Golfer's Elbow Info
Last reviewed
Golfer’s elbow (medial epicondylitis) — causes, symptoms, and conservative treatment options.
What you're feeling
You likely have pain along the inside of your elbow, at the bony bump that points toward your body when your palm is up. The pain often starts gradually and worsens with activities that grip strongly or twist the wrist — carrying shopping, swinging a golf club, lifting a kettle, screwing a lid on a jar. You may also feel an ache running down the inside of your forearm toward the wrist.
Many people first notice it when they wake up with a stiff inner elbow that loosens with movement. Some find their grip is weaker than usual or that simple tasks like turning a doorknob bring on a sharp twinge.
Despite the name "golfer's elbow," most people who develop this have never picked up a club — it's just as common in plumbers, builders, painters, and anyone who repeatedly grips and twists. The condition tends to be stubborn, lasting months, but most people get better without surgery.
What's actually happening
The pain comes from the tendons that connect your wrist and finger FLEXOR muscles to the bony bump on the inside of your elbow, called the medial epicondyle. Repeated heavy gripping or twisting overloads where these tendons join the bone, and small tears develop in the tendon fibres. Despite the old name "medial epicondylitis," the problem is usually not active inflammation — it's a degenerative tendinopathy, where the tendon has failed to heal properly between cycles of overuse.
A useful way to picture it is a frayed rope: the outer fibres look intact, but inside, individual strands have been stretched and damaged. The body keeps trying to heal the area, but ongoing overuse outpaces the repair.
Risk factors include occupations or sports with repetitive forearm-flexor work, being between 40 and 60 years of age, smoking, and obesity. The ulnar nerve runs in a groove right behind the medial epicondyle, and a small number of patients also develop ulnar nerve symptoms (pins and needles in the ring and little fingers) alongside the elbow pain.
What we can do about it
Most people improve with non-surgical care over several months. Your surgeon will usually work through the gentler options first.
Activity modification and physiotherapy are the cornerstones. Cutting back temporarily on the activities that flare your pain, using a lighter grip, taking frequent breaks, and avoiding repetitive twisting all help. A hand therapist or physiotherapist will guide you through eccentric strengthening exercises — slow lengthening of the flexor-pronator muscles under load — which has the best evidence for remodelling the tendon. Stretching the forearm flexors gently before activity also helps.
A counterforce strap worn around the upper forearm can offload the tendon attachment during activity. Simple painkillers and short courses of anti-inflammatories help when the pain flares.
Injections are sometimes used when pain persists despite a fair trial of therapy. Corticosteroid injections give short-term relief, but the long-term benefit is modest and repeated injections may weaken the tendon. Platelet-rich plasma (PRP) injections are an alternative; the evidence is mixed but they don't share the tendon-weakening concern.
Surgery is reserved for the small group of patients whose pain persists despite a year or so of well-conducted non-surgical treatment. The damaged tendon tissue is debrided and the healthy ends are re-secured to the bone, sometimes through a small open incision and sometimes endoscopically. If the ulnar nerve is involved, that's addressed at the same operation. Most patients are significantly improved after surgery, though full recovery can take six to twelve months.
When to see someone
Most golfer's elbow settles with time and a sensible program of activity modification, stretching, and strengthening. You don't need to rush to a specialist for occasional ache.
Do see someone if your pain has lasted several months despite simple measures, if it is waking you at night, or if it limits work or sport. Seek earlier review if you have numbness, tingling, or weakness in your hand (which could mean the ulnar nerve is involved), or if pain follows a sudden injury rather than gradual overuse — that pattern can suggest a tendon avulsion rather than tendinopathy.
