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Golfer's elbow
What is golfer’s elbow?
Golfer's elbow is also known as medial epicondylitis and causes pain and inflammation at the point where the flexor tendons of the forearm are attached to the upper arm. The pain is located around the bony lump on the inside of the elbow, although it may radiate along the forearm.
Golfer's elbow is usually caused by overuse of the muscles in the forearm that allow you to rotate your arm and bend your wrist down. Repetitive flexing, gripping or swinging can cause pulls or tiny tears in the tendons close to where they are attached to the bone.
How do we treat golfer’s elbow at the Mansfield Clinic?
Dr Allfree may use manual therapy techniques such as massage and manipulation, to relieve pain and stiffness, and encourage blood flow to your arm. He will also show you some exercises to keep your arm mobile and strengthen your forearm muscles.
If your golfer’s elbow does not settle down, Dr Allfree may suggest using other more specialised techniques, including steroid injections, autologous blood injections, or Extracorporeal Shock Wave Therapy.
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You don’t have to be a golf player to get golfer’s elbow. Any repetitive hand, wrist or forearm motions can lead to golfer's elbow. Common causes include tennis, squash and other racquet sports, bowling and cricket. People may also get it from using tools like screwdrivers and hammers, raking in the garden, or using a paintbrush.
Golfer's elbow is a very similar condition to tennis elbow, which is another type of elbow tendinitis. Unlike golfer's elbow, tennis elbow affects the tendons on the outside of the joint.
Symptoms of golfer’s elbow
The primary symptom of golfer's elbow is pain located around the bone on the inside of the elbow. Sometimes it spreads all along the inner forearm. You are most likely to feel it when you bend your arm inwards or bend your wrist down. In most cases, the pain becomes gradually worse.
Diagnosing golfer's elbow
Dr Allfree will carefully examine your elbow and arm to make the diagnosis. It is normally a very straightforward diagnosis to make, and it is unlikely that any other investigations will be needed.
Treatment for golfer’s elbow
As with any overuse injury, it is very important to get treatment for golfer's elbow quickly. Initially, ice applied to your elbow for 15-20 minutes three to four times per day may help. Purpose made ice packs are available from the Mansfield Clinic. You will need to rest the elbow and avoid movements that aggravate the problem, You may need to modify the way you carry out everyday activities. You may benefit from a special strap to prevent pulling of the injured tendon.
Dr Allfree may use osteopathic techniques such as massage and manipulation, to relieve pain and stiffness, and encourage blood flow to your arm. He will also show you some exercises to keep your arm mobile and strengthen your forearm muscles.
Dr Allfree will probably recommend an anti-inflammatory drug like ibuprofen to reduce pain and swelling - these are also available over the counter. These are available in tablet, cream and gel forms. If the symptoms are troublesome, he may also recommend using a steroid injection into the tender area of inflammation. This may help to relieve pain and swelling in the short term.
If your symptoms return, or persist, then sometimes a technique called Autologous Blood Injection can help. This simply involves withdrawing a small amount of your own blood from a vein, and re-injecting it around the injured tendon.
Shock Wave Therapy is another non-invasive treatment where high-energy shockwaves are passed through the skin to help relieve pain and promote movement in the affected area. It is a useful treatment for cases that have not responded to steroid injections or autologous blood injections. How many sessions you will need depends on the severity of your pain. You may have a local anaesthetic to reduce any pain or discomfort during the procedure.
The National Institute for Health and Care Excellence (NICE) states that shock wave therapy is safe, although it can cause minor side effects including bruising and reddening of skin in the area being treated.
Research shows that shock wave therapy can help improve the pain of golfer’s elbow in some cases. However, as with all medical treatments, it does not work in all cases.
Surgery
Surgery may be recommended as a treatment of last resort in cases where golfer’s elbow is causing severe and persistent pain. The damaged part of the tendon will be removed to relieve the painful symptoms. If a surgical opinion is needed, Dr Allfree will help you with the arrangements.