Golfer's Elbow

What the model shows: 3D model of the inner side of the right elbow in Julio: the flexor and pronator muscles, their tendons and ligaments, with the pronator teres and FCR highlighted in blue and the ulnar nerve visible close by. Julio, Team Clinic 360° Anatomical detail: In blue: the pronator teres and the flexor carpi radialis (FCR), which attach together with other muscles at the common flexor origin on the inner bony bump of the humerus. In yellow beside them: the ulnar nerve. Interaction: this is an interactive 3D model from Julio. Once the 3D view loads it rotates automatically, unless the device is set to reduce motion. Drag to change the viewing angle and examine the anatomy from different sides; after you start interacting you can also zoom in and out.

Rotates automatically · drag to change the angle

What is golfer's elbow?

Golfer's elbow, or medial epicondylitis, is an overuse injury of the wrist and finger flexor tendons at their attachment to the bony prominence on the inner side of the elbow. According to the Mayo Clinic, the pain centers on the inner elbow and can radiate down the forearm.

As with tennis elbow, the name is misleading: most patients do not play golf. The condition is common in anyone who performs repetitive gripping and wrist-flexing motions - manual labor, weight training, climbing, working with tools, even carrying children and shopping bags.

And as with tennis elbow, in most cases this is not an acute inflammation but a process of tendon degeneration and overload - which is why "an anti-inflammatory pill" alone is not a treatment plan.

What does golfer's elbow feel like?

Patients with golfer's elbow often describe:

• Pain or tenderness on the inner side of the elbow
• Pain radiating down the forearm toward the wrist
• Pain with a strong grip or handshake
• Pain when lifting objects or weights
• Pain when turning the hand - opening a jar, using a screwdriver, turning a handle
• Morning stiffness in the elbow
• Weakness of grip
• Sometimes numbness or tingling in the ring and little fingers

That last point matters: the ulnar nerve runs right next to the affected area. In some cases it becomes irritated as well - and that changes the treatment picture. StatPearls notes that ulnar nerve symptoms accompany a meaningful share of medial epicondylitis cases.

Why does an accurate diagnosis matter?

Not every pain on the inner side of the elbow is golfer's elbow.

Pain in this region can also come from ulnar nerve entrapment (cubital tunnel syndrome), from the elbow's inner ligament, from the joint itself, from the neck radiating down the arm, or from myofascial pain in the forearm muscles. And sometimes the pain is actually on the outer side - tennis elbow - or on both sides at once.

The difference matters, because the treatment is not the same.

With golfer's elbow we need to understand: Is the problem limited to the tendon? Is the ulnar nerve involved? Is there a cervical component? And which treatment fits the stage - conservative care, medical dry needling, prolotherapy, an ultrasound-guided injection, or hydrodissection of the nerve in suitable cases?

An accurate diagnosis saves time, pain, and treatments aimed at the wrong target.

Why "waiting for it to pass" is not always enough

It is true that most cases of golfer's elbow improve with conservative care. But the process can take months, and time alone is not a treatment plan.

While waiting, a patient may go through persistent pain, declining grip strength, an impact on work and training, and a growing tendency to avoid using the arm.

More than that - uncontrolled load on an irritated tendon perpetuates the problem, while complete and prolonged rest weakens the tendon and muscles. And if an unrecognized ulnar nerve problem is part of the picture, the "standard" treatment simply will not work.

That is why the key is an accurate diagnosis, correct load management, pain control and gradual strengthening.

Our approach at Team Clinic 360°

At Team Clinic 360° we do not look at golfer's elbow as just another "sore elbow."

We look at the whole picture:

• How the pain began - suddenly or gradually
• Which activities make it worse and which ease it
• How long the problem has been present and what has already been tried
• The nature of your work, sport and daily load on the arm
• Whether there is numbness, tingling or weakness in the fingers
• Whether the ulnar nerve is involved
• Whether the neck or shoulder are part of the picture
• Grip strength and overall function

The exam includes a focused clinical evaluation, specific tendon loading tests, a neural exam as needed, and at times the use of diagnostic ultrasound - to assess both the tendon and the nerve and rule out other problems.

Your evaluation and treatment are led by Dr. Lior Shem Tov, a specialist in anesthesiology and pain medicine, and Dr. Natalie Siegel, a specialist in family and pain medicine.

Treatment for golfer's elbow

Treatment for golfer's elbow depends on how long the problem has been present, the intensity of pain, the condition of the tendon, whether the nerve is involved, and your medical background.

In suitable cases, treatment options may include:

• Assessment by a pain physician and a full clinical evaluation
• Diagnostic ultrasound as needed
• Load management - at work, in sport and in daily life
• Medication to reduce pain, when appropriate
• Physical therapy focused on graded strengthening of the flexor tendons
• Ultrasound-guided medical dry needling of the tendon region and forearm muscles
• Prolotherapy - injections aimed at stimulating a healing response in the tendon
• Ultrasound-guided injections in suitable cases
• Treatment of the ulnar nerve, including ultrasound-guided hydrodissection, when the nerve is involved
• A structured, graded home exercise program

In golfer's elbow, precision matters twice over: the ulnar nerve runs immediately next to the treatment area, so any injection in this region should be performed carefully - and preferably under ultrasound guidance.

There is no single treatment that fits everyone. There is a tendon. There is a nerve. There is a person. And there is a plan that has to fit them.

Golfer's elbow or a nerve problem?

This is one of the most important distinctions on the inner side of the elbow.

Tendon pain worsens with gripping and with wrist flexion against resistance. Ulnar nerve entrapment, by contrast, usually causes numbness and tingling in the ring and little fingers, sometimes with subtle weakness of the hand. And sometimes - both problems exist together.

The neck can confuse the picture as well: pressure on a cervical nerve root can radiate pain and numbness down the arm into the fingers.

That is why, in our exam, we do not stop at the tendon. We examine the nerve, the neck and the pattern of pain - because precise treatment starts with the right address.

When should you come in for an evaluation?

It is worth considering a visit to a pain physician or a clinic that focuses on pain if:

• Pain on the inner side of the elbow has lasted more than a few weeks
• The pain returns every time you go back to activity
• Your grip strength is declining
• There is numbness or tingling in the ring and little fingers
• The pain interferes with work, training or sleep
• Rest and painkillers have not brought stable improvement
• You had an injection and the pain came back
• It is unclear whether the problem is the tendon, a nerve or the neck

What happens at the appointment?

At the appointment we carry out a medical evaluation aimed at understanding whether this is golfer's elbow, the state of the tendon, whether the nerve is involved, and whether other factors are part of the picture.

The appointment may include:

• An in-depth medical conversation
• A clinical exam of the elbow, forearm and wrist
• Specific tendon loading tests
• A neural exam of the ulnar nerve as needed
• Examination of the neck, shoulder and radiating areas as needed
• Diagnostic ultrasound based on clinical need
• Review of previous tests and imaging
• Evaluation of suitability for conservative care, dry needling, prolotherapy, an injection or hydrodissection
• Building a clear treatment direction

The goal is for you to leave with an understanding: what is happening in the elbow, what the true source of the pain is, and what can be done now.

What to bring to the appointment

We recommend coming with:

• Previous visit summaries
• Ultrasound / MRI / EMG / X-ray reports, if you have them
• A list of medications and treatments you have tried
• A short summary: when the pain started, what makes it worse, what eases it, and what you can no longer do
• Records of physical therapy, injections or previous treatments, if any

Frequently asked questions