Ask the Doctors - Can acupuncture ease the pain of tennis elbow?

Dr. Robert Ashley, MD

Dear Doctor: I have played tennis for many years, but have been unable to play over the last year, due to tennis elbow. Does acupuncture help with tennis elbow?

Lateral epicondylitis, or tennis elbow, is a tendon inflammation at the elbow. You don’t have to play tennis to develop the condition, but the specific motion of hitting a ball with a tennis racket is an effective way of doing so. There are many different types of treatment for tennis elbow, including anti-inflammatory medications, physical therapy, ultrasound, platelet rich plasma injections, and steroid injections.

As for acupuncture, a 2005 review of four studies published in the British Journal of Sports Medicine attempted to answer the question you now ask. One of the studies found significant pain relief with acupuncture compared with placebo. Overall, reduction of pain was 55.8 percent in the acupuncture group and 15 percent in the placebo group. However, another study showed an immediate improvement of symptoms with acupuncture after 2 weeks, but no difference after 2 months compared to placebo. Lastly, a study comparing acupuncture to ultrasound therapy for tennis elbow found no difference between the two treatments. Overall, the authors concluded that acupuncture was helpful for tennis elbow, but it did not have a sustained response, lasting only 2-8 weeks.

A 2015 study combined results from six different studies. Two of the studies compared real acupuncture with sham acupuncture, which involves placing the needle in non-traditional acupuncture points at random. The authors found a benefit with standard acupuncture compared to sham acupuncture. That review also found that acupuncture with electrical stimulation was beneficial, while another study using acupuncture with electrical stimulation did not.

One other review from 2002 showed that acupuncture for tennis elbow did have immediate benefit for tennis elbow, but the authors could not conclude a long term benefit.

Now, I have to acknowledge that I’ve been performing acupuncture for tennis elbow for the last 12 years and have seen that the treatment has been beneficial for the majority of patients. I have treated these patients with non-traditional acupuncture points at the tendon insertion of the elbow and have used electrical stimulation. I also add additional traditional acupuncture points. It is difficult for me to assess how much of the benefit is from the acupuncture , how much is from physical therapy and how much is just the tincture of time. The studies do appear to show pain relief, but I feel that acupuncture should be combined with physical therapy. In summary, acupuncture is one of many modalities that can help the pain of tennis elbow.

Robert Ashley, MD, is an internist and assistant professor of medicine at the University of California, Los Angeles.

Ask the Doctors is a syndicated column first published by UExpress syndicate.