Adding Tendon Dry Needling & Manipulation to Multimodal Treatment for Lateral Elbow Tendinopathy

Man with painful grimace expression holding his elbow joint

Lateral elbow tendinopathy (also referred to as lateral epicondylalgia/epicodylitis or tennis elbow) is a common condition resulting in pain and disability. It was previously assumed that the pathology of the condition was an inflammatory process, but this line of thinking has recently evolved, and it is now considered to be a result of repetitive loading in the area resulting in histological changes within the tendon.

Nonoperative treatment typically includes physical therapy, injection, extracorporeal shockwave therapy, and high-power laser therapy. Further, multimodal treatment programs including manual therapy and exercise have shown beneficial effects in reducing pain and disability and is supported by recommendations in recent clinical practice guidelines.

Other conservative treatments for lateral elbow tendinopathy include spinal thrust manipulation and dry needling, with preliminary evidence showing support for its use in this patient population. Spinal thrust manipulation has been shown to significantly increase pressure pain thresholds and pain free grip strength. Dry needling has been found to provide equal or superior outcomes compared to corticosteroid injections, platelet-rich plasma injections, and nonsteroidal anti-inflammatory drugs combined with counterforce bracing. The combined effects of thrust manipulation plus electrical dry needling have not been investigated in patients with lateral elbow tendinopathy.

The purpose of this clinical trial was to investigate the effects of adding thrust manipulation and electrical dry needling to a multimodal therapy program of manual therapy, exercise, and ultrasound for lateral elbow tendinopathy.

RESEARCH REVIEW: Adding Tendon Dry Needling & Manipulation to Multimodal Treatment for Lateral Elbow Tendinopathy

This paper was published in Clinical Rehabilitation (2024).

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