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.
An injection of local anaesthetic and steroid into the most tender spot (the medial epicondyle) gives instant relief and allows therapy to begin.
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 further 1-2 injections may be given if the symptoms recur.
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.