Question

The patient had pain several weeks ago after his tennis team went to a regional competition. When he rests, the pain seems to go away. The pain is alleviated when he takes Naprosyn. No history of trauma or infection in the elbow. Past medical and social history non contributary. He's a junior at the local high school and just started taking tennis lessons 2 months ago and his coach is working with him on his backhand serve. Focused physical exam revealed point tenderness over the lateral epicondyle which increases with pronation and supination. The APRN diagnoses him with lateral epicondylitis and orders a wrist splint to prevent wrist flexion. Question: Why did the APRN feel a wrist splint would be helpful? What patient characteristics lead to this diagnosis.

Answer 1

Tennis elbow, also known as lateral epicondylitis, is a condition in which the outer part of the elbow becomes painful and tender.

The basic problem is related to overuse pathology at the origin of extensor carpi radialis brevis (ECRB) and less commonly the extensor digitorum communis (EDC) ; both of them originate in the lateral epicondyle.

Typically this occurs as a result of work or sports, classically racquet sports.

Treatment involves decreasing activities that bring on the symptoms , together with physical therapy.

Pain medications such as NSAIDS or acetaminophen may be used.

The aim of the treatment is also to limit wrist movements , which decreases the stresses on the tendons at  the elbow. Bracing or splinting the wrist may be used to treat tennis elbow .

Splints of pliable thermoplastic materials may be used for conditions that do not require rigid immobilization,
for those in which swelling may be anticipated, and for those that require special skin care.

The splint helps to immobilize and support the body part in a functional position.

The wrist should be positioned in 35 degrees of extension.