Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with localized pain over the right lateral epicondyle, exacerbated by repetitive wrist extension and gripping activities. Symptoms are chronic/subacute, characterized by a dull ache radiating into the proximal forearm. No history of acute trauma, numbness, or paresthesia in the hand.
Clinical Examination Findings
Right elbow inspection reveals no erythema or swelling. Palpation demonstrates point tenderness directly over the 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 pain. Range of motion is full and painless. Neurovascular status is intact distally.
Treatment Protocol
Conservative management initiated: Activity modification to avoid aggravating movements, application of ice packs for 15 minutes BID, and use of a counterforce elbow brace. Prescription of NSAIDs (e.g., Naproxen 500mg BID) for 10 days. Referral to physical therapy for eccentric strengthening exercises and ultrasound therapy.