Medial epicondylitis

47 year old golfer flew in from Japan for evaluation of his right elbow today. Patient has been diagnosed with medial epicondylitis. Patient has tried anti-inflammatory, Chinese and Korean acupuncture, His orthopedic surgeon felt his case is more of a non-surgical case and advocated physical therapy. Patient describes pain as "a shooting sensation down the forearm while gripping objects." His past medical history is essentially unremarkable and he has been blessed with good health, he does not smoke and does not drink alcohol.

Discussion: A very stubborn condition is Golfer's elbow also known as medial epicondylitis it occurs on the inside of the elbow (as oppose to Tennis elbow or lateral epicondylitis) where muscles of the inner part of the forearm attach to the epicondyle of the upper arm bone ( humerus ). Golfer's elbow is tendonitis caused by overuse or overload of the inner forearm muscles. These muscles flex the wrist, allowing you to bend your hand toward your body. Other activities that involve the wrist, such as racquetball, also may cause golfer's elbow. As the tendon tries to repair itself, scar tissue may form. The current theory is that a lack of blood flow to the aging tendons makes them weak and prone to injury. The pain typically elevates when flexing the wrist, and may radiate down the forearm. Activities that use the flexor muscles in a bending motion or grasping with the hand can increase the symptoms.

Treatment may include:

  • Rest
  • Anti-inflammatory medications, such as ibuprofen (Advil, Motrin, others)
  • Ice massage
  • Deep tissue massage
  • Exercises to stretch and strengthen your wrist and forearm muscles
  • A forearm strap
  • Keeping your wrist in a rigid position when lifting objects
  • In some cases, injections

Case Study Date: 9/20/2010