Symptoms

Golfer's elbow is characterized by:

• Pain and tenderness on the inner side of your elbow. Sometimes the pain extends along the inner side of your forearm.
• Stiffness. Your elbow may feel stiff, and it may hurt to make a fist.
• Weakness. You may have weakness in your hands and wrists.
• Numbness or tingling. Many people with golfer's elbow experience numbness or a tingling sensation that radiates into one or more fingers — usually the ring and little fingers.

The pain of golfer's elbow may appear suddenly or gradually. The pain may get worse when you:

• Swing a golf club or racket
• Squeeze or pitch a ball
• Shake hands
• Turn a doorknob
• Lift weights
• Pick up something with your palm down
• Flex your wrist

When to see a doctor
Consult your doctor if rest, ice and over-the-counter pain relievers don't ease your elbow pain and tenderness. Seek immediate care if:

• Your elbow is hot and inflamed and you have a fever
• You can't bend your elbow
• Your elbow looks deformed
• You suspect you've broken a bone

Causes

Golfer's elbow, also known as medial epicondylitis, is caused by damage to the muscles and tendons that control your wrist and fingers. The damage is typically related to excess or repetitive stress — especially forceful wrist and finger motions. Improper lifting, throwing or hitting, as well as too little warm-up or poor conditioning, also can contribute to Golfer's elbow.

Many activities can lead to golfer's elbow, including:

• Golf. Gripping or swinging the clubs incorrectly can take a toll on your muscles and tendons.
• Racket sports. Excessive topspin can hurt your elbow. Using a racket that's too small or heavy also can lead to injury.
• Throwing sports. Improper pitching technique in baseball or softball can be another culprit. Football, archery and javelin throwing also can cause golfer's elbow.
• Weight training. Lifting weights using improper technique, such as curling the wrists during a biceps exercise, can lead to overload of the elbow muscles and tendons.
• Other activities. Any activity that causes you to repeatedly bend and straighten your elbow can cause golfer's elbow. This includes activities such as painting, raking, hammering, chopping wood, using a computer, doing assembly-line work and cooking. A day or two of yardwork or cooking for company usually won't cause golfer's elbow, though. The activity generally needs to be done for more than an hour a day on many days to cause a problem.

Risk factors

Golfer's elbow is most common in people older than 35. Despite its name, golfer's elbow can affect anyone who repetitively stresses the wrists or fingers.

Complications

Left untreated, golfer's elbow can cause:

• Chronic elbow pain
• A limited range of motion
• A lasting, fixed bend (contracture) in your elbow

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 may refer you to a sports medicine specialist or to a doctor with advanced training in the treatment of musculoskeletal disorders.

Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• List any symptoms you've been having, and for how long.
• Write down your key medical information, including other conditions with which you've been diagnosed and all medications and supplements you're taking.
• Log your typical daily activity, including the length and intensity of sports or other activities that tax your elbow. Your doctor also will be interested to know if you've recently changed the frequency, intensity or method of your workouts.
• Note any recent injuries that may have damaged your elbow.
• Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.

Below are some basic questions to ask a doctor who is examining you for possible golfer's elbow. If any additional questions occur to you during your visit, don't hesitate to ask.

• What is the most likely cause of my signs and symptoms?
• Are there any other possible causes?
• Do I need any 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?
• What is the likelihood that I will need surgery?
• How often will you see me to monitor my progress?

What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to talk about in-depth. Your doctor may ask:

• What are your symptoms and when did you first notice them?
• Is your pain constant? Is it severe?
• Do common tasks that use your elbow — such as lifting, gripping, carrying, typing or shaking hands — trigger pain?
• Are your symptoms affecting your ability to complete normal, daily tasks, including work or sleep?
• What is your regular exercise or sports-training routine?
• Have you recently made any changes to your training routine or equipment, such as using new techniques or a new racket?
• What activities do you perform at work?
• What are your most common recreational activities or hobbies?
• Have you tried any at-home treatments so far? If so, has anything helped?
• Have you recently had any injuries that may have caused elbow damage?
• Have you been diagnosed with any other medical conditions?

What you can do in the meantime
In the time leading up to your appointment, try self-care measures at home. Until your doctor sees you, avoid using your elbow in ways that cause or worsen pain. Icing the affected area and taking over-the-counter pain medications also may help.

Tests and 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 possible causes of elbow pain, such as a fracture or arthritis. Rarely, more comprehensive imaging studies — such as magnetic resonance imagining (MRI) — are performed.

Treatment and drugs

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 may also 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 (Aleve, others) or acetaminophen (Tylenol, others).
• Stretch and strengthen the affected area. Your doctor may suggest specific stretching and strengthening exercises. Physical or occupational therapy can be helpful too.
• Reduce the load on your elbow. Wrap your elbow with an elastic bandage or use a forearm strap. And remember to maintain a rigid wrist position during all lifting activities.
• Consider other medications. If over-the-counter pain relievers aren't effective, your doctor may recommend a cortisone injection to reduce pain and swelling. These injections usually provide only short-term pain relief.
• Gradually return to your usual activities. When you're no longer in pain, 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.

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

Prevention

You can take steps to prevent golfer's elbow:

• Strengthen your forearm muscles. Use light weights or squeeze a tennis ball. Even simple exercises can help your muscles better absorb the energy of sudden physical stress.
• Stretch before your activity. Walk or jog for a few minutes to warm up your muscles. Then take time for gentle stretching before you begin your game.

• Fix your form. If you golf, ask an instructor to check your grip and swing technique. The golf swing is a whole-body swing, from the legs up. Sometimes, problems with your swing will cause you to use your wrist muscles more than you should, leading to overload. If you're using older golfing irons, consider upgrading to lighter graphite clubs.

  If you play tennis, ask an instructor to check your technique for serving or hitting a forehand. The design of the racket may play a role too. A racket with a small grip or a heavy head may increase the risk of elbow problems.

• Lift smartly. When lifting anything — including free weights — keep your wrist rigid and stable to reduce the force transmitted to your elbow.

It's also important to know when to rest. At the first sign of elbow pain, take a break. In addition to self-care measures, time off is often needed to promote healing.