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.
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