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Background: Elbow pain may present itself in many forms and identifying its cause to treat it can prove equally as variable. Lateral and medial epicondylalgia are two common musculoskeletal diagnoses of the upper extremity. In the existing literature, there are no comprehensive protocols or methods of treating lateral or medial epicondylalgia. One factor that may contribute to elbow pain is cervical radiculopathy, a condition that results from compression or irritation of cervical nerve roots. Purpose: The purpose of this case report is to highlight the importance of screening for and treating cervical involvement and myotomal weakness that may be contributing to symptoms at the elbow. Case Description: This case report describes the treatment of a 51-year-old male who presented to physical therapy with right lateral elbow pain. The laterality of his elbow pain had changed after three visits, leading to further examination of factors contributing to the patient's pain. At visit 3, weakness was noted in the C7 myotome on the right compared to the left, as tested by both tricep extension and wrist flexion. Additionally, the patient was hypomobile at his cervicothoracic junction (CTJ), first rib, and thoracic spine. Interventions: After finding myotomal weakness of C7, interventions focused on cervical manual therapy techniques, improving cervicothoracic mobility, improving cervical and periscapular strength and stability, and addressing occasional neural tension. Outcomes: After nine visits, the patient demonstrated sustained improvements in C7 myotomal strength testing, grip strength, and reductions in his symptoms. He returned to all activities without pain. Discussion: The results of this case report suggest that assessment and treatment of the cervical spine may be considered in individuals with lateral or medial epicondylalgia, especially those presenting with myotomal weakness.