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Posterior Interosseous Nerve Palsy as a Complication of Friction Massage in Tennis Elbow

Wu, Ya-Ying, MD; Hsu, Wei-Chih, MD, PhD; Wang, Han-Cheng, MD

American Journal of Physical Medicine & Rehabilitation: August 2010 - Volume 89 - Issue 8 - p 668-671
doi: 10.1097/PHM.0b013e3181c567af
Case Report: Musculoskeletal
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Wu Y-Y, Hsu W-C, Wang H-C: Posterior interosseous nerve palsy as a complication of friction massage in tennis elbow. Am J Phys Med Rehabil 2010;89:668–671.

Friction massage is a commonly used physical therapy that is usually safe and without complication. We report an unusual case of posterior interosseous nerve palsy that arose after friction massage. Electrophysiologic findings confirmed a focal neuropathy 4–6 cm distal to the lateral epicondyle. The neurologic symptoms resolved completely 2 mos after discontinuation of friction massage. This case experience broadens the spectrum of etiologies of posterior interosseous nerve palsy. Nerve conduction studies may be a useful adjunct to a thorough physical examination to confirm the diagnosis and is important to prognostic evaluation, if unexplained neurologic symptoms develop after certain physical therapy procedures. Further treatment includes avoiding compression and observation.

From the Department of Neurology (Y-YW, W-CH, H-CW), Shin-Kong WHS Memorial Hospital; College of Medicine (W-CH), Fu-Jen Catholic University; and College of Medicine (H-CW), Taipei Medical University, Taipei, Taiwan.

All correspondence and requests for reprints should be addressed to Han-Cheng Wang, MD, Department of Neurology, Shin-Kong WHS Memorial Hospital, 95 Wen-Chang Road, 111, Taipei, Taiwan.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article. No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

© 2010 Lippincott Williams & Wilkins, Inc.