Functional and Pain Improvement in Tennis Elbow with Dry Needling as Alternative Treatment: Case Series

Introduction: Lateral epicondylitis, or tennis elbow, is pain in the lateral elbow as a result of repetitive forearm pronation and supination in elbow extension. Treatment varies from anti-inflammatory to surgical treatment. Dry needling has recently been developed as a therapeutic modality in lateral epicondylitis; it is less invasive and can reduce the cost and time taken to carry out the procedure compared with other pain interventions or surgery. Case series: This case series reports three female patients, aged 38–42, with lateral elbow pain. Lateral epicondylitis diagnosis was based on medical history and palpatory findings, and was confirmed with provocative tests. Dry needling was performed on the extensor carpi radialis brevis (ECRB) and lateral epicondyle periosteum of all three patients. Two patients also had trigger points on the ECRB muscle, and therefore underwent needling on this location. Patients were evaluated using the functional and pain Patient-Rated Tennis Elbow Evaluation (fPRTEE and pPRTEE) scoring systems. Improvements to total pain resolution were obtained at the first evaluation (first week) until the last evaluation (fourth week post-treatment). Mean baseline fPRTEE score decreased from 72.0 ± 7.1 standard deviation (SD) to 34.0 ± 5.4 SD at the first evaluation. pPRTEE score also decreased from 33.3 ± 1.2 SD at baseline to 14.7 ± 2.1 SD at the first evaluation. Both scores were then 0 in the last evaluation. Conclusion: The improvement in patient-reported pain in these cases shows that dry needling could be considered as one of the treatment options for lateral epicondylitis. Further research is needed to support its clinical significance and efficacy.