Golfer's elbow

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Overview
Golfer's elbow, or medial epicondylitis, is an inflammatory condition of the elbow which in some ways is similar to tennis elbow.

The flexor muscles of the forearm, the muscles responsible for bending the fingers and thumb, clenching the fist and supinating the hand excluding biceps brachialis, come together in a common tendon which is inserted in to the medial epicondyle of the humerus at the elbow joint. In response to minor injury, or sometimes for no obvious reason at all, the point of insertion becomes inflamed.

Causes
The condition is called Golfer's elbow because in making a golf swing this tendon is stressed; many people, however, who develop the condition have never handled a golf club. It is also sometimes called Pitcher's elbow due to the same tendon being stressed by the throwing of objects such as a baseball, but this usage is much less frequent.

Symptoms
The predominant symptom is pain on the medial aspect of the elbow joint, which is made much worse if the flexor muscles of the forearm arm under tension but may occur at rest. On examination the medial epicondyle of the humerus is exquisitely tender. There may be some weakness of flexor function, caused by pain-mediated reflex inhibition of function of the flexor muscles.

Treatment
Simple analgesic medication has a place, as does more specific treatment with oral anti-inflammatory medications. The definitive treatment is, however, the injection into and around the inflamed and tender area of a long-acting glucocorticoid (steroid) agent. After causing an initial exacerbation of symptoms lasting 24 to 48 hours, this will produce a resolution of the condition in some five to seven days.

The ulnar nerve runs in the groove between the medial humeral epicondyle and the olecranon process of the ulna. It is most important that this nerve should not be damaged accidentally in the process of injecting a Golfer's elbow.