Acupuncture for Golfer's Elbow

How Chinese medicine understands golfer’s elbow

In Chinese medicine, golfer’s elbow is a local Bi syndrome: Qi and Blood blocked where the forearm tendons attach to the inner elbow. The Heart and Small Intestine channels pass over the inner side of the elbow, and the Pericardium channel runs close by down the middle of the forearm. Where your pain sits along these lines helps decide which points are used.

The pattern behind it decides the rest. The common ones are:

• Qi and Blood stagnation. Sharp, fixed pain that flares with gripping and lifting, usually after a stretch of heavy work, a new sport or more training. Treatment moves circulation through the area.
• Wind, Cold and Damp. An aching elbow that is stiff in the morning and in cold weather, and better with warmth. Treatment warms the area and clears the channels.
• Qi and Blood deficiency. Pain that has lingered for months, a weak grip, and general tiredness. In Chinese medicine the tendons are not being nourished well enough to repair, so treatment also builds you up.

Pain on the outer side of the elbow is a different tendon and channel, covered on the tennis elbow page.

What treatment involves

Your first visit at the clinic in Keswick starts with a lot of questions about your work, sports, tools and grip, how long the elbow has hurt, and your general health. I look at your tongue and take your pulse. An assessment usually also includes pressing along the inner elbow and forearm to find the tender spots, and testing which wrist and grip movements bring on the pain.

Acupuncture is usually the main treatment. Needles go into points around the inner elbow and along the forearm, and into points elsewhere on the body chosen for your pattern. I treat the whole body at every treatment, not only the area that hurts. The aim is to ease pain and loosen the forearm muscles that pull on the tendon.

Depending on the diagnosis, treatment may also include cupping or tuina massage to release the forearm, moxibustion to warm the elbow for a Cold pattern, or Chinese herbal medicine: a formula written for your pattern and dispensed at the clinic.

Tendons change slowly, and progress is easier when the strain that caused the problem eases too. Plan on 5–10 treatments to judge progress.

Between visits

• Change how you lift. Carry bags close to the body and lift with your palm facing down where you can, which takes load off the inner elbow.
• Break up repetitive work. Short, frequent rests do more than one long break at the end of the day.
• Check your grip. A thicker tool handle or a golf grip sized for your hand can reduce strain. A coach can look at your swing.
• Load it gradually. Gentle strengthening exercises from your physiotherapist or doctor usually help tendons. Stop short of sharp pain.
• Don’t rest it completely. Weeks of no use tend to weaken the tendon further.

When to see your doctor first

See your doctor before starting treatment, or promptly if you are already coming in, if:

• The pain started with a fall, a pop or a sudden injury, or the elbow is swollen and you cannot straighten it.
• Your ring and little fingers are numb or tingling, or your hand feels weak or clumsy.
• The elbow is red, hot and swollen, or you have a fever.
• The pain keeps getting worse, or is severe at rest and at night.
• You also have neck pain with pain running down the arm.