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Case-Study 8

 

 
 
“M.G.” is a 44 year old female.

History:

“M.G.” presents with an approximate 11 month history of persistent pain in the region of the right elbow (specifically, the right lateral epicondyle). These symptoms began following heavy use of the right arm while working. She denies any numbness or tingling in the right arm, but notices that the right hand gets fatigued quite quickly.


Physical Examination:

There was muscle tenderness in the upper and lower regions of the right arm, but the major findings were on palpation of the lateral and medial epicondyles. Both of these were tender (lateral more than medial) and the insertion of the extensor tendon to the lateral epicondyle was also tender to palpation. Resisted wrist extension on the right caused pain over the lateral epicondyle. Similar tests in the left arm were normal.


Previous Therapies:

  • Physiotherapy, massage therapy, and exercise treatments were temporarily helpful in managing the pain.


Diagnosis:

The history and physical findings are consistent with right lateral epicondylitis (extensor tendonitis).


Pulsed Signal Therapy (PST):

Pain Scale:


Before PST

Right after PST

6 weeks after PST

6 months after PST

Date of treatment

Aug 24, 2009

Sept 03, 2009

Dec 01, 2009

Feb 23, 2010

Intensity of pain

3

2

2

1

Frequency of pain

4

2

1

1

Rest. of Mov.

2

2

2

1

Swelling

3

0

0

0

Warming

3

0

0

0

Discolouring

0

0

0

0

Paresthesic

0

0

0

0

Explanation of ratings: 
0 = none or never
1 = slight or seldom
2 = moderate or sometimes
3 = severe or often
4 = extreme or always
NA= Not applicable


Daily Function Scale:


Before PST

Right after PST

6 weeks after PST

6 months after PST

Sleep

0

0

0

0

Pronation of forearm

4

3

2

1

Supination of forarm

4

3

2

1

Explanation of ratings: 
0 = six or more hours before the pain increases and disturbs function. 
1 = around 4 hours before the pain increases and disturbs function. 
2 = around 2 hours before the pain increases and disturbs function. 
3 = 20 min to 1 hour before the pain increases and disturbs function. 
4 = 5 min to 20 min before the pain increases and disturbs function. 
NA = not applicable


Conclusions:

  • Six months after PST, the pain intensity decreased 67%, the pain frequency decreased 75%, while the restriction of movement improved 50%.
  • Patient had an improvement of 90% in supination/pronation of the right forearm



 

 

 
 
 
 
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