WHAT IS INNER ELBOW PAIN?
Golfer’s elbow also known as medial epicondylitis is a form of tendonitis. This causes pain, inflammation, and tenderness in the muscles or tendons located on the inside of the elbow and the forearm.
The pain focuses on the bony bump on the inside of the elbow and might radiate into the forearm and wrist. The pain is usually caused by overuse or wear and tear of the tendons, bones, and muscles used for grasping and wrist flexion. The pain and associated symptoms usually get better with rest. This is the result of activities requiring repetitive gripping motions like throwing, rock climbing, racket sports, or weight training.
Lack of movement leads to joint stiffness and muscles around the elbow to weaken or increase symptoms. Hence, it is advised not to rest for too long and do simple exercises to reduce the risk of future problems. Chronic or long-term elbow pain could lead to arthritis.
WHAT CAUSES INNER ELBOW PAIN?
The elbow joint is the junction where the long bone at the top of the arm (humerus) meets the two bones (radius and ulna) in the forearm. The joint is known as a hinge joint that allows the arm to bend.
The upper part of the radius helps in twisting the forearm as it can rotate. The end of the humerus consists of two bony parts at either side of the elbow, which are the lateral epicondyle on the outside and the medial epicondyle on the inside of the arm.
Muscles attached on the outside of the humerus are essential for straightening the wrist and fingers, whereas the muscles on the inside of the humerus help in bending the wrist and fingers, and grasping objects.
The inner elbow pain is caused due to damage of the muscles and tendons controlling the wrist and fingers. The damage is the result of excess or repeated stress, mainly forceful wrist and finger motions, improper lifting, throwing or hitting, and little warm-up or poor conditioning.
Other reasons for pain, inflammation and damage to muscles and tendons in inner elbow are:
- Racket sports – Using improper technique in tennis such as the backhand might cause injury to the tendon. Repetitive and excessive use of racket shots like topspin which is small or heavy might also lead to injury.
- Throwing sports – Improper pitching technique in sports such as baseball or softball, football, archery and javelin throw could cause golfer’s elbow.
- Weight training – Lifting weights in improper posture or technique like curling the wrists during a biceps exercise might overload the elbow muscles and tendons causing rupture or breakage.
- Forceful, repetitive occupational movements – These occur mainly in field related work like construction, plumbing and carpentry.
Golfer’s elbow pain does not happen suddenly but is a result of repetitive injury over a period of time.
People above 40 or older are at higher risk of developing inner elbow pain apart from obese, smokers or people performing above repetitive activities for at least two hours a day.
WHAT ARE THE SYMPTOMS OF INNER ELBOW PAIN?
The main symptom of medial epicondylitis is pain along with stiffness that can happen suddenly or with time. Other symptoms associated with pain are:
- Stiffness in your elbow
- Tenderness and pain mainly on the inner side of the elbow or forearm
- Pain with certain movements such as making a fist or swinging even the light weight objects
- Tingling or numbness in the fingers mainly in the ring and little finger
- Weakness in the hands and wrists
- Weakened grip
- Pain while shaking hands
- Difficulty moving the elbow
- Stiff elbow
- Weakened wrist
It is important to seek medical care in case of lingering, unexplained pain that does not go away even after rest. Resting the affected site would lead to improvement in pain and related symptoms. However, people experiencing severe symptoms, or only limited relief even after rest should immediately see a doctor.
HOW TO DIAGNOSE INNER ELBOW PAIN?
The doctor would be able to diagnose the cause of the symptoms and pain by physical examination and imaging tests like X-ray or MRI.
The doctor would rest the arm on a table with the palm side up, and ask the patient to raise the hand by bending the wrist with resistance. Doctor would also apply pressure on the hand and ask the patient to bend the palm towards the wrist. The medial epicondylitis is confirmed if you experience pain on the inner side of the arm while flexing the wrist after applying pressure by the doctor.
TREATING INNER ELBOW PAIN
Resting the problematic area is the initial treatment for golfer’s elbow. Usually the pain and stiffness would subside after rest.
Apart from rest other treatment options that provide relief would be:
- RICE (Rest, Ice, Compression and elevation) therapy – Along with rest, application of ice to the elbow and inner part of the forearm along with elevation helps in reducing the inflammation and pain.
- Medicines – To help reduce the pain doctor would prescribe over-the-counter painkiller and anti-inflammatory medications. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen help in easing the pain, swelling and stiffness muscles and tendons of the inner elbow region. Application of creams and ointments (such as gel based) also help in reducing pain from the affected region.
- Injections – In case of severe pain, doctors would recommend steroid injections that provide instant relief from pain and gradually reduce the inflammation. These are beneficial for short term use only. Platelet-rich plasma injections are also beneficial in easing off the pain and increasing the movement of the affected joint.
- Splints – In case of any sport or work related injury affecting the movement of the elbow using a splint (also known as epicondylitis clasps) for supporting the elbow would ease the strain during certain activities that cause the pain to flare up. These are available from chemists, sports shops and physiotherapists.
- Braces – Wearing a counterforce brace on the affected arm would reduce tendon and muscle strain by decreasing the pressure on them.
- Exercise – Stretching and strengthening exercises help in reducing the stiffness, increase flexibility as well as prevent the pain from reoccurring. Exercises such as eccentric exercises help to strengthen the muscle when they are relaxed and not tight as well as stretching the muscles and tendons helps with mobility. Some of the common exercises are: isometric wrist extension & flexion; ball squeeze; Forearm pronation & supination; resisted wrist extension & flexion with light weight and elbow stretch.
- Surgery – It is rarely required when the above therapies, medicines and exercises (alone or combined) do not provide relief even after 6 to 12 months of treatment. TENEX procedure might be used instead of surgery, involving minimally invasive, ultrasound-guided removal of scar tissue from the region of tendon pain.
With above exercises and medicines it is important to return gradually to activities which involve the use of the arm like sports. When the pain eases off you should practice the arm motions such as during sports
Golfer’s elbow or medial epicondylitis is characterized by pain radiating from the elbow to the wrist on the inside (medial side) of your elbow. The pain is majorly the result of damage to the tendons which are responsible for bending the wrist toward the palm. The pain would go away with rest and painkillers (on moderate to severe pain) in a few days. In some rare cases surgery known as open medial epicondylar release procedure might be required.
If you or anyone you know is suffering from inner elbow pain, our expert providers at Specialty Care Clinics will take care of your health and help you recover.