Ask the Doctor – Dealing with Golfer’s Elbow

Have you experienced an intense pain along your inner elbow joint during or after a round? If so, you may be experiencing a condition called golfer’s elbow (Medial Epicondylitis) or pitcher’s elbow (often termed Tendinosis or Epicondylalgia). 

Golfer’s elbow is a condition caused by inflammation of the tendon where the forearm muscles connect to the bone. This is due to overload or overuse of those forearm muscles.  Pain may appear where the tendons of your forearm muscles attach to the bony bump on the inside of your elbow and can spread into your forearm, wrist, and fingers. 

Getting diagnosed with golfer’s elbow does not mean you have to stay off the course. Many professional players, including Tiger Woods, Padraig Harrington, and Miguel Angel Jimenez have suffered from golfer’s elbow and have gotten back in the game. If you’re in pain, don’t wait. 

Anyone sidelined with this condition is eager to know when they can get back in the game. Treatment options are available and most cases this condition can be handled non-surgically.

We’ve asked Dr. John East of Addison Pain + Regenerative Medicine to tell us more about the treatments available and recovery of golfer’s elbow. 

What causes Golfer’s Elbow? 

Golfer’s elbow is usually caused by abnormal or overuse of the muscles in your forearm, which allows you to grip with your hand, rotate your arm and flex your wrist. This condition is often diagnosed in people who repeatedly swing a golf club or perform other activities; however, many activities and occupations can lead to golfer’s elbow. Repetitive flexing, gripping, twisting, throwing, or swinging can small tears in the tendon to develop.

While the most at risk for this condition are men over the age of 35, there are other conditions that increase risk as well, such as smokers, those with a high body mass index, and those who perform repetitive activities for two or more hours per day. In an athletic person, this condition can develop due to training errors or improper biomechanics, meaning the structure and function of the body are mispositioned for the activity. Sports such as tennis, racquetball, American football, bowling, weight training, and other throwing and pitching sports can lead to this injury as well. However, about 90% of golfer’s elbow cases are non-sports related. Labor intensive occupations can also be a cause due to forceful, repetitive activities that are required of carpenters, plumbers, and construction workers. Any activity that requires the bending and straightening of the wrist and elbow repeatedly, such as painting, hammering, typing, cooking, and yard work, can lead to golfer’s elbow.  

What are the symptoms of Golfer’s Elbow? 

If you are experiencing elbow pain, is the pain in your inner or outer elbow? Do you experience pain, tenderness or stiffness in your elbow that worsens with certain movements?  With golfer’s elbow, usually the pain is felt on the inner side of the elbow and can extend along the inner side of the forearm. You may also notice weakness in your hands and wrists, or more stiffness when making a fist. Numbness or tingling could occur as the pain radiates into one or more fingers, usually the ring and little fingers. If you are a golfer, you may notice a shooting pain sensation down the forearm while gripping your club. If you are experiencing any of these symptoms, you should consult your doctor.

How is Golfer’s Elbow different than Tennis Elbow?

Golfer’s elbow is very similar to tennis elbow, except tennis elbow pain occurs on the outside of the elbow. Tennis players and others who repeatedly use their wrists or clench their fingers also can develop golfer’s elbow. What matters is not what sport you play, but where the pain occurs in the body. Whether you have golfer’s elbow or tennis elbow, rest and appropriate medical treatment can get you back into the swing of things.

What non-surgical treatments are available for Golfer’s Elbow? 

There are many non-surgical treatments available to help ease pain from golfer’s elbow, some more effective than others. Cortisone injections and topical steroids may help to relieve pain and inflammation but tend to be a band aid fix. Other treatments such as ultrasound, electrical nerve stimulation or dry needling can aid in the healing process but are usually not as effective as a stand-alone solution. 

As a long-term solution, Dr. East recommends physical therapy combined with regenerative medicine treatments such as platelet-rich plasma (PRP), ozone, PRP with ozone, bone marrow or exosomes to reduce inflammation and help to oxidize the injured tissue to stimulate healing and activate stem cells. 

When can I get back on the course (or back to life) after treatment? 

Ultimately, it depends on the severity of the pain and symptoms, as well as how much damage there has been to the tendon. Some patients can get back on the course right away, and for others it may take more time. Most regenerative medicine patients see results within a few weeks of the procedure, but it may take up to three months. Some patients need more than one treatment. If the discomfort is minimal, Dr. East believes it’s important to keep the joints active and to get back to your game (or life) right away. There are other ways to manage the pain including a change in technique and custom-fitted grips. 

What happens if Golfer’s Elbow goes untreated?

If you do have golfer’s elbow and you ignore your pain and discomfort for too long, this condition could eventually cause a permanent contracture (bend) of the elbow, and possibly a permanent disability. Over time you could lose your elbow range of motion, loss of grip strength, and suffer from chronic pain. If you are experiencing elbow pain and think you might have golfer’s elbow, schedule a consultation at Addison Pain + Regenerative Medicine today.  

John East, D.O. is the owner of Addison Pain + Regenerative Medicine serving the DFW Metroplex. Dr. East has been practicing regenerative medicine since 2014 and is a leader in this field. He is board-certified in both Physical Medicine & Rehabilitation (PM&R) and Pain Medicine. Dr. East has completed advanced training and certification at the Institute of Regenerative Medicine and is a member of the American Academy of Stem Cell Physicians (AASCP). Dr. East continues to study new treatment options and performs clinical trials surrounding the field of regenerative medicine. His latest endeavor is the completion of ozone certification and advanced Prolozone with Dr. Frank Shallenberger.