What is Golfers Elbow?
Sometimes called medial epicondylitis, this is an overuse injury similar to tennis elbow except that the pain and stiffness is felt on the inner side of the elbow. Sometimes the pain also spreads along the forearm.
It occurs when the muscle that attaches to the inner elbow (medial epicondyle) becomes overworked due to repetitive activity or excessive force. Its name comes from the fact that it can be seen in golfers who grip their clubs incorrectly, but it is also seen in those who play other sports and can occur after certain manual activities.
How is it diagnosed?
Diagnosis by a specialist is usually straightforward, and further tests are usually not necessary. X-rays may be performedto exclude other causes for elbow pain. In some cases that are not as clear-cut, an ultrasound scan may be performed to confirm the diagnosis.
How is Golfers Elbow treated?
Treatment starts with correcting any provoking factors and the use of simple anti-inflammatory tablets and painkillers. Appropriate stretches and muscle strengthening, usually under the guidance of a physiotherapist can also help. Avoiding repetitive movements and correct warming-up and stretching techniques can also help.
What is the role of Shock Wave Therapy?
Sometimes the condition does not respond to these simple measures and the pain becomes longstanding (chronic). In these cases other treatments are considered. A steroid injection may be suggested, but the evidence for this being of benefit in golfer’s elbow is not clear. We do not recommend in the first instance as it does not usually result in a permanent cure by creating a healing response. We prefer to use shock wave therapy as the next line of treatment and have had excellent results with this needle-free, outpatient procedure in 65-70% of patients. This treatment induces a healing response and so is more likely to result in the condition being cured.
We have also used platelet-rich plasma (PRP) injections in some very resistant cases. This works by injecting healing cells derived from the affected persons own blood into the affected area.
As a last resort, in patients with severe symptoms that have not responded to all other treatments, surgery is considered. This involves detaching the tendons from the inner part of the elbow. Unfortunately even this can be unsuccessful in about a third of cases.