Medial epicondylitis, otherwise known as “Golfer’s Elbow,” is characterized by elbow pain. Patients complain of a vague pain along the “inside” (ulnar side) of the elbow. Both medial epicondylitis and lateral epicondylitis (Tennis Elbow) arise due to repetitive use injuries of the arm. However, they differ by affecting different sides of the elbow (“inside” versus “outside”), and are caused by overuse of opposing muscle forces (forearm flexors versus forearm extensors). Additionally, lateral epicondylitis occurs far more commonly than medial epicondylitis.
Medial epicondylitis is caused by tendon injury due to overuse of forearm flexors and pronators. The muscles that allow you to flex your wrist and turn your palm down to the ground have a tendinous attachment to a bony prominence at the elbow. This bony prominence of the humerus is called the medial epicondyle. It is located on the side of the elbow that is closer to your body. Overuse of the muscles of wrist flexion and forearm pronation causes microscopic damage to the tendon which connects the forearm muscles to the medial epicondyle. With chronic overuse, tendon damage accumulates and pain results. After awhile, even regular activities of daily living may be enough to prevent the inflammation and pain from resolving. Sometimes, the surrounding inflammation can cause enough localized swelling that the ulnar nerve also becomes affected. As the ulnar nerve passes directly behind the medial epicondyle through a space called the cubital tunnel, it may become compressed and irritated, as well. This can cause symptoms of numbness, tingling, or pain in the ulnar side (pinky side) of the hand.
Fortunately, medial epicondylitis usually improves with convervative (non-operative) measures. Behavioral modification, oral anti-inflammatories, splinting, therapy, and stretching exercises often lessen the pain. Occasionally, steroid injections are used to diminish the inflammation at the medial side of the elbow from where the pain originates. Rarely is surgery necessary to correct the problem, but it is available for those refractory to all other conservative measures. If the ulnar nerve is involved (see Cubital Tunnel Syndrome), then that may be treated, as well.