Tennis Elbow: Why Dry Needling Might Beat the Anti-Inflammatories
Tennis elbow, have you had it, or know someone who has?
Despite the name, most people who get it have never picked up a racquet. Lateral epicondylalgia (its proper name) shows up in tradies, office workers, gardeners, and gym-goers just as often as tennis players - anyone doing repetitive gripping, lifting, or wrist extension. It affects around 1-3% of the general population, but that jumps to 15% in people doing repetitive manual work (Sánchez-Milá et al., 2025).
What is actually going on?
Tennis elbow is pain and irritation at the tendons on the outside of your elbow, where your wrist extensor muscles attach to the lateral epicondyle. It flares up with gripping, lifting, resisted wrist extension, or even just shaking someone’s hand. Left untreated it can hang around for months and quietly limit the things you do every day - opening jars, turning a doorknob, carrying the shopping.
The research
A study published this year in the Journal of Evidence-Based Integrative Medicine put three approaches to the test in 111 people with tennis elbow over 30 days: dry needling plus eccentric exercise, oral anti-inflammatories (NSAIDs) plus eccentric exercise, or topical anti-inflammatory gel plus eccentric exercise.
Everyone improved. But the dry needling group came out on top by a clear margin - the greatest reduction in pain, the biggest improvement in pressure pain thresholds, and the best functional outcomes on the HAND10 questionnaire (things like gripping, lifting, turning a tap, doing up buttons). The topical gel group came in second, and the oral anti-inflammatory group improved the least across the board (Sánchez-Milá et al., 2025).
What can you do to help yourself?
Eccentric exercise was part of every group in this study, and it’s the one thing that mattered across the board. Slow, controlled lengthening of the wrist extensor muscles - think slowly lowering a light weight held in your hand, wrist bending downward, then using your other hand to reset it - done in small sets, most days, is one of the best-supported ways to load and strengthen the tendon.
Dry needling to the affected muscles can be a really useful add-on to that exercise programme based on what this research is showing, and it’s something we use here at MotionPlus alongside a tailored eccentric loading plan.
If your elbow pain has been hanging around, don’t just reach for the anti-inflammatories and hope. Get it assessed properly - come in and we’ll figure out what’s driving it and build you a plan.
Tennis elbow isn’t the only repetitive strain issue we see a lot of in clinic - if sore thumbs from your phone or gaming sound familiar too, have a read of Text Thumb.
This is not medical advice, and if pain carries on go see your local practitioner.
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References list.
Sánchez-Milá, Z., Abuín-Porras, V., Fidalgo-Gómez, H., Mínguez-Esteban, I., Almazán-Polo, J., & Velázquez-Saornil, J. (2025). Efficacy of Dry Needling Combined with Eccentric Exercise Versus Oral and Topical NSAID Treatment in Patients with Tennis Elbow: A Randomized Controlled Trial. Journal of Evidence-Based Integrative Medicine, 30. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC12254548/