- Also known as
- Medial epicondylitis
- Most common in
- Adults 35–55
- Natural course
- Self-limiting, 12–18 months
- First-line
- Load management + eccentric loading physio
- Surgery rate
- Less than 10%
What golfer's elbow is.
Golfer's elbow — properly called medial epicondylitis — is a degenerative tendinopathy of the common flexor tendon origin on the inside of the elbow. As with tennis elbow, the histology is a tendon-failure-and-disorganised-repair process rather than true inflammation. The name is misleading: most patients are not golfers but manual workers, tradespeople or office workers with sustained wrist-flexion or gripping postures.
Natural history.
Golfer's elbow is genuinely self-limiting in the great majority of patients, with symptoms resolving over approximately 12–18 months. Treatment is therefore aimed at managing symptoms during the natural recovery window.
Overlap with cubital tunnel.
An important examination point: the ulnar nerve runs immediately behind the medial epicondyle. Co-existing cubital tunnel syndrome is common in patients with golfer's elbow, particularly those with more chronic symptoms. The history must include a specific enquiry about numbness in the ring and little finger.
Non-operative treatment.
- Education and load management — the most important intervention.
- Eccentric loading physiotherapy — the best-evidenced non-operative treatment.
- Counterforce brace — modest evidence; often helpful in heavy gripping work.
- Short courses of anti-inflammatories.
- Corticosteroid injection — provides short-term relief but is associated with worse long-term outcomes when used early; reserved for disabling acute flares.
Surgery.
Less than 10% of patients require surgery. The threshold is 6–12 months of well-conducted non-operative care without satisfactory improvement. The operation involves a small incision over the medial epicondyle, debridement of the diseased flexor tendon origin, and (if co-existing cubital tunnel is present) decompression of the ulnar nerve at the same setting. Recovery to comfort takes 2–3 months; full strength returns over 6 months.
Frequently asked questions.
How long will golfer's elbow last?
On average 12–18 months from first symptom to resolution. Some patients are better sooner; a minority take longer.
Will physiotherapy fix it?
Eccentric loading physiotherapy is the best-evidenced non-operative treatment. Combined with load management, it improves outcomes through the natural recovery period.
Should I get a cortisone injection?
Cortisone provides short-term relief but is associated with worse long-term outcomes when used early. It is reserved for disabling acute flares, not as first-line treatment.
What if I also have numb fingers?
Co-existing cubital tunnel syndrome is common and matters — the ulnar nerve runs immediately behind the medial epicondyle. If you have numbness in the ring and little finger, the assessment must include nerve conduction studies.
When is surgery the right answer?
After 6–12 months of well-conducted non-operative care without satisfactory improvement, in patients whose symptoms are interfering with work or sport.
References.
- Shiri R, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11):1065–1074.
- Vinod AV, Ross G. An effective approach to diagnosis and surgical repair of refractory medial epicondylitis. J Shoulder Elbow Surg. 2015;24(8):1172–1177.