injury but is often associated with work or daily activities.
What are the symptoms?
Usually, the condition occurs slowly and may not be related to a single traumatic event. Most patients have pain over the inside of the elbow. It may be related to exertion and overuse.
How is it evaluated?
A history and physical examination will be done. Occasionally, the patients will need x-rays of the elbow and in more complex cases, an MRI may be necessary to help differentiate the potential causes of medial elbow discomfort.
How is it treated?
Non-surgical treatment strategies are effective for this condition and should be the mainstay of the treatment program. We recommend that treatment begin by instituting changes that are likely to be effective and have low risk. If these treatments are unsuccessful, then additional treatment alternatives will be discussed.
Treatments that HAVE BEEN shown to be effective:
- Rest and avoidance of the activity that caused the symptoms
- Use of a counterforce brace or other splint
- Stretching exercises and then when the condition improves strengthening exercises
- Externally applied modalities ( heat in the morning and ice in the evening)
- Equipment modifications
- Non- steroidal anti-inflammatory agents
- Occupational therapy (including modalities)
- Corticosteroid injections
Treatments that have HAVE NOT been shown to be effective
- Laser light treatment
- Serum injection
- Extracorporeal shock wave therapy (ECSWT)
Because most patients improve with the non-surgical strategies we suggest that you pursue these alternatives for at least 6 months. If you do not experience enough improvement after 6 months of non surgical treatment, then surgery is a reasonable alternative treatment.
At the time of surgery, the degenerated tendon is excised and repaired to the bone. For the surgery to result in significant symptom improvement, the repair needs to heal securely to the bone. After surgery, we use a program of occupational therapy to allow elbow range of motion but protect the repair site. 8 out of 10 patients have significant improvement in their discomfort after this surgical procedure.