Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of chronic, activity-related lateral elbow pain in the left upper extremity. Pain is localized to the lateral epicondyle, exacerbated by repetitive gripping, wrist extension, and forearm supination. No history of acute trauma, numbness, or paresthesia in the distribution of the radial nerve. Symptoms are progressive, impacting activities of daily living.
Clinical Examination Findings
Left elbow inspection reveals no erythema, edema, or deformity. Palpation demonstrates focal tenderness directly over the left lateral epicondyle and the origin of the extensor carpi radialis brevis (ECRB). Pain is reproduced with resisted wrist extension and resisted middle finger extension (Maudsleyโs test). Passive wrist flexion with the elbow extended (Millsโ test) elicits pain. Neurovascular status is intact distally.
Treatment Protocol
Conservative management initiated: Activity modification to avoid aggravating movements, application of ice packs for 15 minutes post-activity, and use of a counterforce elbow brace. Prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and a structured physical therapy program focusing on eccentric strengthening of the wrist extensors. Follow-up in 4-6 weeks to assess progress.