This condition is classically described in golfers although is common in anyone who has undertaken unaccustomed heavy manual work which involves a lot of lifting and carrying, particularly with the palm turned up. Golfers may also get Tennis elbow (lateral epicondylitis)
WHAT ARE THE SIGNS AND SYMPTOMS?
Pain is felt over the inside of the elbow joint. A small area (the medial epicondyle) is usually exquisitely tender. The pain may spread down into the forearm. Gripping, carrying and flexing the wrist all make the pain worse.
HOW IS THE DIAGNOSIS MADE?
The doctor will listen to the description of events and examine the elbow. X-Rays will also be taken to determine whether there is a piece of bone involved. Usually no further investigation is needed although sometimes, in difficult cases, ultrasound or MRI may be helpful.
WHAT IS THE INITIAL TREATMENT?
Firstly it is important to determine why the condition occurred so that recurrence may be avoided. If it is sports related the equipment or grip must be altered. Often the racquet handle is too small or too big for the hand.
The mainstay of treatment is Physiotherapy.
Exercises to improve wrist flexibility and increase the wrist flexor and extensor muscle strength must then be started as these are part of the initial problem.
A number of bands and devices are available to place round the forearm. These aim to “offload” the insertion of the extensor muscles into the lateral epicondyle. They are not a substitute for therapy but do provide symptomatic relief.
Steroid injections are used rarely as evidence has shown that, although there is good short term relief, the symptoms recur after a few months.
A newer treatment is offered by the LONDON SHOULDER PARTNERSHIP.
A small amount of blood is taken from the arm and spun in a centrifuge. This concentrates the active components of the blood (1-2ml) which are then extracted and injected into the affected area under ultrasound guidance.
These active components (Growth factors) then support healing of the damaged tendon.
You will need to check with your insurer if this treatment is covered under your policy.
The Arthrex ACP system
The following link will direct you to a video explaining the Arthrex ACP system