Soreness on outside of elbow. Clinical case

Soreness on outside of elbow

48-year-old woman. Complains of soreness on outside of left elbow in quiet position, at night and especially when moving. The pain appeared more than a year ago.

Objective examination: orthopedic tests for lateral epicondylitis were positive (Mill, Cozen tests), external condyle of elbow was sharply painful (elbow outside bone), extensor muscles of fingers and hand, when pressed hurt and reproduced the patient's usual pain in the forearm and hand.

Diagnosis: lateral epicondylitis (tennis elbow), enthesopathy (painful attachment sites) caused by myofascial syndrome of extensor muscles of the hand and fingers.

Treatment: mobilization of the ulna in the lateral direction, appropriate movements, the method of progressive increase of pressure for the extensor muscles, fixation of the achieved improvement with plaster for 24 hours (Mulligan's taping).

Results: after five repetitions of mobilization, pain during movements (bending the elbow, clenching the fist) disappeared completely, painfulness on palpation remained, recommendations for self-massage were given. The next day an aggravation followed, apparently related to the patient's attempt to "massage" the painful area with a strong stream of water. All the previous manipulations were repeated, the positive result was fixed by plaster, the patient was advised not to touch the arm. Five days later, no aggravations and no pain were observed.

Sore elbow outside bone. Conclusions.

What was especially memorable in this case was the complete disappearance of pain while movement on outside of elbow after only five mobilizations (less than one minute), while the patient was being assured by a 40-year traumatologist that tennis elbow or lateral epicondylitis was untreatable and had to live with it. Of course it's not all that simple, but the effect is too obvious not to notice and not to use it for good. The problem is that it is necessary not only to improve the biomechanics of the joint (although this is an important and maybe even decisive factor), but also to eliminate myofascial muscle syndrome, enthesopathy (tendon and periosteum changes) caused by them, long-term inflammation and swelling of the joint tissues. And, of course, think about the movements and strains that seem to be the root cause of the disorder.