Golfer's Elbow Treatment
Approximately 90% of golfer’s elbow resolves without surgery. Recommended treatment often includes activity-modification, physiotherapy, injections or shockwave therapy.
Activity-modification and physiotherapy: This is usually the first line of treatment. Avoiding repetitive and painful movements or modifying activities to use other muscle groups will provide symptom relief. Physiotherapy exercises aim to combine stretching exercises with exercises to strengthen the flexor muscles. This is usually effective in the long-term. Splinting can be useful to reduce the strain on the insertion of the tendon on the bone.
Injections: Steroid can be injected locally into the affected area. This may provide short-term pain relief and is very helpful in acute phases. Up to three injections can be given. But, despite good short-term relief recent studies show no change of the disease or sometimes an even longer recovery time after steroid injections.
Shockwave therapy: A machine delivers sound waves into the affected area. Reported rates of success are extremely variable and therapy can sometimes be considered an experimental treatment but new evidence is coming out about its efficacy. However, whilst it is not possible to guarantee that it will work, it is very safe.
PRP injection: This is a new treatment used for some common orthopaedic conditions in your elbow like lateral epicondylitis (tennis elbow) or medial epicondylitis (golfer’s elbow).
Platelet rich plasma (PRP) is blood plasma with concentrated platelets (the body’s repair for damaged tissue). The concentrated platelets found in PRP contain growth factors that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate connective tissue healing and repair, promote development of new blood vessels, and stimulate the healing process.
The treatment involves obtaining a blood sample, centrifuging (spinning) it to retrieve the growth factors and reinject it in the tendon area, often under local anaesthesia.
Scientific evidence of this treatment is mild to moderate. There are no long-term studies but when it works this treatment may eliminate the need for more aggressive treatments such as long-term medication or surgery and a major advantage is the patient’s own growth factors are used rather than foreign substance is used as, and there are no risk of disease transmission.
Surgery: Surgery is usually performed as a day case and can be open or keyhole. Open surgery is usually very successful with more than 90% of patients improving significantly. Keyhole surgery is still new in this particular disease but it is showing promising results.
Rare complications of surgery include:
- nerve or blood vessel damage
- growth of islands of bone
- prolonged rehabilitation
- need for further surgery