Elbow Inflammation

a. Medial Epicondylitis (Golfer’s Elbow)

What is Golfer’s Elbow?
Medial epicondylitis, or golfer’s elbow, is inflammation of the tendons of the muscles that flex the wrist. The pain is felt where the tendons attach to the bony prominence on the inner aspect of the elbow. This bony prominence is called the medial epicondyle. A second bony prominence, on the outside of the elbow, is called the lateral epicondyle. Inflammation of these areas is described as epicondylitis. Another term for golfer’s elbow is wrist flexor tendonitis.

What causes Golfer’s Elbow?
Overuse is the most common cause. Patients with occupations that require repetitive motion, such as typists, machinists or carpenters are at risk. Athletes, such as golfers, baseball players or those that play racquet sports may develop pain on the medial elbow as well. When a tendon is used, microscopic tears occur in the tendon. Your body quickly heals these tears. When a tendon is overused, the rate of tearing exceeds the body’s capacity to heal, and pain and inflammation result.

What are the symptoms?
Patients complain of pain over the inner aspect of the elbow, pain with making a fist or pain running down the inside of the forearm when the wrist is flexed. Loss of strength, or inability to firmly grasp objects is a common complaint.

How is Golfer’s Elbow diagnosed?
On physical exam, your doctor will find tenderness over the medial epicondyle. Flexing the wrist against resistance reproduces pain. X-rays are typically normal in appearance.

How is it treated?

Non-operative
Your surgeon will prescribe anti-inflammatory medication, a brace, or physical therapy. Avoiding activities that cause pain will shorten the recovery period. A cortisone injection may be given in the area of the epicondyle. This injection may make the pain worse for two days, then the symptoms should begin to improve. Following an injection, rest and ice is prescribed for the initial 48 hours.

Operative
In cases where the tendons become detached, or when non-operative treatment fails to relieve pain, surgery is indicated. Your surgeon will make an incision over the injured tendon, remove the injured tissue, and stimulate the area to heal by drilling into, or removing, a section of bone. This allows bone marrow containing blood cells that assist in the healing process to fill the operative sight. The tendon is then repaired to the bone.

b. Lateral Epicondylitis (Tennis Elbow)

What is Tennis Elbow?
Lateral epicondylitis, or tennis elbow, is inflammation of the tendons of the muscles that extend the wrist. The pain is felt where the tendons attach to the bony prominence on the outer aspect of the elbow. This bony prominence is called the lateral epicondyle. A second bony prominence, on the inside of the elbow, is called the medial epicondyle. Inflammation of these areas is described as epicondylitis. Another term for tennis elbow is wrist extensor tendonitis.

What causes Tennis Elbow?
Overuse is the most common cause. Patients with occupations that require repetitive motion, such as typists, machinists or carpenters are at risk. Athletes who participate in tennis and other racquet sports, baseball players or golfers may develop pain in the lateral elbow. When a tendon is used, microscopic tears occur in the tendon. Your body quickly heals these tears. When a tendon is overused, the rate of tearing exceeds the body’s capacity to heal, and pain and inflammation result.

What are the symptoms?
Patients complain of pain over the outer aspect of the elbow or pain running down the outside of the forearm when the wrist is extended. Loss of strength, or inability to firmly grasp objects is a common complaint.

How is Tennis Elbow diagnosed?
On physical exam, your doctor will find tenderness over the lateral epicondyle. Extending the wrist against resistance reproduces pain. X-rays are typically normal in appearance.

How is it treated?

Non-operative
Your surgeon will prescribe anti-inflammatory medication, a brace, or physical therapy. Avoiding activities that cause pain will shorten the recovery period. A cortisone injection may be given in the area of the epicondyle. This injection may make the pain worse for two days, then the symptoms should begin to improve. Following an injection, rest and ice is prescribed for the initial 48 hours.

Operative
In cases where the tendons become detached, or when non-operative treatment fails to relieve pain, surgery is indicated. Your surgeon will make an incision over the injured tendon, remove the injured tissue, and stimulate the area to heal by drilling into, or removing, a section of bone. This allows bone marrow containing blood cells that assist in the healing process to fill the operative site. The tendon is then repaired to the bone.

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