Golfer’s Elbow & Low Back Pain Causes and Treatment


 
The two common injuries that I’d like to focus on are elbow related with both medial and lateral epicondylitis better known as tennis & golfer’s elbow. I will also review lower back pain injuries specifically disc related injuries and  facetogenic related injuries.
 
Medial epicondylitis, more commonly known as golfers elbow is a very common repetitive stress injury that may be caused as a result of an acute injury. The flexor musculature of the forearm which attaches to the bony aspect on the inside of the elbow can often get stressed as result of excessive gripping of the club and or taking a divot during a normal swing. Patients will commonly complain of pain in the surrounding area especially with flexion at the wrist and flexion at the fingers. In addition, the bony aspect on the outside or lateral aspect of the elbow can also become a repetitive stress injury as a result of golf specifically with gripping of the club along the extensor portion of the arm. This group of musculature is responsible for extension at the wrist and extension at the fingers.
 
At New York Pain Medicine and Physical Therapy we do a proper evaluation of the specific injury and are able to provide the quickest and safest techniques for proper healing. These may include injection of steroid to hasten the recovery process at either epicondyle, proper fitting of a brace mechanism, and/or physical therapy treatment.
 
Discogenic Related Low Back Pain
 
Discogenic related low back pain commonly affects patients when they are in a flexed or bent posture at the waist. This commonly occurs as a result of frequent bending at the hip in order to retrieve your golf ball, putting your golf ball or simply putting a tee in the ground.  By bending at the hip, this increases pressures in the disc and may commonly present as bilateral or unilateral low back pain symptoms.  Often, if the disc is pushing far enough, it may compress an exiting nerve from the spinal column.  This is commonly referred to as “sciatica” but in medical terms it’s known as a radiculopathy.  Patient’s will complain of “nerve pain” extending often down the buttock and into the leg.  These symptoms are often relieved with standing in an upright posture or laying flat.  A proper history and physicial evaluation at New York Pain Medicine would be able to determine the specifics of which nerves are affected as a result of this spinal condition.
 
Treatment may include physical therapy, lumbar epidural steroid injection, oral medication management.  Proper ergonomics at the workplace including the addition of a standing desk is often advised.  Parents of small children are frequently dependent on bending and lifting, we teach the best approach to limit continued symptoms.
 
Facetogenic Related Lower Back Pain
 
These joints along the posterior aspect of the bony lumbar spine are responsible for much of the stability of the spine and when irritated can cause low back pain or diffuse low back pain symptoms that may extend into the buttock and even into the back of the thigh. Patients who experience this usually have difficulties with standing for a prolonged period of time or walking.  The facet joints are further irritated during the “turn” of a normal golf swing either at the end of the backswing or at the end of the follow through/finish.
 
Treatment for this condition also may include physical therapy, interventional techniques such as medial branch nerve blocks which is the nerve that responsible for innervating the joints, radio-frequency ablation of the medial branch, oral medication, and education on proper techniques to limit the likelihood of those joints expressing pain.
 
We at New York Pain Medicine and Physical Therapy provide an accurate diagnosis, and a definitive treatment program to get you back to playing golf safely.
 
To learn more about these conditions and treatments visit the Education section of our website.

Dr. Allen

Dr. Douglas Allen is dual board certified in physical medicine and rehabilitation and interventional pain management. Pain management is a sub-specialty of medicine that has evolved over the last 15 years to better treat the specific needs of patients suffering from acute and chronic painful conditions. Dr. Allen received his interventional pain training at Jackson Memorial Hospital/ University of Miami’s Department of Anesthesiology. He received his Physiatry training at St. Vincent’s Hospital in Manhattan.