Lateral epicondylitis, or tennis elbow, is a painful condition affecting the forearm tendons that attach to the bony prominence on the outside of the elbow. Classified as an overuse injury, it results from repetitive strain and micro-tears, most often in the extensor carpi radialis brevis. While rest and physical therapy are standard approaches, many explore complementary methods like acupuncture to manage persistent discomfort. This traditional technique involves inserting fine needles into specific body points, and its potential to relieve musculoskeletal pain is under investigation. The question is whether acupuncture offers a viable path to relief for this specific and often chronic condition.
How Acupuncture Intervenes in Tendon Pain
Acupuncture exerts its effects on chronic tendon injuries through local and systemic responses. Locally, needle insertion stimulates microcirculation, enhancing blood flow to the injured tendon tissue. Increased circulation is important because poorly vascularized tendons rely on this mechanism to deliver oxygen and nutrients for healing and to clear inflammatory byproducts.
The stimulation also triggers neurological responses that modulate the perception of pain. Acupuncture stimulates the nervous system to release endogenous opioids, such as endorphins and enkephalins, which are the body’s natural pain-blocking chemicals. This release provides an analgesic effect that helps reset the nervous system’s pain thresholds, offering relief from the chronic pain characteristic of tennis elbow.
Furthermore, the needling process can initiate anti-inflammatory responses and help relax muscles that may be tight due to the overuse injury. By reducing inflammation and muscle tension, acupuncture aims to lessen the mechanical stress on the injured tendon attachment. These physiological actions address both the pain symptoms and the underlying tissue repair challenges inherent in chronic tendon conditions.
Clinical Research on Efficacy for Tennis Elbow
Clinical studies on acupuncture for lateral epicondylitis suggest it offers a benefit, especially in the short term. Research indicates that acupuncture provides statistically significant pain relief compared to a placebo, with some studies noting a substantial reduction in pain. This immediate relief is often a primary goal for patients dealing with persistent elbow pain.
However, the overall scientific consensus on its long-term functional improvement remains complex. Systematic reviews often highlight that studies on acupuncture for tennis elbow have a high risk of bias or lack methodological robustness for definitive conclusions. Evidence for recovery and long-term efficacy has been described as low in some analyses, often due to small patient numbers and varied study designs.
Studies comparing true acupuncture to sham acupuncture (where needles are inserted superficially or in non-acupuncture points) yield mixed results regarding long-term outcomes. While some trials show a clear advantage over sham treatment for immediate pain scores, others find no notable difference after a few months. This suggests that a portion of the relief may be due to the placebo effect, though true acupuncture often demonstrates superior short-term pain relief.
Acupuncture is often recommended as an adjunctive treatment, used in addition to conventional therapies like physical therapy. This combination approach has shown benefits in some trials, though isolating the exact contribution of the acupuncture can be difficult. Current evidence suggests acupuncture is a reasonable option for patients who have not responded well to standard treatment or for those seeking a non-pharmacological method for pain reduction.
What to Expect During Acupuncture Treatment
A typical acupuncture session begins with a review of your medical history and an assessment of the injury. The practitioner selects specific acupuncture points, often including local points around the outer elbow and forearm, as well as distant points on the hand or leg. These distant points are chosen based on their traditional connection to the affected meridians or energy pathways.
The acupuncturist will insert very thin, sterile needles into the chosen points. The sensation is usually minimal, often described as a mild tingling, a dull ache, or brief pressure, rather than sharp pain. The needles are typically left in place for 15 to 30 minutes, during which time the patient is encouraged to relax.
For chronic conditions like tennis elbow, a single session is unlikely to provide lasting relief. A course of treatment usually involves multiple sessions, commonly once or twice a week. Patients may receive an average of six treatments over three weeks, though the total number depends on the severity and duration of the condition.
Acupuncture is considered safe when performed by a licensed practitioner. Side effects are minimal and may include minor soreness or bruising at the needle insertion sites. Patients are often advised to rest the arm for a day after a session to extend the therapeutic benefits.