Common Conditions of the Elbow
Golfers Elbow
(Medial Epicondylitis)
This condition is classically described in golfers although is common
in anyone who has undertaken unnacustomed heavy manual work which involves
a lot of lifting and carrying, particulaly with the palm turned up.
Golfers may also get Tennis elbow (lateral
epicondylitis)
What are the signs and symptoms?
Pain is felt over the inside of the elbow joint. A small area (the medial
epicondyle) is usualy exquisitely tender. The pain may spread down
into the forearm. Gripping, carrying and flexing the wrist all make
the pain worse.
How is the diagnosis made?
The doctor will listen to the description of events and examine the
elbow. X-Rays will also be taken to determine whether there is a piece
of bone involved. Usually no further investigation is needed although
sometimes, in difficult cases, ultrasound or MRI may be helpful.
What is the initial treatment?
Firstly it is important to determine why the condition occurred so that
recurrence may be avoided. If it is sports related the equipment or
grip must be altered. Often the raquet handle is too small or too big
for the hand.
An injection of local anaesthetic and steroid into the most tender spot
(the medial epicondyle) gives instant relief and allows therapy to begin.
Exercises to improve wrist flexibility and increase the wrist flexor
and extensor muscle strength must then be started as these are part
of the initial problem.
A further 1-2 injections may be given if the symptoms recurr.
If initial treatment doesn't work, what's next?
If injections and therapy fail to settle the symptoms then surgery may
be required to excise the scar tissue over the medial epicondyle.
Medial epicondyle release.
How can further injury be prevented?
Keep the wrist and elbow supple
Keep the flexor and extensor muscles strong
Have sports equipment checked to ensure that the grip is appropriate
for the hand size
Do not suddenly increase the demands on the area (i.e. build up to sports
and no sudden weekends of heavy manual labour)
Be aware of any pain, stop the activity and apply RICE.
