August 2009

Acupuncture for Golfer's Elbow

By Elliot Wagner, O.M.D., L.Ac., Doctor of Oriental Medicine

All you golfers who have tried unsuccessfully to heal a chronically sore elbow, take heart! After you have tried cortisone injections and icing, stretching and exercises, there is another tried and true treatment to restore your elbow to the point where you can play golf pain-free again. That therapy is acupuncture.

What we refer to colloquially as golfer's elbow — or pain in the inner elbow joint (closest to the body when the palm is facing up) — is a common musculoskeletal problem. Golf was not known in ancient China, and the first golf course in China opened in 1984, but Chinese medicine has been treating this ailment for a long time. That's because golfer's elbow is not only caused by playing too much golf, but by any overuse injury to the inner elbow. Many other activities can cause golfer's elbow, including the tennis forearm, weekend carpentry, throwing a baseball, and chopping wood.

The flexor tendons are strong bands that anchor the muscles that flex the wrist and fingers to their origin in the bony protrusion on the inside of the elbow. Tendons are particularly tough and rigid, so the muscles of the forearm are stabilized as they do their job of gripping, and flexing and rotating the wrist. However, this rigidity also means that tendons are rather inflexible and prone to injury. Injury to tendons is what produces the pain of golfer's elbow. The anatomical name for the bony protrusion on the inside of the elbow is the medial epicondyle of the humerus, and medically, golfer's elbow is known as medical epicondylitis. It is a form of tendinitis.

Medical treatment for golfer's elbow includes injections, rest, ice, self-massage, stretching, and exercises to strengthen weak muscles. Many times these procedures, prescribed by an orthopedist or more usually a physical therapist, and followed regularly, will deal with the problem.

When they don't, I have found that acupuncture provides help to many patients, even if the problem has become unresponsive to other treatments, and has been in place for six months or more.

At our office we believe it important to know the patient's history. Often there is a history of earlier sports or other injuries. Also, there may be internal conditions that tend the muscles, bones and tendons to injury. All these can be considered at the first consultation, so that when you proceed with treatment we know thoroughly what we are dealing with.

Among the reasons that acupuncture may help you even if other therapies have not is that no one therapy can help everyone. For example, in western orthopedics it is considered a primary rule of thumb that overuse injuries often result in inflammation, and that they should be treated with anti-inflammatory medications, rest, and ice. This combination works for many people.

In Chinese medicine, we consider the treatment of inflammation to be important only for the first 24 hours. After that, we are much more likely to address the problem with acupuncture and other therapies to improve local circulation and reduce swelling and edema, as well as treat the probable reasons the injury took place to begin with. Our purpose is to treat the problem such that health is restored, and the injury much less likely to recur.