title: Combination of manipulation, exercise, and physical therapy for the treatment of a 57-year-old woman with lateral epicondylitis.
abstract: OBJECTIVE
  This case report presents a simple systematic approach consisting of a 10-week specific sequential multimodal conservative management approach to chronic lateral epicondylitis.
  
  
  METHODS
  A 57-year-old female science teacher experiencing elbow pain for 5 months presented to our multidisciplinary clinic complaining of whole-arm pain extending to the wrist.
  
  
  RESULTS
  In the 10-week protocol, we used high-velocity and low-amplitude manipulation, high-voltage pulsed galvanic stimulation, a hard-padded elbow brace, ice, and exercise, along with restricted use of the affected elbow. The Patient-Rated Forearm Evaluation Questionnaire, currently named as the Patient-Rated Tennis Elbow Evaluation, was used for an outcome measurement. Overall, there was a systematic reduction of pain (92.86%), specific activity (100%), and usual activity (96.87%), and even after 3 weeks of follow-up, we did not notice significant changes in all of the data.
  
  
  CONCLUSIONS
  This case study showed the possible beneficial effects of the specific sequential multimodal treatment approach in a patient with resistant chronic lateral epicondylitis.
authors.affiliation: Tehran Chiropractic Center, 180, Mirdamad Boulevard, Suite No. 2, Tehran 154984, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Radpasand
mesh_terms: D003131:Combined Modality Therapy; D017679:Cryotherapy / Q000379:methods; D004599:Electric Stimulation Therapy / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D026882:Manipulation, Chiropractic / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013716:Tennis Elbow / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome