I’m really frustrated because I’ve spent the last six months chasing around trying to get some relief from my elbow pain. It’s been diagnosed as golfer’s elbow though I understand this can happen in nongolfers like me. Why haven’t my symptoms improved?

With epicondylitis, it is known that the damaged tendon doesn’t heal correctly. Degeneration occurs with fibrotic (scar) tissue forming instead of new, healthy tissue.

However, there may be some other reason for your elbow pain. For example, cervical radiculopathy (pinched nerve in the neck) can also cause elbow pain. In the case of medial epicondylitis linked with cervical radiculopathy, weakness of the muscles supplied by the pinched nerve leads to problems at the elbow. The spinal nerve roots affected and thus associated with golfer’s elbow are C6 and C7.

Weakness compounded by repetitive motion and overload of the muscle-tendon junction can then lead to microtearing and tendon damage. But we also know that weakness from cervical radiculopathy can be enough to put the elbow at risk for the development of medial epicondylitis.

Now let’s go back to the idea that with chronic elbow pain (golfer’s elbow or tennis elbow), we know there is a lack of healing at the tendon-muscle-bone interface. The failure to heal properly is possibly another end-result of the compromised (pinched) nerve tissue in the neck. The connection between poor tendon healing and the cervical radiculopathy has not been proven yet, so this is just a suggested theory for now.