Medial Epicondylitis

Medial Epicondylitis (Golfer’s Elbow) – Effective Treatment and Recovery

Medial epicondylitis, commonly known as golfer’s elbow, is a painful condition stemming from forearm-to-elbow tendon damage due to injury or overuse. Previously considered a form of tendonitis, it’s now categorized as tendonosis, involving collagen fiber deterioration within the tendon. Those with this condition often experience inner elbow pain that can extend into the forearm, caused by pressure on the ulnar nerve in the forearm. In many cases, simple measures such as arm rest and ice application can effectively manage medial epicondylitis. However, surgical intervention may be necessary in severe instances.

Recognizing Symptoms and Diagnosis

Symptoms can develop suddenly or gradually and may involve:

• Inner elbow or forearm pain
• Weakness or stiffness in wrists and hands
• Tingling or numbness, particularly in the ring finger or pinkie
• Increased pain with specific movements like arm swings, gripping, or lifting objects, especially when the palm faces downward.

Diagnosis of medial epicondylitis relies on a physical examination, X-rays, and occasionally, additional diagnostic tests like MRIs or ultrasound.

Treating Medial Epicondylitis

Various straightforward treatments can alleviate medial epicondylitis:

• Resting the affected arm
• Wearing wrist or elbow support
• Applying ice
• Over-the-counter pain relief
• Therapeutic exercises
• Electrical stimulation
• Oral or injected corticosteroids
• Shock wave treatments

Symptoms may resolve within weeks or linger for months. A physical or occupational therapist can suggest arm movements that reduce the risk of recurrence. If symptoms persist for over 3 to 6 months, indicating chronicity, surgery becomes an option.

Surgical Repair of Medial Epicondylitis

Multiple surgical procedures exist to repair medial epicondylitis, whether arthroscopic or open, typically outpatient with local anesthesia. Surgery lasts around 3 to 4 hours. Patients can return to a near-normal routine in roughly 4 weeks but might experience discomfort, weakness, or numbness for months post-surgery. Physical therapy is typically advised. Surgical options include:

• Tendon Debridement: Removing affected tissues within the tendon.
• Medial Epicondyle Release (Epicondylectomy) and Ulnar Nerve Release: Removing the medial epicondyle, freeing the ulnar nerve.
• Ulnar Nerve Transposition: Temporarily disconnecting forearm muscles from the epicondyle to move the ulnar nerve.

Understanding Risks

While these surgeries are generally safe, all surgeries carry potential risks, including:

• Excessive bleeding
• Blood clots
• Anesthesia or medication reactions
• Post-surgical infection
• Breathing issues

Surgery-specific risks include chronic regional pain syndrome (CRPS), a rare complication marked by ongoing swelling, pain, skin discoloration, and stiffness.