Dry Needling vs. Standard Therapy for Tennis Elbow

Overseen By James Dunning, DPT PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: Alabama Physical Therapy & Acupuncture

Disqualifiers: Hypertension, Diabetes, Heart disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 8

Duration: 4 weeks

110 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial compares two methods for treating inner elbow pain: one using hands-on therapy, exercises, and ultrasound, and another adding electric dry needling. It aims to find out which method is more effective for patients with this condition. Dry needling is similar to acupuncture and frequently regarded as a form of acupuncture, with evidence supporting its use for localized musculoskeletal pain conditions.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the idea that Dry Needling vs. Standard Therapy for Tennis Elbow is an effective treatment?

The available research shows that dry needling can be effective for treating tennis elbow. One study compared dry needling to open-release surgery and found that dry needling helped reduce pain and improve function in workers with chronic tennis elbow. Another study on a similar condition, golfer's elbow, showed that a single session of dry needling improved pain and disability, allowing the patient to return to normal activities. While these studies suggest dry needling can be beneficial, they do not directly compare it to standard therapy for tennis elbow. However, they indicate that dry needling can be a useful option for managing elbow pain. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment for tennis elbow?

Research shows that dry needling can improve pain and function in conditions similar to tennis elbow, like golfer's elbow. Additionally, therapeutic ultrasound has been shown to enhance recovery in most patients with tennis elbow, improving pain and grip strength. ^{1 2 3 4 5}

What safety data exists for dry needling in treating tennis elbow?

The studies provided do not directly address the safety data for dry needling in treating tennis elbow. However, they do explore the efficacy of dry needling compared to other treatments like Kinesio Taping, open-release surgery, and other therapies for conditions similar to tennis elbow. The studies suggest that dry needling can be effective in reducing pain and improving function, but specific safety data or adverse effects are not detailed in the abstracts provided. ^{1 2 3 4 6}

Is dry needling safe for treating elbow conditions?

Dry needling has been studied for various elbow conditions, and while it can help with pain and function, the studies do not report any major safety concerns. However, as with any treatment, it's important to discuss potential risks with your healthcare provider. ^{1 2 3 4 6}

Is the treatment Manual Therapy, Exercise, Ultrasound, and Electric Dry Needling a promising treatment for Tennis Elbow?

Yes, this treatment is promising for Tennis Elbow. Studies show that dry needling can reduce pain and improve function. Combining it with manual therapy, exercise, and ultrasound may enhance these benefits, offering a comprehensive approach to managing symptoms. ^{1 2 3 4 7}

How does the treatment of manual therapy, exercise, ultrasound, and electric dry needling differ from other treatments for tennis elbow?

This treatment is unique because it combines manual therapy, exercise, ultrasound, and electric dry needling, which may offer a comprehensive approach to managing tennis elbow by addressing pain, improving function, and enhancing muscle strength. Unlike treatments that focus solely on one method, this combination targets multiple aspects of the condition, potentially leading to more effective and holistic results. ^{1 2 3 4 7}

Research Team

James Dunning, DPT PhD

Principal Investigator

American Academy of Manipulative Therapy

Eligibility Criteria

This trial is for adults aged 18-60 with medial epicondylalgia (tennis elbow) pain for at least 6 weeks, who haven't had related treatments in the past 6 months. Participants must speak English and have a specific diagnosis of medial epicondylalgia. Pregnant individuals or those with certain medical conditions like severe hypertension, diabetes, heart disease, previous elbow surgery or injuries are excluded.

Inclusion Criteria

I haven't had treatments like physical therapy for elbow pain in the last 6 months.

I have been diagnosed with pain on the inside of my elbow, worsened by certain wrist and forearm movements.

I am between 18 and 60 years old and can speak English.

Exclusion Criteria

I have had issues with my joints, ligaments, or nerves in my elbow.

I have had elbow surgery, dislocation, fracture, or tendon rupture in the past.

I have nerve or spinal issues, including recent severe neck or back injuries.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Treatment

Participants receive either manual therapy, exercise, and ultrasound or manual therapy, exercise, ultrasound, and electric dry needling

4 weeks

8 treatments (2 treatments per week)

Follow-up

Participants are monitored for safety and effectiveness after treatment

3 months

Treatment Details

Interventions

• Manual Therapy, Exercise and Ultrasound
• Manual Therapy, Exercise, Ultrasound and Electric Dry Needling

Trial Overview The study compares two treatment strategies for tennis elbow: one group receives manual therapy, exercise and ultrasound; another group gets these plus electric dry needling. The goal is to determine if adding electric dry needling improves outcomes.

Participant Groups

Group I: Experimental: Electric DN, Manual therapy, exercise and US Experimental Treatment 1 Intervention

Dry needling, manual therapy, exercise and ultrasound

Group II: Active comparator: Manual therapy, exercise and ultrasound Active Control 1 Intervention

Active comparator: Manual therapy, exercise and ultrasound

Who Is Running the Clinical Trial?

Alabama Physical Therapy & Acupuncture

Lead Sponsor

Trials

15

Recruited

2,200+

Universidad Rey Juan Carlos

Collaborator

Trials

137

Recruited

10,300+

Findings from Research

In a study of 78 patients with lateral epicondylitis, both Kinesio Taping (KT) and dry needling (DN) showed significant short- and long-term improvements in pain, functionality, and muscle strength compared to exercise alone.

Dry needling was found to be more effective than Kinesio Taping in improving clinical parameters and tendon characteristics, as measured by ultrasonography, indicating it may be the preferred treatment option for this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The comparison of the effectiveness of Kinesio Taping and dry needling in the treatment of lateral epicondylitis: a clinical and ultrasonographic study. Altaş, EU., Birlik, B., Şahin Onat, Ş., et al.[2022]

In a study of 80 patients with lateral epicondylitis (tennis elbow), local steroid injections (triamcinolone acetate) provided significantly quicker pain relief and functional improvement compared to therapeutic ultrasound over a two-week period.

Patients receiving steroid injections reported almost complete pain relief and tenderness reduction within one week, while those receiving ultrasound showed only mild to moderate improvements, highlighting the superior efficacy of steroid injections for immediate treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparative Efficacy of Local Steroid and Therapeutic Ultrasound for Quicker Functional Improvement in Tennis Elbow. Rahman, MS., Salek, AK., Ullah, MA.[2019]

In a study of 62 participants with chronic lateral epicondylosis, ultrasound-guided dry needling showed similar effectiveness to open-release surgery in reducing pain and improving function, with no adverse events reported.

Both treatments had high success rates (83% for surgery and 81% for dry needling), suggesting that dry needling could be a viable first-line treatment option before considering surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Treatment of chronic lateral epicondylosis: a randomized trial comparing the efficacy of ultrasound-guided tendon dry needling and open-release surgery. Bureau, NJ., Tétreault, P., Grondin, P., et al.[2023]

A 40-year-old retired elite athlete with chronic elbow pain experienced significant improvement in pain and disability after just one session of dry needling, marking a successful intervention after two years of ineffective treatments.

This case highlights the potential of dry needling as an effective therapy for conditions like Golfer's elbow, especially when other therapies have failed to provide relief.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute effects of one session dry needling on a chronic golfer's elbow disability. Shariat, A., Noormohammadpour, P., Memari, AH., et al.[2020]

In a study of 76 patients with lateral epicondylitis, those receiving ultrasound treatment showed a significant improvement in recovery (63% improvement) compared to only 29% in the placebo group, indicating the efficacy of ultrasound therapy.

Patients treated with ultrasound also demonstrated better outcomes in specific clinical measures such as pain score, weight lifting ability, and grip strength, highlighting the therapeutic benefits of ultrasound in managing this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Is therapeutic ultrasound effective in treating soft tissue lesions? Binder, A., Hodge, G., Greenwood, AM., et al.[2019]

In a study of 58 patients with tennis elbow, low-level laser therapy (LLLT) was found to be more effective than brace or ultrasound treatments in improving grip strength after treatment, although all methods reduced pain severity.

While all treatment groups showed significant pain reduction, the brace treatment had a shorter beneficial effect compared to ultrasound and laser therapy, indicating that LLLT may provide longer-lasting benefits for grip strength.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial. Oken, O., Kahraman, Y., Ayhan, F., et al.[2015]

Dry needling significantly reduces pain intensity and related disability in patients with lateral epicondylalgia, showing large effect sizes in a meta-analysis of 7 studies involving 320 patients.

The treatment also improves pressure pain thresholds and grip strength, particularly showing the most significant benefits in the short term, although the overall evidence quality was downgraded due to variability in results.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis. Navarro-Santana, MJ., Sanchez-Infante, J., Gómez-Chiguano, GF., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

The comparison of the effectiveness of Kinesio Taping and dry needling in the treatment of lateral epicondylitis: a clinical and ultrasonographic study. [2022]

2. Bangladesh pubmed.ncbi.nlm.nih.gov

Comparative Efficacy of Local Steroid and Therapeutic Ultrasound for Quicker Functional Improvement in Tennis Elbow. [2019]

3. Germany pubmed.ncbi.nlm.nih.gov

Treatment of chronic lateral epicondylosis: a randomized trial comparing the efficacy of ultrasound-guided tendon dry needling and open-release surgery. [2023]

4. Korea (South) pubmed.ncbi.nlm.nih.gov

Acute effects of one session dry needling on a chronic golfer's elbow disability. [2020]

5. England pubmed.ncbi.nlm.nih.gov

Is therapeutic ultrasound effective in treating soft tissue lesions? [2019]

6. United States pubmed.ncbi.nlm.nih.gov

The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: a prospective, randomized, controlled trial. [2015]

7. England pubmed.ncbi.nlm.nih.gov

Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review and meta-analysis. [2022]