Executive Summary: Work Related Injury

DOI: 9/1/2012. The patient is a 42-year-old female referral coordinator who sustained a work-related injury to her bilateral wrists, right index finger and right elbow due to repetitive typing. As per office notes dated 6/8/16, the patient has not returned to work. She complains of bilateral hand numbness and tingling with grinding and popping upon flexion and extension of the index and middle fingers of the right hand. She complains of bilateral extensor forearm and lateral elbow pain, made worse by grasping and pulling. Objective findings revealed that there is tenderness over the lateral epicondyle. There is positive Cozen’s. There is tenderness over the proximal extensor muscle mass. There are bilateral well-healed surgical scars and bilateral
decreased sensation to the thumb, index, and middle fingers. There is positive Phalen sign bilaterally. There is slight grinding at the level of the A1 pulley of the right index finger, but there is no palpable nodularity and no acute triggering. As per medical record review, “of note dated 4/14/15, ‘she is now getting overuse symptoms and pain in the left elbow’. Examination of the left elbow demonstrates tenderness directly over the lateral epicondyle. There is pain with resisted wrist and finger extension.” Diagnoses include status post bilateral carpal tunnel release, status post right elbow lateral release, left elbow lateral epicondylitis, and history of right index trigger finger. As per plan, it was noted that by the end of 2014, the patient is having increasing left upper extremity symptoms and was diagnosed with left elbow lateral epicondylitis, which is a result of compensatory overuse from the injury from right upper extremity. It was mentioned that the therapy will be done quickly, the patient may be treated without invasive care, such as “PRP” injections and/or surgery. As per call verification, the physical therapy for the left elbow is an initial request.