Golfer’s elbow injections help in complex cases that fail other treatment. But how do you diagnose golfer’s elbow correctly, and what treatments are available besides a medial epicondylitis injection? Is a steroid or cortisone injection for golfer’s elbow a good idea — or are other injections better?
What is golfer’s elbow?
Golfer’s elbow, or medial epicondylitis, is a form of elbow tendonitis causing pain and swelling on the inside of the elbow. The pain centres on the bony bump — the medial epicondyle — where the forearm muscles attach. It’s the less well-known cousin of tennis elbow, which is the same problem on the outside of the elbow (lateral epicondylitis).
Golfer’s elbow doesn’t only affect golfers. It’s also common in manual workers, tennis players, and gym-goers.
What are the symptoms of golfer’s elbow?
Common symptoms include:
- Pain on the inside of the elbow, triggered by movements such as hitting a golf or tennis ball
- Tenderness over the bony bump on the inner elbow
- Weakness of the forearm and wrist
Other conditions mimic golfer’s elbow, including ulnar nerve entrapment (cubital tunnel syndrome), elbow joint swelling, and biceps tendonitis. Ultrasound or MRI sometimes helps — to show the tendon swelling or tearing, and to rule out these other causes.
What causes golfer’s elbow?
Golfer’s elbow comes from overusing the forearm muscles — especially when gripping, rotating the forearm, or bending the wrist. Repetitive or excessive movement of the tendon can cause it to swell. Besides a golf swing, common causes include:
- Tennis played with the wrong technique, or a racquet that’s too heavy or tight
- Throwing or pitching incorrectly, in sports such as baseball or archery
- Repetitive, forceful forearm movements resulting from trades such as carpentry or plumbing, or office work
What are the treatment options for medial epicondylitis?
Most cases improve with activity modification and exercise therapy.
Rest and ice help the pain in the short term. A forearm brace placed just below the elbow reduces the load on the tendon. Progressive strengthening of the forearm muscles — flexing and rotating the wrist — reduces pain, and recent evidence suggests lighter weights done more frequently work well for elbow tendonitis. Change the activity that caused it to give the tendon time to heal, then return gradually — and have your golf or tennis swing checked by a professional.
What if simple treatments fail — is a medial epicondylitis injection an option?
If activity modification and exercise don’t settle the symptoms, other options come in.
- GTN patches — applied to the skin over the diseased tendon, these release nitric oxide, which increases collagen production and promotes healing. Recent evidence supports them for elbow tendonitis.
- Shockwave therapy — sound waves that promote healing and calm the pain-transmitting nerves. We usually recommend 3–5 sessions, at least a week apart.
- Injections — reserved for more complex cases that fail simple treatment.
Golfer’s elbow injections: what are the options?
Why we usually avoid cortisone
Traditionally, doctors used a cortisone or steroid injection for golfer’s elbow. We now know that cortisone can be potentially harmful to elbow tendons. The evidence in tennis elbow shows that while cortisone reduces pain in the short term, people often do worse at three months. We don’t have specific data for golfer’s elbow — but for that reason, we generally try to dissuade people from a steroid injection for golfer’s elbow.
The medial epicondylitis injection we prefer
- Needle tenotomy — repeated dry needling of the diseased tendon that can be local anaesthetic, which stimulates healing and reduces pain.
- PRP (platelet-rich plasma) — prepared by separating the plasma from your own blood in a centrifuge, then injecting it into the tendon. PRP has shown promising results in tennis elbow.
As with cortisone, the strong evidence for needle tenotomy and PRP is in tennis elbow rather than golfer’s elbow specifically — but they don’t carry cortisone’s risk of tendon harm. Dr Masci has written a summary of injections in tendonitis, including golfer’s elbow.
Frequently asked questions about a medial epicondylitis injection
What simple treatments should I use for a painful golfer’s elbow?
Ice packs (10–15 minutes, three times a day), topical and oral ibuprofen, and a forearm (tennis elbow) brace. In cases of pain, using GTN patches early on helps.
Is cortisone for tendon damage/golfer’s elbow?
Generally no. Cortisone can harm the tendon — in tennis elbow it gives short-term relief but worse outcomes at three months — so we usually advise against a steroid injection for golfer’s elbow, and prefer needle tenotomy or PRP.
How is golfer’s elbow different from tennis elbow?
They’re the same problem on opposite sides of the elbow. Golfer’s elbow (medial epicondylitis) affects the inside; tennis elbow (lateral epicondylitis) affects the outside. Golfer’s elbow is the less common of the two, and the two are treated along similar lines.
How long does golfer’s elbow take to heal?
Like most tendon problems, it’s usually a matter of months rather than weeks, and it responds best to a progressive strengthening programme. Pushing back into the aggravating activity too soon is a common reason it lingers — a graded return, guided by symptoms, works better.
Which is the best injection for golfer’s elbow?
There’s no clear winner on the evidence, but we favour needle tenotomy and PRP over cortisone, because they aim to help the tendon heal rather than risk weakening it. The right choice depends on your tendon and how you’ve responded to previous treatment.
Final word from Sport Doctor London about golfer’s elbow injections
We treat golfer’s elbow much like tennis elbow. Simple treatment comes first, then GTN patches and shockwave therapy, and — where those fail — needle tenotomy or PRP. A cortisone injection for golfer’s elbow is not recommended, because of the risk of harming the tendon.
If you have persistent inner-elbow pain, Dr Masci can assess you in London, including ultrasound in clinic. Contact the team here or call +44 (0) 203 488 0350.
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