Tennis elbow, also known as lateral epicondylalgia is the most common reason for elbow pain and 2nd most common overuse injury in the arm after the shoulder. Lateral elbow pain was previously described as an inflammatory condition, but we now know this condition affects the muscles’ common insertion point where the tendon meets the bone and is not associated with an inflammatory process. Instead this can best be described as a tendinopathy a cellular degenerative process where old cells are replaced by new immature tendon cells waiting to complete the healing process (remodeling). These changes occur because the tendon is overloaded and unable to withstand the forces placed on the tendon in daily or recreational activities such as tennis.

While long term beneficial results can best be found with a gradual, progressive loading Physical Therapy program short term improvements can be found with a variety of manual therapy interventions including dry needling. Navarro-Santana and colleagues reviewed the evidence on Physical Therapy dry needling from 7 studies of over 300 patients with lateral elbow pain (Clinical Rehabilitation. 2020). Authors reported large effect sizes on reduced pain and disability following this intervention. In addition, smaller effect sizes were noted for improved grip strength following dry needling of the forearm musculature. Results were found primarily in the short term for dry needling. Consistent with other forms of manual therapy, dry needling is best incorporated with a strength training program to improve long term outcomes for patients with musculoskeletal pain.

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