Medial Epicondylitis (Golfer's Elbow)

Overuse injury of the hand, especially finger flexor tendons which originate in the medial humoral epicondyle

Aetiology

  • Can be caused by repetitive strain or degeneration of the common flexor origin
  • Less common than lateral epicondylitis

Clinical presentation

Symptoms

  • Medial elbow pain with a tender point over the origin of the flexors at the medial epicondyle
  • Pain is aggrevated by wrist flexion and pronation
  • Pain worse upon grasping e.g. opening a jar

Signs

  • Flex elbow to 90° in supination, pain produced when wrist flexed against resistance

Investigations

  • Mainly clinical
  • USS and MRI may be required where diagnosis uncertain
  • Nerve conduction study should be carried out if there are any nerve symptoms

Management

  • Conservative - rest, NSAIDs, physio, injection of LA and steriods
    • Injection carries a risk of injury to the ulnar nerve
  • Surgical release for refractory cases