Medial Epicondylitis (Golfer’s Elbow)

Evidence: Promising, Mixed Evidence — ASPN 2024: Level II-2 · Grade C

CAUSES

• Repetitive wrist-flexion and forearm-turning movements like golf swings, throwing sports, weightlifting
• Manual labor involving repeated gripping, like hammering
• Trauma

SYMPTOMS

• Pain and tenderness on the inner (pinky side when the palm is facing up) side of the elbow
• Pain that worsens with gripping or making a fist
• Occasional stiffness or reduced grip strength
• Pain radiating down the inner forearm

IMAGING

Ultrasound can show tendon thickening, tearing, or degeneration. MRI is reserved for cases where surgery is being considered or the diagnosis remains unclear.

CAN PRP HELP?

Golfer’s elbow has fewer dedicated studies than tennis elbow. The evidence that does exist suggests PRP may match surgery for long-term relief, supporting it as a reasonable injection option once bracing, stretching, and physical therapy haven’t fully improved symptoms.

Leukocyte Preparation: Leukocyte-Rich

Dosing: Single Injection, reassess to evaluate for response

ASPN 2024 CONSENSUS GUIDELINE

ASPN grades medial epicondylitis Level II-2, Grade C — a step below the Level I, Grade B evidence for lateral epicondylitis (tennis elbow), reflecting the smaller trial base. One technical note carried through from the guideline: the ulnar nerve runs immediately behind the medial epicondyle and should stay in view on ultrasound throughout the injection.

Sources: D’Souza et al. (ASPN Consensus), Journal of Pain Research, 2024 · Bonczar et al., Folia Medica Cracoviensia, 2023

FREQUENTLY ASKED QUESTIONS

What’s the difference between golfer’s elbow and tennis elbow?

Golfer’s elbow (medial epicondylitis) affects the tendons on the inner elbow where the wrist-flexor muscles attach, with pain that worsens gripping or making a fist. Tennis elbow affects the outer elbow’s extensor tendon instead.

Does PRP work as well for golfer’s elbow as it does for tennis elbow?

There’s less dedicated research on golfer’s elbow. ASPN grades current evidence as Level II-2, Grade C, a step below tennis elbow’s Level I, Grade B, reflecting the smaller trial base. What evidence exists suggests PRP may match surgery or tenotomy for long-term relief.

Is one PRP injection enough for golfer’s elbow?

A a single leukocyte-rich injection can be offered, with a repeat considered if the response is incomplete.