Movements of the forearm and hand are controlled by muscle tendons that attach at the medial (inside) and lateral (outside) elbow. Degenerative changes within these strong bands of the tissue connecting muscle to bone can cause significant pain. Two common issues are lateral epicondylitis, or “tennis elbow,” and medial epicondylitis, or “golf elbow.”
These conditions do not happen overnight; instead, they occur over time and with repetitive use. This is why they are referred to as “overuse injuries.”
Lateral epicondylitis, or tennis elbow, is much more common than golf elbow. It affects 1% to 3% of people and is most common in individuals aged 30 – 50. Pain is typically reproduced with extension of the wrist as if going to give a high five, and clockwise rotation of the forearm, similar to turning a key in the ignition. Common activities that aggravate the extensor muscle tendons include typing, handshaking, racquet sports, carrying groceries, painting, knitting, and raking. Chronic pain caused by degenerative changes of these tendons typically lasts 12-18 months before complete resolution.
Medial epicondylitis, or golf elbow, affects less than 1% of the population, usually in individuals aged 30 – 50. Pain is reproduced with flexion at the wrist, like when bouncing a basketball, and counterclockwise rotation of the forearm. Repetitive motions during golf, tennis, overhead throwing, and activities requiring forceful grip (e.g., machine working and automotive work) over time may lead to medial (inside) tendon wear at the elbow.
In most cases, diagnosing conditions of the elbow can be done with a simple exam in the office. Ultrasound and MRI are modalities used to identify tendinopathy or degenerative changes within tendons. X-rays also can be useful if joint pathology is suspected. The treatment goals are to treat pain and inflammation, return to normal function, and
prevent a recurrence. This is done by minimizing overuse of the tendons, using ice, bracing, and medication, as well as physical therapy. If conservative therapies are inadequate, local injection with steroid or platelet-rich plasma (PRP) is then given. Surgery is required in very few cases.
The physicians and physician assistants at Spine West will use a combination of the above diagnostic tools and therapies to treat disorders of the elbow.