Medial Epicondylitis and Medial Elbow Pain Syndrome: Current Treatment Strategies
Journal Title: Journal of Musculoskeletal Disorders and Treatment - Year 2016, Vol 2, Issue 2
Abstract
Medial elbow pain is a common complaint in the active population. The most frequent muscular or tendinous condition to cause medial elbow pain is Medial Epicondylitis (ME). The disorder is classically described as "Golfer's elbow" due its association with elbow pain caused by excessive eccentric force across the common flexor origin encountered during the golf swing. In the working population, the condition is frequently associated with repetitive use and is seen in manual laborers who require forceful wrist flexion and pronation along with grasping. Medial Epicondylitis is frequently accompanied by additional medial sided elbow pathology such as ulnar neuritis, ulnar collateral ligament injury, flexor pronator strain, and snapping medial triceps. Treatment is directed towards addressing tendon degeneration at the common flexor tendon origin. The mainstay of treatment is non-operative with stretching, rest, activity modification, therapy, and injections. Intermediate techniques include extracorporeal shockwave therapy (ECSW), ultrasound (US), platelet-rich-plasma (PRP) injections, and newer techniques of ultrasound guided fasciectomy. Surgical treatments are tailored to the severity of the pathoanatomy and need to be inclusive of concomitant pathology. The patient who presents with medial elbow complaints requires a broad differential diagnosis. It is appropriate to consider medial epicondylitis a primary etiology within the larger concept of "Medial Elbow Pain Syndrome" as the presence of ME does not exclude other origins of medial elbow pain.
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