Chronic medial epicondylitis, often referred to as golfer’s elbow, is a condition that causes pain and discomfort on the inner part of the elbow due to overuse or strain of the tendons that attach to the medial epicondyle. If left untreated or not properly managed, this condition can lead to a partial tear of the common flexor tendon, which can significantly affect your daily activities and quality of life. Understanding the symptoms, diagnosis, and treatment options for this condition is crucial to managing it effectively and getting back to a pain-free lifestyle.
In this article, we’ll explain what chronic medial epicondylitis with or without partial tendon tear is, the symptoms to look for, how it’s diagnosed, and most importantly, how it can be treated — with a special focus on the Open Modified Bosworth Technique (Medial), a highly effective surgical option for certain cases.
General Points
Symptoms of Chronic Medial Epicondylitis
Chronic medial epicondylitis typically develops gradually over time due to repetitive stress on the tendons of the inner elbow. If you have this condition, you may notice the following symptoms:
- Pain and Tenderness: The primary symptom is pain on the inside of the elbow, right over the bony prominence (the medial epicondyle). This pain may start as a dull ache but can worsen with repetitive movements, such as gripping, lifting, or swinging a racquet or golf club.
- Stiffness and Weaknes: You may also experience stiffness in the elbow joint, especially after rest or in the morning. Weakness in the forearm, hand, and wrist can make it difficult to perform simple tasks like shaking hands, opening a door, or lifting objects.
- Swelling and Inflammation: In some cases, the elbow may feel swollen or appear inflamed, particularly after physical activity that involves repetitive arm motions.
- Pain with Specific Movements: The pain typically intensifies when performing activities that require flexing the wrist or gripping objects tightly. Movements like lifting weights, typing, or using tools can aggravate the condition. If you are experiencing these symptoms for an extended period, especially without improvement from rest or conservative treatments, it’s important to seek medical advice.
How is Chronic Medial Epicondylitis Diagnosed?
The diagnosis of chronic medial epicondylitis is based on a thorough evaluation by an orthopedic specialist. During your visit, your doctor will take a detailed history of your symptoms and your activity level, as well as conduct a physical examination. Here’s how your doctor will typically confirm the diagnosis:
- Physical Exam: The doctor will press on the medial epicondyle (the bony bump on the inside of your elbow) to check for tenderness. They may also move your arm in certain directions to see if any specific movements reproduce your pain.
- Imaging Tests: In some cases, the doctor may recommend imaging tests such as X-rays or an MRI to check for any structural damage, such as tendon tears or inflammation. An MRI is particularly useful in cases where there may be a partial tear of the common flexor tendon, as it provides a clear view of soft tissue.
Treatment Options for Chronic Medial Epicondylitis
Most cases of chronic medial epicondylitis can be managed successfully with non-surgical treatments. These options aim to reduce pain, improve function, and allow the tendon to heal. Common non-surgical treatments include:
- Rest and Activity Modification: Rest is one of the most important steps in recovery. Limiting activities that strain the elbow, such as lifting or gripping, allows the inflamed tendons to heal.
- Ice and Anti-inflammatory Medications: Applying ice to the affected area for 15-20 minutes at a time can help reduce inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may also be used to manage pain and inflammation.
- Physical Therapy: A physical therapist can guide you through stretching and strengthening exercises designed to alleviate pain and improve the function of the forearm muscles and tendons.
- Corticosteroid Injections: If the pain is severe and doesn’t respond to other treatments, corticosteroid injections may be used to reduce inflammation and promote healing. However, these are typically a temporary solution, and overuse of steroids can lead to tendon weakening.
- Platelet-Rich Plasma (PRP) Therapy: PRP therapy involves injecting a concentration of your own platelets into the damaged tendon to promote healing. This treatment has shown promising results for chronic tendon injuries.
When Is Surgery Necessary?
In some cases, especially when conservative treatments fail and there is a partial tear of the common flexor tendon, surgery may be the best option to achieve long-term relief. One of the most effective surgical procedures for chronic medial epicondylitis is the Open Modified Bosworth Technique (Medial).
The Open Modified Bosworth Technique (Medial)
What is the Open Modified Bosworth Technique?
The Open Modified Bosworth Technique is a specialized surgical procedure designed to treat chronic medial epicondylitis with or without a partial tear of the common flexor tendon. This surgery involves removing the damaged tissue, reattaching the tendon, and promoting healing by using precise techniques that minimize scar tissue formation.
When is this Surgery Recommended?
Surgery is generally recommended for patients who have not responded to conservative treatments (e.g., rest, physical therapy, injections) and who have a confirmed partial tear of the tendon or severe degeneration. The Open Modified Bosworth Technique is especially beneficial for those who experience persistent pain and functional limitations despite trying non-surgical options.
How Does the Procedure Work?
The procedure is performed under general anesthesia, and an incision is made over the medial epicondyle (inside part of the elbow). The surgeon carefully removes the damaged tendon tissue and reattaches the healthy tendon using sutures. The technique ensures that the tendon is anchored securely, allowing for optimal healing.
One of the key advantages of the Modified Bosworth Technique is that it uses advanced techniques to minimize damage to surrounding tissues, which leads to a faster and smoother recovery process.
What Can You Expect After Surgery?
After the procedure, patients typically experience a significant reduction in pain and a return to functional use of the elbow. However, as with any surgery, recovery does take time. Here’s what the recovery process generally looks like:
- Immediate Post-Op Care: You will need to keep your elbow immobilized for a few weeks to allow the tendon to heal properly.
- Physical Therapy: Once the initial healing period is over, physical therapy will be crucial to help restore full strength and mobility to your elbow. Therapy may last for several months but is essential to achieving the best possible outcome.
- Return to Activities: Most patients can return to light activities within 4-6 weeks, with full recovery typically taking 4-6 months, depending on the severity of the condition and the patient’s adherence to rehabilitation.
Success Rates and Long-Term Outcomes
The Open Modified Bosworth Technique has a high success rate, with most patients experiencing a significant improvement in pain relief and elbow function. Studies show that the majority of patients report full recovery or substantial improvement within 6 months of surgery, allowing them to return to their normal activities without pain.
Your Path to Recovery
Chronic medial epicondylitis, with or without a partial tear of the common flexor tendon, can significantly affect your quality of life. However, with the right treatment plan, including the Open Modified Bosworth Technique (Medial) for more severe cases, you can achieve long-term relief and return to an active, pain-free lifestyle.
If you’ve been diagnosed with chronic medial epicondylitis and conservative treatments haven’t worked, scheduling a consultation with an experienced orthopedic specialist can help you explore surgical options like the Open Modified Bosworth Technique. This advanced surgery offers great promise for those seeking a lasting solution.
Don’t let elbow pain control your life. Reach out today to consult with a trusted orthopedic surgeon and take the first step toward a full recovery.
Are you ready to take control of your elbow pain and start your recovery journey? Schedule a consultation with one of our expert orthopedic surgeons today to learn more about how the Open Modified Bosworth Technique can help you get back to living without discomfort.
