Medial epicondylitis or “golfer's elbow”

The typical symptoms of medial epicondylitis are:

• pain localized on the inner side of the elbow;
• discomfort that develops gradually, often without any specific trigger;
• increased pain during certain movements, such as flexing the wrist or rotating the forearm;
• pain that may radiate to the forearm, wrist, or fingers;
• in some cases, pain even at rest or during the night.

The intensity of these symptoms varies from simple temporary discomfort to chronic pain that limits daily activities such as shaking hands, carrying a bag, or lifting a cup.

Medial epicondylitis results from repeated microtrauma to the flexor tendons of the forearm. Repetitive movements or exertion cause tiny lesions to form in the tendons, which heal poorly and gradually alter their structure. This is not an acute inflammation, but rather a degenerative tendon process. The onset is gradual and the discomfort can last for several months or even years.

Various factors can contribute to the onset of medial epicondylitis:

The diagnosis of medial epicondylitis is based primarily on clinical evaluation and patient questioning.

• The medical history helps to identify the activities or movements that may be causing the pain.
• The clinical examination, particularly palpation, reveals specific pain on the inner side of the elbow.

Specific functional tests can be performed to reproduce the pain by contracting or stretching the muscles involved.

When the diagnosis remains uncertain or if symptoms persist despite appropriate treatment, additional tests may be indicated:

• Ultrasound allows the condition of the tendon to be assessed and its progress monitored over time.
• X-rays help to identify any calcifications or signs of associated osteoarthritis.
• MRI, reserved for chronic or severe forms, provides a detailed view of the tendons, ligaments, and joint structures.

Conservative treatment

In most cases, the first approach is a so-called conservative treatment, i.e., without resorting to surgery. This generally includes:

• Relative rest of the affected limb, avoiding painful movements while maintaining moderate activity, without total immobilization.
• Adaptation of daily movements and postures, with ergonomic advice such as adjusting the working position or the equipment used.
• Physiotherapy, which combines stretching and muscle strengthening exercises, as well as various techniques such as shock waves or dry needling (insertion of fine needles to reduce pain and release tension).
• Anti-inflammatory drugs, prescribed locally or orally depending on the pain and tolerance.
• Wearing orthotics, support bands, or epicondylar bracelets, designed to limit tendon strain and relieve the affected area.

Even without specific medication or surgery, the condition usually improves over time (see section on Progression and possible complications).

Injections

An injection involves injecting a product directly into a joint, tendon, or near a nerve.
In the case of medial epicondylitis, this option may be considered when rehabilitation is difficult to implement or when pain remains intense despite conservative treatments.

• Corticosteroid injections: these often provide rapid pain relief, but the effect is temporary. Repeated use can increase the risk of recurrence in the medium term and cause certain side effects, such as weakening of the tendon or skin discoloration.
• PRP (platelet-rich plasma) injections: this newer method aims to stimulate tissue regeneration. It has few side effects, but its cost is generally not covered by basic insurance.

Surgery

Surgery is only considered as a last resort, when the pain becomes debilitating and non-surgical treatments have not led to satisfactory improvement.

Two main techniques may be offered:

• Open surgery, a traditional technique performed under general anesthesia. It involves making a small incision in the elbow to directly access the damaged area.
• Arthroscopic surgery, a newer and less invasive approach, using a camera and small instruments inserted through fine incisions. This generally allows for a faster recovery and more discreet scarring.

Both methods offer good long-term results.
Immobilization is not usually necessary after the procedure, and arm mobilization begins in the first few days after surgery.

The natural progression of medial epicondylitis is usually favorable: more than 90% of patients recover spontaneously within a year, without the need for surgery.
However, in some cases, the pain may persist for several years (sometimes more than three years), and a minority of patients require surgery. After recovery, the risk of recurrence remains low.
On the other hand, repeated corticosteroid injections can increase the risk of complications and cause a rebound effect, i.e., the reappearance of symptoms after temporary improvement.

A few simple measures can help protect the elbow and reduce the risk of medial epicondylitis:

It is advisable to consult a healthcare professional in the following situations:

• when the pain persists for several weeks without any noticeable improvement;
• when the discomfort limits daily activities or disrupts sleep;
• if you have a history of elbow injections or surgery;
• if associated symptoms appear, such as numbness, loss of muscle strength, or decreased range of motion

Can I suffer from golfer's elbow even if I don't play golf?

Yes. Despite its name, golfer's elbow does not only affect golfers. The majority of cases are caused by repetitive movements that place excessive strain on the muscles and tendons of the forearm, often in a professional context or during other physical activities.

Can golfer's elbow be cured?

Yes, in the vast majority of cases, golfer's elbow heals spontaneously within a few months. When treatment is necessary (such as physical therapy, injections, or, more rarely, surgery), the outcome is generally favorable and recurrences are rare.

Does golfer's elbow always require surgery?

No, surgery is only considered as a last resort. It is reserved for chronic and painful cases, when other treatments have not worked. In the vast majority of cases, golfer's elbow heals spontaneously within a few months.

What is the difference between tennis elbow and golfer's elbow?

Tennis elbow (lateral epicondylitis) causes pain on the outside of the elbow, while golfer's elbow (medial epicondylitis) occurs on the inside. Both conditions result from overuse of the forearm tendons, but they affect different muscle areas.