Initial pharmacologic treatment for pain in an adolescent recently diagnosed with epicondylitis is:

Rationale: A. Intra-articular corticosteroid injections are generally reserved for persistent or severe cases that do not respond to conservative therapy; they are not first-line. B. COX-2 inhibitors are a type of NSAID but are not typically first-line due to cost and cardiovascular risk considerations in otherwise healthy adolescents. C. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are the initial pharmacologic treatment for epicondylitis. They reduce inflammation and relieve pain, complementing rest, activity modification, and physical therapy. D. Oral acetaminophen with codeine is not recommended initially due to risks of opioid use, side effects, and limited anti-inflammatory effects.