Dry Needling Therapy for Tennis Elbow

This article will offer an in-depth exploration of dry needling therapy for tennis elbow, explaining what it is, how it works, its proven effectiveness, and what you can expect during treatment. Discover how this innovative therapy targets pain at the source, promotes healing, and helps restore normal function for a quicker, more effective recovery.

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Understanding the Core Concepts

To effectively address tennis elbow, it’s important to first understand the condition itself, its causes, and its impact on the body. Gaining this insight allows for better treatment decisions and expectations. In this section, we will explore the fundamentals of tennis elbow and how dry needling therapy works to alleviate pain and restore function.

What is Tennis Elbow (Lateral Epicondylitis)?

Tennis elbow, medically known as lateral epicondylitis or lateral epicondylalgia, is an overuse injury affecting the tendons that connect your forearm muscles to the bony prominence on the outside of your elbow (the lateral epicondyle).

Cause: It's caused by repetitive strain from wrist and arm movements, leading to micro-tears, inflammation, and degeneration of the extensor carpi radialis brevis (ECRB) tendon.
Symptoms: The primary symptoms are pain and tenderness on the outside of the elbow, which can radiate down the forearm. Other common issues include a weak grip, pain when shaking hands, or difficulty lifting objects.
Who it Affects: Despite its name, it affects not just tennis players but also painters, plumbers, carpenters, chefs, and office workers who perform repetitive manual tasks.

What is Dry Needling Therapy?

Dry needling is a modern, evidence-based treatment performed by trained physical therapists, chiropractors, and medical doctors. It involves inserting a thin, solid filiform needle (the same type used in acupuncture) into the skin and muscle.

The primary goal is to target and release myofascial trigger points—hyper-irritable "knots" within a taut band of muscle that can cause pain, limit movement, and refer pain to other areas.

Key Distinction: Dry needling is not acupuncture. It is based on Western neuroanatomy and a modern understanding of musculoskeletal dysfunction, whereas acupuncture is based on Traditional Chinese Medicine principles of restoring the flow of "Qi" (energy).

How Dry Needling Specifically Helps Tennis Elbow

Dry needling therapy for tennis elbow is highly targeted. The practitioner focuses on the specific forearm muscles that are overworked and contributing to the tendon problem.

Releasing Trigger Points: The primary targets are trigger points within the forearm extensor muscles (like the ECRB and supinator). Inserting the needle into these knots can elicit a Local Twitch Response (LTR), a spinal cord reflex that causes the muscle fibres to contract and then relax. This immediate relaxation helps decrease muscle tension and reduce pain.
Promoting Blood Flow and Healing: The micro-trauma caused by the needle insertion creates a localised inflammatory response. This signals the body to increase blood circulation to the area, bringing oxygen and nutrients that are essential for tissue healing and repair of the damaged tendon.
Pain Modulation (The "Pain Gate" Theory): The stimulation from the needle can activate nerve fibres that send signals to the brain, helping to "gate" or block the transmission of pain signals from the elbow. It also triggers the release of the body's natural painkillers, like endorphins and enkephalins.
Restoring Muscle Function: By releasing tension and reducing pain, dry needling helps restore the normal function and activation patterns of the forearm muscles. This takes the chronic load off the inflamed tendon, allowing it to heal and preventing re-injury.

What to Expect During Your Dry Needling Therapy Session

Dry needling therapy for tennis elbow involves a structured process aimed at alleviating pain and promoting healing. Below is a breakdown of the steps involved in your treatment session.

Assessment: Your therapist will first conduct a thorough physical examination to identify the specific muscles and trigger points responsible for your pain. They will assess your range of motion, strength, and pain levels.
Positioning: You will be positioned comfortably, usually lying down with your affected arm supported.
Needle Insertion: The therapist will sterilise the area and then gently insert the thin needle directly into the identified trigger points in your forearm. You may feel a small prick, similar to a mosquito bite.
Eliciting a Twitch Response: The therapist may gently manipulate the needle (a technique called pistoning or fanning) to find the trigger point and elicit the local twitch response. This can feel like a brief, deep cramp or ache, which is considered a positive sign of effective treatment.
Duration: The needles may be left in for just a few seconds or for several minutes, depending on the technique and your specific condition.
Post-Treatment Care: After the needles are removed, you may experience some muscle soreness, similar to post-workout fatigue, for 24-48 hours. Your therapist may apply heat or perform gentle stretching. They will likely give you instructions for home care, such as gentle stretching and avoiding strenuous activity for a day.

Boosting Effectiveness: Combining Dry Needling with Other Therapies

There is a growing body of evidence supporting the use of dry needling therapy for tennis elbow, especially when it is part of a comprehensive rehabilitation program. Studies have shown it can lead to significant reductions in pain, improved grip strength, and increased function.

For optimal results, dry needling should not be a standalone treatment. It is most effective when combined with:

Therapeutic Exercise: Specific stretching and strengthening exercises to improve the flexibility and endurance of the forearm muscles.
Manual Therapy: Hands-on techniques to mobilize the elbow joint and soft tissues.
Activity Modification and Ergonomics: Identifying and correcting the movements or workplace setups that caused the problem in the first place.
Load Management: Gradually reintroducing load to the tendon to build its resilience.

Who Can Benefit from Dry Needling Therapy? (And Who Should Avoid It)

Dry needling therapy can provide significant relief for individuals experiencing persistent pain and muscle tightness, especially when traditional treatments have been ineffective. However, it may not be suitable for everyone. Below are the key criteria for who can benefit from this therapy, and who should avoid it for safety reasons.

Dry needling is often recommended for individuals with:

Chronic or sub-acute tennis elbow that hasn't responded to rest or basic stretching.
Palpable trigger points and significant muscle tightness in the forearm.
Pain that limits daily activities or athletic performance.

Contraindications (Situations where it should be avoided):

Severe needle phobia.
In the area of a local skin infection, tumor, or open wound.
Patients with bleeding disorders or on high doses of anticoagulant medication.
During the first trimester of pregnancy.

Relieve Tennis Elbow Pain with Dry Needling Therapy at Physiotattva

Dry needling therapy is an effective and targeted treatment for tennis elbow, offering significant relief from pain, improving muscle function, and promoting faster healing. When combined with other therapeutic approaches such as exercise, manual therapy, and ergonomic adjustments, dry needling can accelerate recovery and help restore normal function.

However, it's important to remember that while dry needling is a highly effective therapy, it may not be suitable for everyone. If you have chronic or sub-acute tennis elbow, muscle tightness, or pain that interferes with daily activities or athletic performance, dry needling could be a beneficial treatment. Always consult with a qualified healthcare provider at Physiotattva to determine if this therapy is right for you.

At Physiotattva physiotherapy clinics in Bangalore and Hyderabad, you receive personalised care tailored to your specific needs, ensuring effective results and comfort throughout your journey to recovery.

Don’t wait to start your recovery! Get in touch with Physiotattva for more details! Contact us at +91 89510 47001.

Frequently Asked Questions

Does dry needling for tennis elbow hurt?

You may feel a slight prick upon insertion. If a trigger point is stimulated, you might feel a brief muscle twitch or a dull ache, which is a positive sign that the treatment is working.

How many dry needling sessions will I need?

This varies greatly. Some patients experience significant relief after just one session. For chronic conditions, a course of 4-6 sessions is often recommended. Your therapist will create a personalized treatment plan for you.

Are there any side effects of dry needling?

The most common side effect is muscle soreness. Minor bruising at the needle site can also occur. Serious side effects are extremely rare when performed by a properly trained and licensed practitioner.

Is dry needling for tennis elbow safe?

Yes, when performed by a certified and experienced physiotherapist like those at Physiotattva, it is a very safe procedure using sterile, single-use needles.

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