Golfer’s elbow (medial epicondylitis) is pain on the inner side of the elbow caused by overload and degeneration of the tendons that attach the forearm flexor and pronator muscles to the bone. It is the inner-elbow counterpart of tennis elbow and is less common. Despite the name, it affects workers, weightlifters, throwers and racquet-sport players as well as golfers. Dr. Andrew Dold, a board-certified, fellowship-trained sports medicine surgeon in Frisco, Texas, treats golfer’s elbow and the ulnar nerve problems that can come with it.
- Pain over the inner elbow bone, worse with gripping, lifting and wrist flexion
- Most patients improve with activity changes, physical therapy and bracing
- Cortisone or PRP injections are options for persistent pain
- The nearby ulnar nerve is often involved and is always checked
- Open surgery is reserved for symptoms that persist despite good non-surgical care
What causes golfer’s elbow?
Repetitive gripping, wrist flexion and forearm rotation overload the common flexor-pronator tendon, causing degenerative changes (tendinosis) rather than simple inflammation.1 In a population study, about 0.4% of working-age adults had definite medial epicondylitis; smoking, obesity, repetitive movements and forceful activities were each linked to it.2 In throwing athletes, symptoms are often worst during the late cocking and early acceleration phases of the throw.1
Symptoms
- Pain and tenderness over the bony bump on the inner side of the elbow
- Pain with gripping, lifting, swinging a golf club or racquet, or throwing
- Weakness of grip or forearm rotation
- Numbness or tingling in the ring and little fingers if the ulnar nerve is irritated
Diagnosis
Dr. Dold examines the elbow for tenderness at the flexor-pronator origin and pain with resisted wrist flexion and forearm pronation. Weakness with resisted pronation can suggest more significant tendon damage.3 Because the ulnar nerve runs just behind the inner elbow bone, he checks it at every visit, and he also looks for an injury to the ulnar collateral ligament (UCL) in throwing athletes. X-rays, ultrasound or MRI are used when the diagnosis is uncertain or before surgery.
Treatment without surgery
Most patients get better without surgery.1 Dr. Dold’s approach is the same as for tennis elbow:
- Activity modification and a review of technique, grip and training load
- Physical therapy with progressive strengthening of the flexor-pronator muscles once pain settles1
- A counterforce strap, ice and short courses of anti-inflammatory medicine
- Injections for persistent pain. Cortisone can relieve pain in the short term, but in tendinopathy research its benefit often does not last.4 Another option is PRP; a small systematic review found results similar to surgery, though only two studies were available.5 Dr. Dold has published a systematic review of PRP for cartilage damage6 and will discuss whether it is reasonable for you.
Most of the high-quality research on elbow tendinopathy comes from tennis elbow; see the tennis elbow page for those trials.
Surgery
Surgery is considered when symptoms persist after several months of good non-surgical treatment; across published studies, the median time to surgery was about 6 months.7 Dr. Dold performs an open debridement: the damaged tendon tissue is removed and the flexor-pronator origin is repaired as needed. If the ulnar nerve is irritated, it can be released or moved (transposed) during the same operation.
In a series of 60 patients treated with open debridement and repair, elbow function scores improved from 58 to 88 at one year; ulnar neuritis was addressed in 20% of patients.3 A 2025 systematic review of 17 surgical studies found significant improvement after surgery with an overall complication rate of about 3%, although most studies were retrospective.7 Another 2025 review noted that the evidence is limited and generally of low quality.8
Recovery after surgery
Most patients use a splint or sling briefly, begin gentle motion early and start strengthening over the following weeks. Return to golf, throwing or heavy lifting usually takes a few months; Dr. Dold will give you a specific plan.
What the research shows
Golfer’s elbow has been studied much less than tennis elbow, so some treatment advice is borrowed from tennis elbow research. Here is what the medial-specific studies show.
Most people recover without surgery
In one series of 95 cases, most patients recovered with non-surgical care and about 1 in 8 needed an operation. Most cases were related to work rather than sport, so changing workload and technique is an important part of treatment. Strengthening, including eccentric exercise, appears to help, although the evidence is still limited.
Look beyond the tendon
MRI studies of golfer’s elbow often show other problems nearby, including changes in the ulnar collateral ligament and the ulnar nerve. Calcium deposits at the tendon origin are common and have been linked to more pain and to ulnar nerve symptoms. This is why the ulnar nerve and UCL are checked carefully.
Surgery when needed
For pain that persists despite good non-surgical care, surgery has a high success rate in pooled studies, whichever technique is used. Open surgery remains the standard approach.
Why see Dr. Dold
- Board certified by the American Board of Orthopaedic Surgery, with subspecialty certification in Sports Medicine
- Sports medicine and arthroscopy fellowship at NYU Langone / Hospital for Joint Diseases; orthopedic residency at the University of Toronto
- Fellow of the American College of Surgeons (FACS), the American Academy of Orthopaedic Surgeons (FAAOS), the American Orthopaedic Association (FAOA) and the Royal College of Surgeons of Canada (FRCSC)
- Author of a SLAP repair book chapter (Springer, 2017) and research on shoulder suture anchors (KSSTA, 2013)
- Team physician and surgical consultant to Rugby Canada; has cared for professional athletes from the NFL, NBA, NHL, MLS, PGA Tour and Major League Rugby
- D Magazine Best Doctors (Collin County), 2019–2026 · Rated 4.9 on Google
Frequently asked questions
What is the difference between golfer’s elbow and tennis elbow?
Golfer’s elbow affects the tendons on the inner side of the elbow; tennis elbow affects the outer side. Tennis elbow is about three times more common.2
Will golfer’s elbow go away on its own?
Most patients improve with non-surgical treatment such as activity changes, physical therapy and bracing.1
Why does my ring and little finger tingle?
The ulnar nerve runs just behind the inner elbow and can become irritated along with golfer’s elbow. Dr. Dold checks the nerve and treats it if needed.
Can PRP help golfer’s elbow?
PRP is an option for persistent pain. Early studies are encouraging, but the research specific to golfer’s elbow is limited.5
When is surgery needed?
When significant pain continues despite several months of good non-surgical treatment. Open debridement and repair has shown good results in published series.3,7
Research cited on this page
- Amin NH, Kumar NS, Schickendantz MS. Medial epicondylitis: evaluation and management. J Am Acad Orthop Surg. 2015;23(6):348-355. PubMed
- Shiri R, Viikari-Juntura E, Varonen H, et al. Prevalence and determinants of lateral and medial epicondylitis: a population study. Am J Epidemiol. 2006;164(11):1065-1074. PubMed
- Vinod AV, Ross G. An effective approach to diagnosis and surgical repair of refractory medial epicondylitis. J Shoulder Elbow Surg. 2015;24(8):1172-1177. PubMed
- Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010;376(9754):1751-1767. PubMed
- Alzahrani WM. Platelet-Rich Plasma Injections as an Alternative to Surgery in Treating Patients With Medial Epicondylitis: A Systematic Review. Cureus. 2022;14(8):e28378. PubMed
- Dold AP, Zywiel MG, Taylor DW, Dwyer T, Theodoropoulos J. Platelet-rich plasma in the management of articular cartilage pathology: a systematic review. Clin J Sport Med. 2014;24(1):31-43. PubMed
- Barakat A, Jha G, Raval P, et al. Systematic review of surgical techniques for medial epicondylitis: evaluating the impact of preoperative injections and concomitant ulnar neuritis on postoperative outcomes. Ann R Coll Surg Engl. 2025;107(7):457-468. PubMed
- Poolton JT, Minett J, Kazmi A. Surgical treatment for medial epicondyle tendinopathy: a systematic literature review. Acta Orthop Belg. 2025;91(4):429-438. PubMed
- O’Dwyer KJ, Howie CR. Medial epicondylitis of the elbow. Int Orthop. 1995;19(2):69-71. PubMed
In a series of 95 cases, 90% were work-related, most patients recovered without surgery and about 12% needed an operation. - Shiri R, Viikari-Juntura E. Lateral and medial epicondylitis: role of occupational factors. Best Pract Res Clin Rheumatol. 2011;25(1):43-57. PubMed
A review of lateral and medial epicondylitis recommended workload changes, especially in physically demanding jobs, and noted surgical results come mainly from case series. - See ZH, Loo CE, Jaafar Z. Eccentric exercise therapy for medial epicondylitis: A systematic review of clinical outcomes. Complement Ther Med. 2026;98:103364. PubMed
A 2026 systematic review found eccentric exercise may reduce pain and improve function in golfer’s elbow, particularly as part of a broader program, though evidence certainty is low. - Hoogvliet P, Randsdorp MS, Dingemanse R, et al. Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review. Br J Sports Med. 2013;47(17):1112-9. PubMed
A review of elbow and other tendinopathies supported strength training to reduce symptoms. - Ciccotti MC, Schwartz MA, Ciccotti MG. Diagnosis and treatment of medial epicondylitis of the elbow. Clin Sports Med. 2004;23(4):693-705, xi. PubMed
A review emphasized distinguishing golfer’s elbow from other causes of inner elbow pain, especially in throwing athletes. - Grana W. Medial epicondylitis and cubital tunnel syndrome in the throwing athlete. Clin Sports Med. 2001;20(3):541-8. PubMed
A review highlighted the overlap between golfer’s elbow and ulnar nerve irritation (cubital tunnel syndrome) in athletes. - Bae KJ, Park C, Ahn JM, et al. Magnetic resonance imaging evaluation of patients with clinically diagnosed medial Epicondylitis. Skeletal Radiol. 2021;50(8):1629-1636. PubMed
MRI in patients with golfer’s elbow often showed additional findings in the ulnar collateral ligament, ulnar nerve and bone. - Kang KB, Cheon SH, Lee HD. Radiologic evaluation and clinical effect of calcification in medial epicondylitis. J Shoulder Elbow Surg. 2022;31(2):375-381. PubMed
Calcification at the tendon origin was common in golfer’s elbow and linked to more pain, prior steroid injections and ulnar nerve symptoms. - Bang JY, Hahn S, Yi J, et al. Clinical applicability of shear wave elastography for the evaluation of medial epicondylitis. Eur Radiol. 2021;31(9):6726-6735. PubMed
Ultrasound elastography could help detect golfer’s elbow by measuring tendon stiffness. - Arevalo A, Rao S, Willier DP, et al. Surgical Techniques and Clinical Outcomes for Medial Epicondylitis: A Systematic Review. Am J Sports Med. 2023;51(9):2506-2515. PubMed
A 2023 systematic review found surgery for golfer’s elbow that did not respond to other care had a high success rate, regardless of technique. - do Nascimento AT, Claudio GK. Arthroscopic surgical treatment of medial epicondylitis. J Shoulder Elbow Surg. 2017;26(12):2232-2235. PubMed
A case series found arthroscopic treatment of golfer’s elbow was safe with good outcomes. - Rippke JN, Burkhart KJ. [Epicondylosis : Open surgical procedure-when and how for lateral and medial epicondylitis?]. Orthopadie (Heidelb). 2023;52(5):394-403. PubMed
A review described open surgery as the standard technique for golfer’s elbow, with limited comparative data for arthroscopy.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. Last reviewed October 2026. This page is general information, not medical advice. Individual results vary.
