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
