Dry needling in lateral epicondylitis: a prospective controlled study

Int Orthop. 2017 Nov;41(11):2321-2325. doi: 10.1007/s00264-017-3604-1. Epub 2017 Aug 21.


Purpose: Lateral epicondylitis (LE), a common disease, especially in middle age, causes decreased productivity and economic losses. The first-line treatment for LE is conservative and consists of topical and oral anti-inflammatory drugs, ice application, and brace use. If the first-line treatment fails, second-line treatment modalities, which are generally invasive, are offered. Second-line therapeutic regimens include saline, corticosteroid, or platelet-rich plasma injections. Dry needling is relatively new. We hypothesized that dry needling would be at least as effective as first-line treatment for LE. We compared the outcomes of first-line treatment and dry needling.

Methods: The study allocated 110 patients into groups using online randomization software. After completing the Patient-rated Tennis Elbow Evaluation (PRTEE), patients in group I received dry needling, whereas those in group II received first-line treatment, consisting of ibuprofen 100 mg twice a day and a proximal forearm brace. The patients were evaluated after three weeks and six months.

Results: The study ultimately analyzed 92 patients. Although both treatment methods were effective at three weeks, dry needling was significantly more effective than the first-line treatment at six months.

Conclusion: Because of the low complication rate, dry needling is a safe method, and it might be an effective treatment option for LE.

Keywords: Dry needling; Lateral epicondylitis; Needling therapy; Tennis elbow.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Braces
  • Female
  • Humans
  • Ibuprofen / therapeutic use
  • Injections
  • Male
  • Middle Aged
  • Pain Management / adverse effects
  • Pain Management / methods*
  • Pain Measurement
  • Prospective Studies
  • Tennis Elbow / therapy*
  • Treatment Outcome
  • Trigger Points / injuries*


  • Anti-Inflammatory Agents, Non-Steroidal
  • Ibuprofen