Medial
epicondylitis is inflammation of the tendon attachment of the flexor pronator
muscles in the forearm. Usually this begins as microscopic tears in the
tissue which leads to an inflammatory or hypervascular process. This occurs
when stiff, underused tendons are suddenly overused or this may occur from
an acute injury. The
treatment includes three treatment options, no treatment, conservative and
surgery.
Surgery is a last
resort and involves cleaning up the tendon from diseased tissue, shaving
down the bone and re-attachment of the tendon. This is necessary in 10-15%
of the patients. Conservative
treatment is in two phases, Phase I is to get rid of the pain and Phase
II is to prevent it from coming back with stretching and strengthening
exercises. To reduce the pain, using the elbow in a flexed position and
the use of an elbow strap counterforce brace is usually the first line
of treatment. If the patient has persistent symptoms a cortisone injection
may be considered. No more than three injections are recommended per year
and if the patient still has persistent symptoms despite conservative
treatment surgery is considered.
