Lateral elbow pain with cervical and nerve-related components

Abstract

Patient Profile and Reported Symptoms: Henry (age 46) reported to physical therapy with a physician diagnosis of ‘tennis elbow’. He worked as a safety engineer consultant for the navy. His job involved computer and desk work interspersed with on-site ship inspections at the naval base. He enjoyed golf, gardening and home improvement projects. Henry’s main problem was right (dominant-limb) lateral elbow pain that limited his ability to perform computer work (keyboard and mouse) and power-grip activities (Fig. 7.1). He took frequent breaks from the computer to complete his work duties. He had no ship inspections at the time of the initial examination, but he thought that pain with gripping handrails would make it difficult to negotiate steep stairwells to reach the different levels of a ship. Henry also took frequent breaks to complete weekly gardening activities and did not start any new gardening or home improvement projects because of his symptoms. Although he liked to golf two or three times a week, he could not play because his elbow pain did not allow him to grip and swing a golf club. Henry also reported having right-sided headaches, right low cervical and upper trapezius area symptoms and a ‘falling asleep’ feeling in his right arm since a motor vehicle accident (MVA) 25 years ago (Fig. 7.1). He stated these symptoms had not changed since his lateral elbow pain started approximately 1 year ago