Golfer's elbow

At a glance

  • Golfer’s elbow arises from irritation where the tendons attach to muscles on the inside of the elbow.
  • It hurts when you move the arm, and it’s hard to grasp objects.
  • It is usually caused by repetitive movements or too much strain, often during sports.
  • At first it’s a good idea to stop doing the things that are causing the symptoms.
  • After that, specific strengthening exercises can help.
  • Mostly you will need patience.

Introduction

Photo of a woman with elbow pain at a computer

Golfer’s elbow (medical term: medial epicondylitis) is usually caused by repetitive or strenuous movements – for instance, when playing sports like golf or doing manual work.

The main symptom is pain on the inside of the elbow. But the pain may also spread to the whole arm.

People who have golfer’s elbow often have to be patient: It typically takes a few months for the symptoms to go away. The main treatment consists of stretching and strengthening exercises.

Symptoms

Golfer’s elbow is characterized by pain on the inside of the elbow. It usually only hurts when you move or touch it, and the pain is sometimes also felt in the upper arm, forearm or hand. The symptoms mainly occur when you bend your wrist, for instance when writing or lifting something – or when making sudden jerking movements with your wrist, like when playing golf. It’s also hard to grasp objects tightly, and sometimes people can’t move their arm as much as they usually can.

The pain may go away when you rest your arm. But it might also be a problem at night and disturb your sleep.

Pain on the outside of the elbow could be a sign of a condition known as tennis elbow. The treatment for tennis elbow and golfer’s elbow is usually similar.

Illustration: Painful areas in golfer’s elbow – as described in the article

Causes and risk factors

In golfer’s elbow, the pain arises where the tendons attach to muscles on the inside of the elbow. These tendons are involved in wrist movements. For this reason, hand and arm movements that put a strain on them – such as bending, stretching, twisting, grasping and lifting – can lead to the typical symptoms.

Golfer’s elbow often affects people who generally don’t use their forearm muscles much, and then suddenly use them a lot. The symptoms may appear after short-term overuse, but also after long-term frequent repetitive use. The possible causes include the following:

  • Sports such as golf, weightlifting or “throwing sports” (e.g. javelin, shot put)
  • Manual work such as painting, hammering, repairing cars and chopping wood
  • Working at a computer
  • Cooking (e.g. chopping or peeling)

So although golfer’s elbow may in fact come from playing golf, in most cases it has nothing to do with this sport.

In the past, people thought that the symptoms were caused by an inflammation in the muscles. That turned out to be wrong, though. Nowadays it's thought that something else plays an important role: Golfer's elbow probably arises from the overuse or incorrect use of muscles, which leads to small injuries and wear-and-tear at the base of the tendons that attach to the muscles. But the exact cause isn’t clear.

Prevalence

Less than 1% of the population are affected by golfer’s elbow. It usually occurs between the ages of 40 and 60, and is much less common than tennis elbow. Women and men are equally likely to get it.

Outlook

Sometimes the symptoms already go away again after a few weeks. But they often last several months. About 80% of those affected are pain-free again after one year. The others continue to have symptoms for longer.

Diagnosis

The doctor will first ask which activities provoke the symptoms, and whether you have any other medical conditions. They will then examine the arm and see which movements hurt. This might involve stretching your arm out with the palm of your hand facing down, and then trying to move your hand downwards against a certain amount of .

This physical examination is usually enough to determine whether it’s golfer’s elbow. X-rays, ultrasound scans or (MRI) are only done if it’s thought that something else might be causing the symptoms.

Treatment

There is hardly any research on treatments for golfer’s elbow. More research has been done on treatments for tennis elbow. The treatment approaches for these two conditions are usually quite similar because the causes and symptoms are similar. The symptoms usually go away after a few months without any special treatment. The most important thing is patience.

Trying to avoid activities that provoke the symptoms – or reducing those activities enough to make the symptoms improve – may already help. After that, stretching and strengthening exercises can be done.

Painkillers and steroid injections can probably relieve the symptoms for a while. One disadvantage of steroid injections is that they might disrupt the healing process. There are also many other treatments for golfer’s elbow, including shock wave therapy, massage and . But it’s not clear how well they work, so German statutory health insurers often don’t cover the costs.

Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg 2015; 23(6): 348-355.

Donaldson O, Vannet N, Gosens T et al. Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies. Shoulder Elbow 2014; 6(1): 47-56.

Hegmann KT, Hoffman HE, Belcourt RM et al. ACOEM practice guidelines: elbow disorders. J Occup Environ Med 2013; 55(11): 1365-1374.

Karanasios S, Tsamasiotis GK, Michopoulos K et al. Clinical effectiveness of shockwave therapy in lateral elbow tendinopathy: systematic review and meta-analysis. Clin Rehabil 2021; 35(10): 1383-1398.

Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol 2011; 25(1): 43-57.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on July 15, 2022

Next planned update: 2025

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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