What is medial epicondylitis?

Medial epicondylitis is a tendinosis (degeneration, not inflammation) of the tendon insertion at the elbow of the muscles that flex the wrist and pronate the forearm (turn the hand palm down).  It is a very common condition, but not anywhere near as common at lateral epicondylitis or tennis elbow.

What are the symptoms of medial epicondylitis?

The most common symptoms of medial epicondylitis are a pain at the inside of the elbow when gripping, lifting or swinging a racket or stick for sport. This is what gives the condition its moniker. In addition, almost all patients will have pain at the bump on the inside of the elbow (medial epicondyle of the humerus).

Who gets medial epicondylitis?

The age range is similar to those with lateral epicondylitis at 35-65 years of age.  While tennis elbow is usually not caused by tennis, golfers’ elbow can in fact be caused by golf, especially if one’s swing needs “some work.” Other causes of the condition can be overuse with any type of lifting exercise, improper weight lifting (straight bar biceps curls), or sudden pulling with the wrist flexed. Patients often experience pain inside the elbow with use or activity.

How is medial epicondylitis diagnosed?

A thorough history and physical examination will usually be enough to make the diagnosis. However, it is important to make sure that there is no compression or injury of the ulnar nerve at the elbow. X-rays are usually done to rule out arthritis.  An MRI is not essential but is diagnostic.

How is medial epicondylitis treated?

It is important to remember that the condition is a result of tendon degeneration, not inflammation. For this reason, traditional anti-inflammatory medications do not work. These include NSAIDs and steroid injections.  There are no definitive studies telling us what treatment works best.  In addition, most all treatments work the same as doing nothing. Therefore, we generally set patients up with a trial of physical therapy.  Eccentric exercises and aggressive soft tissue mobilization set up by a trained therapist with a home program will usually decrease symptoms and allow the patient to return to sport.

However, there is no need to wait for healing to return to sports or work either. We believe that if a patient will do the exercises before their activity, they will be able to perform better and without pain.  The program should be incorporated as part of the warm-up.

In rare cases, patients may need surgical treatment.  The surgery is simple–but will require post-operative immobilization for 10-14 days followed by a supervised therapy regimen.

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