What Is the Best Treatment for Golfer's Elbow?

Golfer’s elbow (medial epicondylitis) is a chronic injury that occurs when there is stress, strain or inflammation of the muscles, tendons or ligaments around the elbow joint and forearm on the inner side. Small tears, called microtears, form in the tendons and muscles, which control the movement of the forearm. They cause a restriction of movement, inflammation and pain.

These microtears may eventually lead to the formation of scar tissue and calcium deposits. If left untreated, this scar tissue and calcium deposits can put so much pressure on the muscles and nerves that the blood flow is cut off and the nerves responsible for controlling the muscles in the forearm are pinched.

Symptoms of golfer’s elbow may include:

• Pain when gripping with the wrists and fingers
• Pain while stretching the wrist muscles
• Tenderness over the bony medial condyle of the elbow (inner bony prominence)
• Inability to move the elbow

Despite the name, golfer’s elbow does not just affect golfers. This painful elbow problem is most often associated with work-related activities and is commonly caused by the overuse of muscles in the forearm that allow you to grip and rotate your arm and flex your wrist. The action of swinging a golf club involves repetitive flexing and gripping, which can cause pulls or tiny tears in the tendons. However, these muscles getting overused in some other sports or do-it-yourself activities are equally common.

• Golfer’s elbow is equally common in men and women, peaking in prevalence in the age group of 30 and 50 years old.
• This inflammation is usually caused by prolonged gripping activities, such as hammering, driving screws, weight lifting, playing certain musical instruments, canoeing, digging in the garden and driving.

By far the most common cause of golfer’s elbow is overuse. Any action that places a repetitive and prolonged strain on the forearm muscles, along with inadequate rest, will strain and overwork those muscles. There are also many other causes, such as:

• A direct injury (a bump or fall onto the elbow)
• Poor technique or form while lifting weights
• Using ill-fitted equipment (such as golf clubs, tennis rackets, work tools)
• Poor levels of general fitness and conditioning

Ice therapy and physiotherapy are the common treatment options for golfer’s elbow, apart from rest. However, other treatment options for golfer’s elbow may include:

• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as acetaminophen and ibuprofen, relieve inflammation and pain.
• Braces: Wearing a counterforce brace to compress the forearm muscles. Request your doctor for the best recommendation based on your lifestyle.
• Cortisone injection: Your doctor may reduce pain and swelling by administering a cortisone injection if over-the-counter medications and physiotherapy do not provide relief.
• Percutaneous electrolysis therapy
  • The choice of most people, especially athletes, suffering from long-term golfer’s elbow.
  • It is a minimally invasive technique that involves the application of a galvanic current of high intensity through an acupuncture needle that stimulates a local inflammatory process in soft tissue.
• Surgery
  • Rarely required but is sometimes recommended in chronic and recurring cases that do not respond to conservative management.
  • The surgery involves releasing the damaged portion of the tendon and resecting it. It may be replaced by a healthy tendon in case of extensive damage. There is a new approach called the TENEX procedure, which is still under research, that involves ultrasound-guided removal of scar tissue in the region of the tendon pain. This is a minimally invasive approach.