Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of chronic, activity-related pain localized to the left lateral epicondyle. Symptoms are exacerbated by repetitive wrist extension, gripping, and forearm supination. No history of acute trauma, numbness, or paresthesia in the distribution of the radial nerve. Pain is described as a dull ache at rest with sharp, stabbing episodes during provocative maneuvers.
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 (Cozenโs test) elicits significant discomfort. Neurovascular status is intact distally.
Treatment Protocol
Conservative management initiated: activity modification to avoid provocative repetitive motions, application of ice packs for 15 minutes BID, and use of a counterforce elbow brace. Prescribed NSAIDs for inflammation control and a structured physical therapy program focusing on eccentric strengthening of the wrist extensors. Consider corticosteroid injection if symptoms persist despite 6 weeks of conservative care.