Golfer's Elbow

Golfer's elbow is pain on the inside of the elbow from overuse of the tendons that bend the wrist and rotate the palm downward where they attach to the bone. Despite the medical term epicondylitis, the problem is not mainly inflammation. Under repeated stress the tendon develops small internal tears and begins to degenerate rather than heal fully, so the pain tends to linger. Because the underlying problem is degeneration, anti-inflammatory treatments can ease symptoms but do not repair the tendon. The ulnar nerve runs just behind this spot, so nerve symptoms in the ring and small fingers sometimes occur alongside the tendon pain.

Common symptoms include:

• Aching on the inside of the elbow that flares with gripping, squeezing, or shaking hands
• Tenderness over the bony bump on the inner elbow
• Pain when curling the wrist against resistance or rotating the palm downward
• A weaker grip during the activity that caused the problem
• Sometimes numbness or tingling in the ring and small fingers if the nearby nerve is irritated

Golfer's elbow is diagnosed from the history and a focused exam, with inner elbow pain reproduced by gripping or resisting wrist flexion and a tender spot at the inner bony bump. The exam also checks the inner-side ligament and the ulnar nerve, which can produce overlapping symptoms. Ultrasound or MRI can confirm tendon degeneration when the diagnosis is uncertain.

Most people recover without surgery, though tendons heal slowly:

• Activity changes to reduce or stop the activities that load the inner elbow
• Physical therapy with progressive loading exercises for the wrist flexors and forearm
• A counterforce brace worn around the upper forearm to take load off the tendon
• Anti-inflammatory medication short-term for a flare
• A corticosteroid injection near the attachment, used sparingly, for short-term relief

Surgery is reserved for the small number of people with persistent, disabling pain after a thorough trial of nonsurgical care. The procedure removes the degenerated portion of the tendon, and the ulnar nerve may be addressed at the same time if it is contributing.

For a fuller explanation, including anatomy, diagnosis, and the full range of treatment:

• Medial Epicondylitis (Golfer's Elbow) — AAOS OrthoInfo