Medial Epicondylitis

Medial Epicondylitis

Medial epicondylitis is also known as Golfer’s Elbow, as it is commonly found in patients who are avid golfers. This condition can also occur in any patient who does repetitive wrist flexion movements as a part of their job or recreational activities. The muscles that move your wrist forward (flexion) attach to the bony prominence found at the inside of the elbow. Repetitive use of these muscles leads to inflammation and damage of the muscles, which causes pain at the elbow with use of the wrist and arm. Medial epicondylitis is much less common than lateral epicondylitis.

Education

Symptoms

Medial epicondylitis can happen at any age, but is more common in patients aged 30-50 years old. Patients will feel pain at the inside of the elbow, especially with movements that flex the wrist (lifting weights, opening a door). Patients may feel weakness with grip or with use of the wrist. Patients may also feel numbness or tingling along the inside of the forearm or the ring and small fingers due to irritation of the ulnar nerve.

Diagnosis

Medial epicondylitis is diagnosed using physical examination and imaging studies to confirm the diagnosis. The physical examination is used to identify areas of pain, weakness, and an evaluation of the nerves of the arm. X-rays help evaluate for the presence of a bone spur or any arthritic changes of the elbow joint. MRI (magnetic resonance imaging) may be used to take a closer look at the muscles of the elbow and identify any damaged tissue. If a patient has symptoms suggesting an injury to a nerve, an electromyography (EMG) test may be ordered to look at nerve function.

Treatment

Treatment of medial epicondylitis can be done with non-surgical or surgical means. The goal of treatment is to reduce pain and regain function of the elbow. Non-surgical treatment is successful in >90% of patients, but can take time as the muscles heal. These therapies are used to reduce inflammation associated with injury and allow you to strengthen the elbow muscles and regain function. Non-surgical treatment options include:

  • Rest: Modifying your activities, particularly sports, is an important part of the treatment of medial epicondylitis. Some patients who have symptoms due to their job find this particularly challenging and we will work with you to identify modifications to decrease the stress on your elbow.

  • If you are having symptoms due to golf or another sport, having an equipment check or evaluation of your swing mechanics can be helpful to identify movements that could be placing stress on your elbow.

  • Non-steroidal anti-inflammatory medications (NSAIDs) can help decrease inflammation

  • Brace: Using a wrist brace (to prevent use of the wrist and decreasing stress on the elbow) or a counterforce brace (a strap around the muscles of the forearm) can be helpful to decrease the inflammation at the elbow

  • Injections: Steroid injections can help decrease inflammation in the elbow, but are not recommended due to the risk of further muscle damage.

  • Physical therapy: This is an important tool to help you strengthen and retrain the muscles of the elbow to work better together

Surgical treatment of medial epicondylitis is reserved for patients who have tried an extensive trial of non-surgical treatment (> 6 months). A small incision is made over the inside of the elbow and the muscles are examined. The damaged muscle tissue is removed and the muscle and tendon are repaired. Patients are immobilized after surgery to allow the muscle to heal and can expect to return to sports 4-6 months after surgery.

Disclaimer: The information presented on this page has been prepared by Dr. Kew and should not be taken as direct medical advice, merely education material to enhance a patient’s understanding of specific medical conditions. Each patient’s diagnosis is unique to the patient and requires a detailed examination and a discussion with Dr. Kew about potential treatment options. If you have specific questions about symptoms you are having and would like to discuss with Dr. Kew, please click below to contact our office to schedule a visit. We hope the information above allows our patients to more thoroughly understand their diagnosis and expands the lines of communication between Dr. Kew and her patients.