Medical Rehabilitation in Patient with Right Lateral Epicondilytis - A Case Report

Abstract

Epidondylitis is a general term used to describe inflammation, pain, or tenderness in the region of medial or lateral epicondyle of the humerus. Lateral epicondylitis implies an inflammatory lesion with degeneration at the tendinous origin of the extensor muscles. The condition was most prevalent in the age group of 45-54 years. Repetitive movements and forceful activities were correlated with lateral epicondylitis. Patient usually report pain in the area just distal to the lateral epicondyle. They may complain of pain radiating proximally or distally. Patients may also complain of pain with wrist or hand movement. The hallmark of epicondylitis is tenderness over the extensor muscle origin. Initial treatment consist of relative test, avoidance of repetitive motion involving the wrist, activity modification to avoid stress on the epicondyle, anti-inflammatory medications, and thermal modalities such as heat and ice for acute pain. the use of wrist immobilization splints may be helpful. Injection may be useful if therapy and exercise have not provide relief. Surgery may be indicated to those patients with continued severe symptom who do not respond to conservative management. The prognosis of the lateral epicondylitis is excellent if treated appropriately. In our clinic, a 54 years-old female, a housewife, complain pain on the lateral side of the right elbow especially while carrying heavy things. On physical examination we found that there is weakness in hand function and also weakness in action of elbow extension.. The Cozen’s and Mill’s test was performed to this patient and supported the diagnosis. Patient was treated first with Pulsed Ultrasound Diathermy 1 MHz, 1 W/cm2, for ten minutes, two to three times weekly. Because of the pain didn’t decrease in ten times of therapy, we changed the modality therapy with Low Level Laser 3J/cm², 100W/cm², 3 minutes during therapy for 5 weeks. Patient also given ice massage at lateral side of the right elbow and therapeutic exercise.