Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a chief complaint of persistent pain localized to the right lateral epicondyle. Onset is insidious, exacerbated by repetitive wrist extension and forearm supination. Patient reports weakness in grip strength and difficulty with activities of daily living, including lifting objects or turning doorknobs. No history of acute trauma or neurological deficits noted.
Clinical Examination Findings
Physical examination of the right upper extremity reveals focal tenderness upon palpation of the lateral epicondyle and the origin of the extensor carpi radialis brevis (ECRB). Pain is reproduced with resisted wrist extension and forearm supination (Cozenโs test positive). Passive wrist flexion with the elbow extended elicits pain (Millsโ test positive). Neurovascular status is intact with no distal sensory or motor deficits.
Treatment Protocol
Conservative management initiated: Activity modification to avoid aggravating movements, application of ice packs for 15 minutes 3-4 times daily, and use of a counterforce brace. Prescribed NSAIDs for pain and inflammation management. Referral to physical therapy for eccentric strengthening exercises and myofascial release.