Elbow tendonitis most commonly results from damage to the tendons (attachment of muscle to bone) of the forearm muscles to the humerus (arm bone). Over time, excessive use of the forearm muscles, either from sports activities or work-related activities, may damage these tendons. The two most common forms of tendonitis seen in the elbow are lateral epicondylitis and medial epicondylitis.
Medial Epicondylitis involves damage to the tendons of the muscles which attach on the inner side of the arm at the elbow. These muscles are responsible for flexing the wrist and fingers as well as pronation of the forearm (twisting of forearm so that palm faces downward). Therefore, pain is felt on the inside of the elbow, and is brought on by activities such as golfing and pitching, tightening a screw, or other gripping motions where flexion and pronation are involved.
It involves the inflammation and damage of flexor muscles of the wrist and fingers that attach to medial epicondyle (inner side of elbow) (fig 1). They are called flexor-pronator mass.
Overuse of the muscles causes inflammation and damage, leading to pain on the inner side of elbow. It can affect anybody who is involved in repetitive motion of the hand, wrist and forearm muscles, such as golfers, painters, plumbers, those who play racquet sports, and persons using tools like screwdrivers, hammers, or rakes.
Pain over the medial epicondyle (inner side of elbow) which gets worse with wrist and forearm motion.
A diagnosis is typically made from the patient’s history and physical examination. Provocative tests can be performed by doctor to confirm, which include resisted forearm pronation and wrist flexion. However, an X-Ray or MRI may be used to rule out other conditions.
Most often, non-operative treatment is effective in addressing the symptoms. This includes:
Rest and Ice
Wearing a Brace
If non-operative treatment is tried for 6 months and it fails to reduce symptoms, the orthopedic surgeon will discuss the possibility of surgery. Surgical treatment involves reattachment of healthy muscle to the bone and removal of damaged tendon.