Diagnosis

Golfer's elbow is usually diagnosed based on your medical history and a physical exam. To evaluate pain and stiffness, the doctor may apply pressure to the affected area or ask you to move your elbow, wrist and fingers in various ways.

An X-ray can help the doctor rule out other causes of elbow pain, such as a fracture or arthritis. Rarely, more comprehensive imaging studies — such as MRI — are performed.

Treatment

The sooner you begin treatment, the sooner you'll be able to return to your usual activities.

  • Rest. Put your golf game or other repetitive activities on hold until the pain is gone. If you return to activity too soon, you may make it worse.
  • Ice the affected area. Apply ice packs to your elbow for 15 to 20 minutes at a time, three to four times a day for several days. To protect your skin, wrap the ice packs in a thin towel. It might help to massage the inner elbow with ice for five minutes at a time, two to three times a day.
  • Take an over-the-counter pain reliever. Try ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, others) or acetaminophen (Tylenol, others).
  • Use a brace. Your doctor might recommend that you wear a counter force brace on your affected arm, which might reduce tendon and muscle strain.
  • Stretch and strengthen the affected area. Your doctor may suggest stretching and strengthening exercises. Physical or occupational therapy can be helpful, too. A type of strengthening (eccentric) that lengthens the tendon of the wrist extensor muscles has been shown to be particularly effective in treating chronic tendon irritation.
  • Reduce the load on your elbow tendons. Wrap your elbow with an elastic bandage or use a splint.
  • Gradually return to your usual activities. When your pain is gone, practice the arm motions of your sport or activity. Review your golf or tennis swing with an instructor and make adjustments if needed.
  • Ask your doctor when surgery is appropriate. Surgery is seldom necessary. But if your signs and symptoms don't respond to conservative treatment in six to 12 months, surgery may be an option. A new procedure involves minimally invasive, ultrasound-guided removal of scar tissue in the region of the tendon pain. More study is needed.

Other treatments used include corticosteroid injections, which have not been shown to be an effective long-term treatment. (1p7) A newer treatment being tried is platelet-rich plasma. This involves drawing a small amount of your blood, spinning it down and injecting it into the tender area. More studies are needed.

Most people will get better with rest, ice and pain relievers. Depending on the severity of your condition, the pain may linger for months to years — even if you take it easy and follow instructions on exercising your arm. Sometimes the pain returns or becomes chronic.

Preparing for your appointment

You'll probably start by seeing your primary care physician. If you don't improve with rest, ice and over-the-counter medications, your doctor might refer you to a sports medicine specialist or to a doctor with advanced training in musculoskeletal disorders.

Here's some information to help you get ready for your appointment.

What you can do

  • List your symptoms and when they began.
  • Write down key medical information, including other conditions you have and all medications and supplements you're taking.
  • Log your typical daily activity, including how often, long and hard you play sports or do other activities that tax your elbow. Note whether you've recently changed the frequency, intensity or method of your workouts.
  • Jot down recent injuries that could have damaged your elbow.
  • Write down questions to ask your doctor to help you make the most of your time together.

Below are some basic questions to ask a doctor who is examining you for possible golfer's elbow.

  • What is the most likely cause of my signs and symptoms?
  • Are there other possible causes?
  • Do I need tests to confirm the diagnosis?
  • What treatment approach do you recommend?
  • With treatment, will I eventually be able to resume the sport or activity that caused my elbow problems?
  • How long will I need to avoid the sport or activity that caused my elbow problems?
  • What kind of exercise routine can I safely follow while I'm healing?
  • Will I need surgery?
  • How often will you see me to monitor my progress?

Don't hesitate to ask other questions.

What to expect from your doctor

Your doctor is likely to ask you questions, including:

  • What are your symptoms and when did you first notice them?
  • Is your pain constant? Is it severe?
  • Do tasks that use your elbow — lifting, gripping, carrying, typing, shaking hands — trigger pain?
  • Are your symptoms affecting your ability to complete daily tasks? Are they affecting your sleep?
  • What is your exercise routine?
  • Have you recently changed your training or equipment, such as using new techniques or a new racket?
  • What activities do you perform at work?
  • What are your recreational activities or hobbies?
  • Have you tried at-home treatments? If so, has anything helped?
  • Have you recently had an injury that might have caused elbow damage?
  • Have you been diagnosed with other medical conditions?
Aug. 25, 2015
References
  1. Jayanthi N. Epicondylitis (tennis and golf elbow). http://www.uptodate.com/ home. Accessed Aug. 7, 2015.
  2. Golf injuries to the hand, wrist or elbow. American Society for Surgery of the Hand. http://www.assh.org/handcare/hand-arm-injuries/Golf-injury. Accessed Aug. 7, 2015.
  3. Golf injury prevention. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00137. Accessed Aug. 8, 2015.
  4. Amin NH, et al. Medical epicondylitis: Evaluation and management. Journal of the American Academy of Orthopaedic Surgeons. 2015;23:348.
  5. Dimitrios S. Exercise for tendinopathy. World Journal of Methodology. 2015;5:51.