⛳ Bilateral disease suggests a systemic condition such as a spondyloarthropathy. 🕑 Early diagnosis and management are essential to prevent chronic pain and functional impairment.

⛳ About Golfer's Elbow

Golfer's Elbow (Medial Epicondylitis) → pain & inflammation over the inner elbow 🦴.
Caused by overuse/repetitive strain of flexor-pronator tendons attaching to medial epicondyle.
Not just golfers 🎾- carpenters, plumbers, painters, office workers also at risk.
Significant cause of elbow pain & functional disability in athletes and non-athletes alike.

🧬 Aetiology

Repetitive loading of the flexor-pronator group (esp. Flexor Carpi Ulnaris & Pronator Teres) → microtears + degeneration at medial epicondyle.

🔄 Overuse injury → repetitive wrist flexion & pronation.
🎯 Flexor Carpi Ulnaris / Pronator Teres = most affected tendons.
💼 Occupational factors → carpentry, plumbing, painting, typing.
🏋️ Sports → golf, baseball pitching, climbing, weightlifting.

🩺 Clinical Presentation

💥 Medial epicondyle tenderness (classic site).
🤲 Pain with resisted wrist flexion / pronation.
⬇️ Grip weakness → difficulty lifting, writing, gripping tools.
🌅 Morning stiffness, improves during day.
🔄 Pain may radiate down forearm.

🧾 Differential Diagnosis

🎾 Tennis Elbow (Lateral epicondylitis – outer elbow pain).
⚡ Ulnar nerve entrapment → tingling in ring/little fingers.
💪 Triceps tendinitis → posterior elbow pain.
🦠 Septic arthritis → hot, swollen elbow (emergency 🚨).
🦴 Osteoarthritis → degenerative joint disease, stiffness.

🔎 Investigations

👉 Clinical exam:
- Tender medial epicondyle.
- Pain reproduced by resisted wrist flexion/pronation.
- ROM assessment.
📡 Ultrasound → tendon thickening, tears.
🧲 MRI → detailed tendon/soft tissue evaluation.
🦴 X-Ray → rule out fractures, OA.
⚡ EMG → if nerve entrapment suspected.

💊 Management

Conservative (first-line):
- 🛑 Rest or modify activities.
- ❄️ Ice packs for flare-ups.
- 💊 NSAIDs (short course).
- 👐 Physiotherapy → stretching, eccentric strengthening, manual therapy.
- 🦾 Elbow strap/brace to offload tendon.
Injections:
- 💉 Corticosteroid → temporary pain relief, but caution (rupture risk).
- 💉 PRP (platelet-rich plasma) sometimes used, evidence mixed.
Other therapies:
- 🌿 Acupuncture (adjunctive pain relief).
- 🔊 Shockwave therapy (ESWT) in resistant cases.
Surgery (rare):
- 🔪 Arthroscopic debridement.
- Open tendon release if >12 months conservative care fails.

📈 Prognosis

✅ Most recover in 6–12 months with conservative care.
⏳ Some develop chronic pain if untreated.
🔄 Prevention → ergono

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Golfer's Elbow (Medial Epicondylitis)