Houston Methodist. Leading Medicine

Elbow FAQ

Question:

I'm newly retired at age 57. I've always wanted to take up golf, so I gave it a try. But after only two rounds (both 18 holes), I developed tennis elbow. Well, I guess you could call it golfer's elbow. I'm really bummed. My golf instructor suggested getting a steroid injection. He thought I could get back in the game faster that way. What do the experts say?

Answer:

Tennis elbow and golfer's elbow are similar but not exactly the same. Tennis elbow tends to affect the common extensor tendon along the outside of the elbow. The result is pain and tenderness in that same area along the lateral elbow. Golfer's elbow affects the medial or inner aspect of the elbow instead. The muscles of the forearm responsible for bending the fingers and thumb, making the fist and turning the hand palm up are involved. Tendons of the flexor muscles come together to form the common flexor tendon. The tendon inserts into the medial epicondyle of the humerus (upper arm bone) at the elbow joint. Just like tennis elbow, golfer's elbow develops as a result of repetitive motions such as the golf swing. It can also occur in response to minor injury, or for no apparent reason at all. At first, there is an inflammatory response. But with chronic golfer's (or tennis) elbow, there are no inflammatory cells present. When pain and tenderness persist without an underlying inflammatory presence, the condition is referred to as tendinosis. Steroid injections bathe the disrupted tissue with a numbing agent and an antiinflammatory. The evidence doesn't support the use of steroid injections for this problem. Injections do provide short-term pain relief. But the effect doesn't last. When compared with other treatments (including placebo), medium- and long-term results are no different. And there are some negative effects of steroids to consider. For example, steroid injections may actually delay tissue healing, thus prolonging the course of recovery. Besides the potential for delayed healing with steroids, post-injection pain is reported as worse than preinjection pain for half the patients studied. Until research can show that steroid injections works better than other forms of treatment (or no treatment at all), the cost of intervention may not be justified. Robert M. Szabo, MD. Steroid Injection for Lateral Epicondylitis. In The Journal of Hand Surgery. February 2009. Vol. 34A. No. 2. Pp. 326-330.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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