Medial Epicondylitis (Golfer's Elbow)

Also known as: Golfer's elbow, Medial elbow epicondylitis, Medial elbow tendinopathy, Common flexor tendinopathy, Flexor-pronator tendinopathy, Medial epicondyle tendinitis

Last updated: December 18, 2024

Medial epicondylitis, also called golfer’s elbow, involves pain and tenderness on the inner side of the elbow where forearm flexor muscles attach to bone. It can affect people who do not play golf and is less common than lateral epicondylitis (tennis elbow). Symptoms include inner elbow pain that may radiate into the forearm and worsens with wrist flexion, gripping, or throwing. Most cases improve over several months with conservative care such as rest and activity modification.

Key Facts

  • •Medial epicondylitis, known as golfer's elbow, is a condition involving pain and tenderness on the inner side of the elbow where the forearm flexor muscles attach to the bone
  • •Pain on the inner side of the elbow
  • •Diagnosed through history, physical exam, and imaging
  • •First-line treatment includes exercise, weight management, and activity modification

What It Is

Medial epicondylitis, commonly known as golfer's elbow, is a condition involving pain and tenderness on the inner side of the elbow where the forearm flexor muscles attach to the bone. Despite its name, it affects many people who do not play golf and is less common than its counterpart, lateral epicondylitis (tennis elbow). The condition results from overuse and repetitive stress to the flexor-pronator muscle group.

Affected Anatomy

This condition affects several structures in and around the joint:

  • •Medial epicondyle of the humerus
  • •Common flexor tendon origin
  • •Flexor carpi radialis and pronator teres (commonly involved)
  • •Other forearm flexor muscles
  • •Ulnar nerve (may be affected in some cases)

Common Symptoms

Symptoms can vary in intensity and may change over time. Common experiences include:

  • •Pain on the inner side of the elbow
  • •Pain that may radiate into the forearm
  • •Pain worsened by wrist flexion, gripping, or throwing activities
  • •Weak grip strength
  • •Tenderness when pressing on the medial epicondyle
  • •Pain with resisted wrist flexion or forearm pronation
  • •Stiffness in the elbow
  • •Numbness or tingling in the ring and small fingers (if ulnar nerve involved)
  • •Symptoms typically develop gradually

Causes and Risk Factors

Multiple factors can contribute to the development of this condition:

Causes

  • •Repetitive wrist flexion and gripping activities
  • •Overuse of the forearm flexor and pronator muscles
  • •Degenerative changes in the tendon at its attachment
  • •Activities involving throwing, swinging, or forceful gripping
  • •Improper technique in sports or occupational tasks

Risk Factors

  • •Age 40 years and older
  • •Occupations involving repetitive forearm motions (construction, assembly work)
  • •Golf, throwing sports (baseball, softball), racquet sports
  • •Weight training, especially with poor technique
  • •Smoking
  • •Obesity
  • •Activities requiring repetitive forceful gripping

How It's Diagnosed

Diagnosis typically involves a combination of clinical assessment and imaging studies:

  • •Medical history focusing on activities, occupation, and symptom patterns
  • •Physical examination of the elbow and forearm
  • •Tenderness over the medial epicondyle
  • •Pain with resisted wrist flexion or pronation
  • •Assessment for ulnar nerve involvement (Tinel sign at elbow)
  • •Evaluation to distinguish from ulnar collateral ligament injury or ulnar neuropathy
  • •X-rays usually normal but may rule out other conditions
  • •MRI may show tendon changes and help exclude other pathology

Treatment Options

Treatment approaches range from conservative measures to surgical interventions, often starting with the least invasive options:

Self-Care and Activity Modification

  • •Rest and activity modification to avoid aggravating motions
  • •Counterforce brace or elbow strap
  • •Wrist flexor stretches and eccentric exercises
  • •Technique modification for sports or work activities
  • •Treatment of concurrent ulnar nerve symptoms if present

Physical Therapy and Exercise

  • •Physical therapy focusing on stretching and strengthening

Medications

  • •Ice application for pain relief
  • •NSAIDs for short-term pain management

Injections and Office-Based Procedures

  • •Corticosteroid injection (may provide short-term relief)

Surgery

  • •Surgical debridement or release for cases not responding to conservative care

Prognosis and Recovery

The course of this condition varies between individuals:

  • •Most cases improve with conservative treatment over several months
  • •Recovery may be slower than lateral epicondylitis
  • •Recurrence is possible if aggravating activities are resumed
  • •Most patients improve without surgery
  • •Surgical treatment may be effective for refractory cases

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