Golfer's Elbow / Medial Epicondylitis

The most common cause is using the muscles of the forearm in a repetitive way that leads to the microtrauma of the tendon that attaches to the elbow inside. Overuse injury of the tendon when used in a way that causes stress on the tendon. 

It is named Golfer's elbow because it is common in racquet sports. Muscles involved in playing golf cause this problem. But even if the patient doesn’t play golf, use of the wrist and forearm in repeated activities can cause a Golfer's elbow.

Common activities include:

• Use of computer mouse or keyboard for a long time
• In jobs like plumbers, carpenters, painters
• The problem with drying clothes with hands in washing loads of clothes 
• Weight lifting 
• If involved in playing musical instruments for long hours 
• Chef, or cooking food for many people for a long time

It usually involves the elbow, which is used more but can occur in both elbows.

Symptoms related to Golfer’s Elbow are:

• Pain in the inside of the elbow 
• Pain while pressing bone at the inside of the elbow
• Pain may also spread to below the elbow area and increase movement at the wrist.
• Common activities like holding a cup, opening a door, opening the cap of a bottle, picking up objects, holding objects and gripping them, and screwing movement all these activities are painful.
• Swelling or stiffness of the elbow 
• Weakness of grip in severe disease

The most common way is a clinical examination by the doctor, x-rays and MRI, and in very few cases, EMG.

Yes, most of the cases can be treated conservatively. With consultation with a doctor, most patients are treated with medicines, splints and physiotherapy.

The treatment for Golfer’s elbow/ Medial Epicondylitis include:

• Rest
• Painkillers and other medicines 
• Splints/ braces
• Physiotherapy
• Ice packing

Ideally, yes, some patients have a habit of holding or gripping during sleep. It can help during the night. Patients can also use pillows below the elbow and hand to relieve pressure in the elbow. But a splint has to be worn whenever a patient does any activity.

In consultation with a surgeon, injections can be given in the elbow. These are Pla-te-let Rich Pl-as-ma Growth Factors (P-R-P GF) injected in the medial epicondyle area/ where pain occurs. This is clinically proven to help in Golfer's elbows, but further studies are required to prove the absolute role.  

Steroid injections give quick pain relief, but many risk factors are involved. How many injections are safe is yet to be discovered, but usually, 1-2 injections are given. Risk factors involve tears of ligament and tendon surrounding the injection site. 

After taking treatment for a long time, the pain is there, and the patient cannot do daily activities. Surgery can be considered in consultation with the surgeon. 

The surgery involves debridement and release of Flexor carpi radialis and pronator teres tendon origin from the bone.

Most cases of Golfer's elbow/ medial epicondylitis are treated without surgery. The Golfer's elbow/ medial epicondylitis usually resolves in a few weeks or months. But in some cases, it may take 1 year for complete recovery. 

Don’t lose hope and continue with the treatment success rate, which is very high, 80-90%.  If the patient still has pain after a few months, injections can be tried. Surgery is only for cases that have not improved after months of treatment.

Golfer’s Elbow can be prevented as follows:

• Don’t avoid pain; consult your doctor 
• Use proper sports tools 
• Stretch before and after a workout
• Take rest in between if working for long hours
• Use the computer mouse and keyboard in a sitting position with the level of the computer screen at your eye level.
• Use a splint if working for a long time without a break and having pain
• Ice frequently in case of developing pain 

It depends on the hospital category chosen by the patients. At Simpainortho.com, we have tried to reduce the cost of surgery and hospital expenses and included complete after-surgery services, which patients require after surgery because we know treatment doesn’t end at the patient's discharge. To ensure the quick recovery of patients in simpainortho.com we believe that a patient requires expert care within the most comfortable surroundings until he/she can join routine activities. So, we have made different packages for different patients according to need, and that too at the most affordable prices.

Yes, most insurances have included Tennis elbow surgery.