Suffer from elbow pain? acupuncture can help

Tennis elbow has many alternative names including lateral elbow pain, lateral epicondylitis, rowing elbow, tendonitis of the common extensor origin, and peritendinitis of the elbow. It can affect sufferer’s work and quality of life. Tennis elbow is common and affects up to 3% of the population and it is characterised by pain and tenderness over the outer part of the elbow and pain on resisted dorsiflexion of the wrist, middle finger, or both. This is caused by an overuse injury of the extensors of the forearm which attach at the lateral epicondyle. Patients with tennis elbow are typically over 40 year old and have a history of repetitive activity during work or recreation. Non steroids pain killers and steroids injection have short term effects in improving symptoms such as pain reduction, global improvement, and grip strength compared with placebo and other conservative treatments. Physiotherapy is commonly used though there is lack of evidence of efficacy.

Acupuncture is an appropriate option for tennis elbow treatment. Previous research showed acupuncture had short term benefit (three days to two months) in pain reduction. The longer term effect still needs to be studied. More recently a study published in a Chinese acupuncture journal. 34 patients with tennis elbow were in two groups for acupuncture treatment in different acupuncture points. Group A was used anti-Ashi-points (points of pain relief or disappearance after local press) and group B was used Ashi-points (pain spots) and surrounded points. Acupuncture was performed once in every two days; 2 courses treatment was given with 10 treatments for 1 course. The effect was assessed at the end of the treatment day, the 7th day, the 30th day, the 6th months and one year after treatment. They found that short term effect was better for group A than group B, but the long term effect (6 months and one year) were similar between the two groups.

Another study analysed the effectiveness of acupuncture on lateral elbow pain (LEP). By comparison of acupuncture and sham acupuncture treatment, patients with LEP received acupuncture treatment had significantly more reduction in pain and greater improvement in elbow mobility, more strength in the arm. There was immediate effect after acupuncture treatment and the effect last for 2 weeks followup period.

By comparison of acupuncture and conventional treatment, it was found from those studies that the acupuncture group had a significantly higher cured rate than conventional therapy, including prednisolone injection, triamcinolone acetonide, lidocaine injection. At 6 month followup, Acupuncture group had significant reduction in VAS pain score when compared with the group that received pulsated ultrasound and massage. Study has shown there was no significant difference between moxibustion and conventional treatment.

By comparison of acupuncture plus moxibustion combination and acupuncture alone, one study has suggested combination of acupuncture with moxibustion had better pain reduction and another study has shown that electro acupuncture had better pain reduction, but there was no clear conclusion because of poor methodology.

About adverse effects, there was no adverse effect reported in acupuncture treatment. One case of permanent scar from blister was reported in moxibustion treatment.

Clinically there were some cases that patients with tennis elbow were completely cured after acupuncture treatments.

Here are some success stories for elbow pain with acupuncture treatment. For example, Lisa who was 42 years of age was diagnosed with tennis elbow for 5 years. Her right elbow pain became persistent after a few years. This affected her daily life. She had terrible pain in her arms around the elbow whenever she used the arm. She tried everything she could to get rid of the pain without success. A friend told her to try acupuncture which she did. After first session of acupuncture, she felt less painful immediately. She was encouraged so much and continued to do a few sessions. She felt much better and could use the arm without feeling too much pain. She did a few more sessions again. The pain was completely gone. After a few years a follow up showed that there was no recurrence of the elbow pain.

Sarah was 50 year old. She had left elbow pain for 10 years. Initially the pain stayed at the lateral part of the elbow and the pain came and went. However the pain spread later to the medial part of the elbow, to the front and the back of the forearm and the arms as well. The pain was getting worse. She could not do anything using the left arm such as writing, combing hair or lifting arm (Because she was left-handed, this causes more problems for her). The examination showed pain at the lateral and medial part of the elbow when she was doing elbow extension and flexion, left arm lifting, left wrist extension and flexion. There were highly sensitive tender points around the elbow. This was a typical case of soft tissue injury around the left elbow or so called tennis elbow. Acupuncture was effective for this case. After a few sessions of acupuncture treatments, she could do things using her left arm without feeling too much pain. With continuing a few sessions of treatments the pain was gone completely. 1 year follow up showed there was no pain at all. She could use the left arm do anything as the right arm. Examination showed there was no pain when she was doing the left elbow extension, flexion or arm lifting. There were no tender points around the elbow.

Acupuncture help relieve symptoms of tennis elbow. It stimulates nerve ends leading to release of analgesic substances such as endorphins to relive the pain. It also reduces inflammation by improving local circulation. It also improves muscle stiffness and joint mobility by increasing local microcirculation.

References
Johnson GW et al Am Farm Physician (2007) 76:843-8
Wan X Zhongguo Zhen Jiu (2011) 31:1078-80
Gadau M et al BMC Complement Altern Med (2014) 14:136