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Examination of and Intervention for a Patient With Chronic Lateral Elbow Pain With Signs of Nerve Entrapment

RA Ekstrom, PT, DSc, OCS, is Assistant Professor, Department of Physical Therapy, University of South Dakota, 414 E Clark St, Vermillion, SD 57069 (USA) (rekstrom{at}usd.edu).
K Holden, PT, MSPT, is Physical Therapist, Department of Physical Therapy, Sioux Valley Vermillion Hospital, Vermillion, SD

Address all correspondence to Dr Ekstrom

Background and Purpose. Lateral elbow pain has several causes, which can make diagnosis difficult. The purpose of this case report is to describe the examination of and the intervention for a patient with chronic lateral elbow pain who had signs of nerve entrapment. Case Description. The patient was a 43-year-old woman who had right lateral elbow pain for about 4 months, which she attributed to extensive keyboard work on a computer. She had a reduction in joint passive range of motion during "neural tension testing," an examination procedure to detect nerve entrapment. This sign, in combination with other findings, suggested that the patient had a mild entrapment of the deep radial nerve (radial tunnel syndrome). The patient was treated 14 times over a 10-week period with "neural mobilization techniques," which are designed to free nerves for movement; ultrasound; strengthening exercises; and stretching. Outcomes. The patient had minimal symptoms at discharge, was pain-free, and had resumed all activities at a 4-month follow-up visit. Discussion. Neural tension testing may be a useful examination procedure and mobilization may be useful for intervention for patients who have lateral elbow pain.

Key Words: Lateral elbow pain • Nerve entrapment • Neural tension testing • Radial tunnel syndrome

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