Pathology

In former times the condition was usually named medial epicondylitis. However, the pathology is no longer thought to be inflammatory. Nowadays the accurate description would be "partially reversible but degenerative overuse-underuse tendinopathy". Because of the complexity of this description, the term " Golfer's elbow " is usually used.

The anterior forearm contains several muscles that are involved with flexing the digits of the hand and flexing and pronating the wrist. The tendons of these muscles come together in a common tendinous sheath, which originates from the medial epicondyle of the humerus at the elbow joint. In response to a minor injury, or sometimes for no obvious reason at all, this point of insertion becomes inflamed.

The initial treatment should be conservative including rest, physiotherapy, and nonsteroidal anti-inflammatory drugs. As in the case of chronic Achilles tendinopathy and chronic plantar fasciopathy, eccentric (lengthening only) exercises have become the mainstay of rehabilitation programs for tennis elbow.

In most circumstances, cortisone injections should not be used. This is due to the fact that cortisone leads to very good results in the short term (six weeks) but has been demonstrated to be harmful in the longer term (more than three months). Surgery should be considered when conservative treatment fails.