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Medial Elbow Pain Syndrome: Current Treatment Strategies.

Gautham Prabhakar, Vaibhav Kanawade, Abdullah N Ghali

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    Medial elbow pain has various causes, including tendon degeneration. Treatment success relies on addressing the common flexor tendon origin, starting with nonoperative methods before considering advanced interventions or surgery.

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    Area of Science:

    • Orthopedics
    • Sports Medicine
    • Musculoskeletal Disorders

    Background:

    • Medial elbow pain is a frequent clinical challenge for orthopedic surgeons.
    • Differential diagnosis includes medial epicondylitis, ulnar neuritis, ulnar collateral ligament injury, flexor pronator strain, and snapping medial triceps.
    • Effective management hinges on accurate diagnosis and targeted treatment of the underlying pathology, particularly tendon degeneration at the common flexor tendon origin.

    Purpose of the Study:

    • To provide a comprehensive overview of the differential diagnosis and treatment strategies for medial elbow pain.
    • To emphasize the importance of addressing common flexor tendon origin pathology.
    • To outline the progression of treatment from conservative measures to surgical interventions.

    Main Methods:

    • Review of current literature and clinical guidelines for medial elbow pain.
    • Discussion of diagnostic approaches, including physical examination and imaging.
    • Categorization of treatment modalities into nonoperative, intermediate, and surgical options.

    Main Results:

    • Nonoperative treatments like rest, therapy, and injections are the mainstay for common flexor tendon origin issues.
    • Intermediate interventions such as extracorporeal shockwave therapy, platelet-rich plasma, prolotherapy, and percutaneous tenotomy are options when conservative care fails.
    • Surgical intervention is reserved for severe cases and depends on pathology and soft tissue involvement.

    Conclusions:

    • Medial elbow pain is often multifactorial, necessitating a thorough differential diagnosis.
    • Successful outcomes are linked to appropriate treatment of the common flexor tendon origin.
    • A stepwise approach, starting with conservative management and progressing as needed, is recommended.