Elbow Pain · Dry Needling · East Setauket, NY
It starts as a twinge when you lift a coffee mug or shake hands, and before long, turning a doorknob or gripping a hammer hurts. Tennis elbow and golfer's elbow are among the most common overuse problems we see, and most people who have them have never played tennis or golf. This guide explains how to tell the two apart, what the research says about dry needling and acupuncture, why strengthening still does the heavy lifting, and what recovery realistically looks like.
Can Dry Needling Help Tennis Elbow?
Research suggests it can. A 2024 meta-analysis in Archives of Physical Medicine and Rehabilitation found dry needling improved pain within the first week, along with function and grip strength, in people with tennis elbow. Golfer's elbow has less direct research, but is treated on similar principles.
Dry needling works best as part of a plan that includes load management and progressive strengthening, not as a standalone fix. The good news: according to the American Academy of Orthopaedic Surgeons, about 80 to 95% of people with tennis elbow get better without surgery.
Tennis Elbow or Golfer's Elbow?
Both are tendinopathies: overuse problems where forearm muscles attach to the elbow by tendons. The location of the pain is the quickest way to tell them apart.
| Tennis elbow | Golfer's elbow | |
|---|---|---|
| Where it hurts | Outer side of the elbow, over the bony bump | Inner side of the elbow, may spread down the forearm |
| Tendons involved | Wrist and finger extensors on the back of the forearm | Wrist flexors on the palm side of the forearm |
| Worse with | Gripping, lifting palm-down, turning a wrench, shaking hands | Gripping, flexing the wrist, swinging, throwing |
| Medical name | Lateral epicondylitis or lateral elbow tendinopathy | Medial epicondylitis |
Both usually come on gradually, over weeks to months, without a single injury, and the dominant arm is most often affected. Weak grip and pain at night can happen with either.
Who Gets It? Not Just Athletes
According to the AAOS, tennis elbow is most common between ages 30 and 50, and painters, plumbers, carpenters, cooks and auto workers get it more often than the general population. Around Three Village and the North Shore we see it in contractors and tradespeople, office workers after a long stretch on the mouse, parents carrying car seats, weekend gardeners, pickleball and tennis players, golfers and climbers. It can also appear without any obvious repetitive cause.
What Does the Research Say?
| Study | What it found |
|---|---|
| Arch Phys Med Rehabil, 2024 | Dry needling showed good effects on pain (within one week), function and grip strength in tennis elbow. Trigger-point techniques that produced a local twitch response appeared important. |
| J Hand Surg Am, 2024 network meta-analysis | No treatment clearly beat placebo in the short term. In the midterm, physiotherapy and exercise showed benefit; dry needling, injections and other options showed potential but need more research. |
| J Evid Based Integr Med, 2025 | Compared dry needling combined with eccentric exercise against anti-inflammatory medication for tennis elbow. |
| JOSPT, 2022 clinical guideline | The physical therapy clinical practice guideline on lateral elbow pain centers care on education, load management and exercise. |
An honest summary
Dry needling is a reasonable option for tennis elbow, with some of the clearest short-term pain benefits among hands-on treatments. Exercise remains the foundation. Research on golfer's elbow specifically is limited, so we apply the same principles with realistic expectations.
How Dry Needling and Acupuncture May Help
Dry needling places fine, sterile, single-use needles into tight, tender bands in the forearm muscles, often producing a brief twitch as the muscle releases. Acupuncture uses similar needles placed according to traditional and anatomical point selection, sometimes with electroacupuncture. Both may help by calming pain signaling and relaxing overworked muscles so you can load the tendon comfortably.
Does a twitch "reset" the muscle or rebuild the tendon?
No. A twitch response is a sign the needle reached an active trigger point, and research suggests it matters for results, but it does not repair the tendon. Tendons adapt to gradual, progressive loading over weeks to months. Needling and acupuncture are best thought of as tools that make that loading more comfortable.
Why Strengthening Still Matters
Tendons get stronger when they are loaded gradually. Most successful plans for tennis and golfer's elbow include:
- Isometric holds early on, pushing against resistance without moving, which many people find eases pain.
- Slow, controlled wrist exercises with a light weight or band, progressing over weeks. Eccentric (lowering) exercises are common, but they are not the only option that works.
- Grip and forearm work, plus shoulder and upper back strength, which supports the whole arm.
The AAOS provides a free therapeutic exercise program for lateral and medial epicondylitis. Your physician or physical therapist can tailor it to you.
What You Can Do Now
Ease the load, don't stop moving
Cut back on the gripping and lifting that flare it for a few weeks, but keep the arm gently active.
Lift palm-up
Carry bags, pans and boxes with your palm facing up or with both hands to spare the outer elbow tendons.
Try a counterforce brace
A strap just below the elbow can reduce strain on the tendon during activity.
Check your equipment
Thicker tool handles, a lighter racquet, looser strings or a softer mouse can all help.
Ice after flare-ups
An ice pack wrapped in a cloth for up to 20 minutes can ease soreness after activity.
Start gentle exercises
Pain-free isometrics and wrist exercises, progressed slowly. Mild discomfort that settles by the next day is usually acceptable.
What Treatment at Messina Acupuncture Looks Like
- First visit · about 75 minutes
Assessment
Where it hurts, what movements provoke it, grip strength, neck and shoulder involvement, work and sport demands. If anything suggests nerve involvement, a tear or another problem, we refer you for imaging or medical evaluation.
- Treatment
Needling plus hands-on care
Dry needling or acupuncture to the forearm and related muscles, sometimes with electroacupuncture, cupping or medical massage.
- Home plan
Load and exercise guidance
Activity changes and a simple strengthening progression, coordinated with your physical therapist if you have one.
- Follow-ups · 45 to 60 minutes
Track grip and function
We retest grip strength and the movements that hurt to see what is changing, then adjust or refer as needed.
Read how to prepare for your first visit and is dry needling safe?
When Elbow Pain Needs a Doctor
Possible Injury
- Pain after a fall or a pop with sudden weakness
- Visible deformity or major swelling
- Can't bend or straighten the elbow
- Redness, heat and fever around the joint
Needs Evaluation
- Numbness or tingling in the fingers
- Pain that is not improving after several weeks of care
- Night pain that wakes you regularly
- Symptoms in both elbows with other joint pain
Typical Overuse Pattern
- Gradual onset with gripping or lifting
- Tender over the outer or inner elbow bump
- Full elbow movement
According to the AAOS, surgery is generally considered only if symptoms do not respond after 6 to 12 months of nonsurgical treatment.
Messina Acupuncture PC is an orthopedic-focused practice at 100 N Country Road in East Setauket, seeing patients from Stony Brook, Port Jefferson, Port Jefferson Station, Centereach, Lake Grove, Miller Place and across Long Island's North Shore.
Care is led by Daniel Messina, MSOM, L.Ac., a New York State Licensed Acupuncturist and NCCAOM Board-Certified Diplomate, in practice since 2016. Meet the Messina Acupuncture team. All treatment uses sterile, single-use needles.
Frequently Asked Questions About Tennis and Golfer's Elbow
Does dry needling work for tennis elbow?
Research suggests it can. A 2024 meta-analysis found dry needling improved pain within the first week, along with function and grip strength. It works best combined with load management and strengthening exercises.
What is the difference between tennis elbow and golfer's elbow?
Tennis elbow causes pain on the outer side of the elbow and involves the wrist extensor tendons. Golfer's elbow causes pain on the inner side and involves the wrist flexor tendons. Both are overuse tendon problems.
Can you get tennis elbow without playing tennis?
Yes. Most people with tennis elbow do not play tennis. Painters, plumbers, carpenters, cooks, office workers and anyone who grips or lifts repeatedly can develop it.
Does dry needling help golfer's elbow?
There is less research on golfer's elbow than tennis elbow, but it is treated on similar principles: needling to ease pain and muscle tension, combined with gradual strengthening.
How many dry needling sessions will I need for tennis elbow?
It varies. Many people notice some change within a few sessions, but tendons take weeks to months to adapt. We reassess grip strength and function as we go and adjust the plan.
Does dry needling heal the tendon?
No. Dry needling may ease pain and muscle tension, but tendons strengthen through gradual, progressive loading. That is why exercise is part of every plan.
Is acupuncture or dry needling better for tennis elbow?
Both use fine needles. Dry needling targets trigger points in the forearm muscles and has the most tennis-elbow research. Acupuncture uses broader point selection and may be combined with electroacupuncture. Your practitioner may use both.
Should I rest tennis elbow completely?
Not completely. Reduce the activities that flare it, but keep the arm gently active and start pain-free exercises. Complete rest can leave the tendon weaker.
How long does tennis elbow take to heal?
Many cases improve over several months with conservative care. The AAOS reports that 80 to 95% of people improve without surgery, which is usually considered only after 6 to 12 months of nonsurgical treatment.
When should I see a doctor for elbow pain?
See a doctor for pain after a fall, sudden weakness, deformity, numbness or tingling in the fingers, fever with redness, or pain that is not improving after several weeks.
Where can I get dry needling for tennis elbow near Stony Brook?
Messina Acupuncture PC in East Setauket, a short drive from Stony Brook, Port Jefferson and Smithtown, offers dry needling and acupuncture for tennis and golfer's elbow. Call 631-403-0504.
Get Your Grip Back With a Plan That Works
From contractors to pickleball players, our East Setauket team combines dry needling, acupuncture and a practical strengthening plan to help you get back to work and play.
Sources and Further Reading
- AAOS OrthoInfo: Tennis Elbow (Lateral Epicondylitis)
- AAOS: Therapeutic Exercise Program for Lateral and Medial Epicondylitis (PDF)
- Archives of Physical Medicine and Rehabilitation (2024): Dry needling for lateral epicondylitis, meta-analysis
- Journal of Hand Surgery (2024): Interventions for lateral elbow tendinopathy, network meta-analysis
- J Evid Based Integr Med (2025): Dry needling with eccentric exercise vs NSAIDs for tennis elbow
- JOSPT (2022): Lateral Elbow Pain and Muscle Function Impairments, clinical practice guideline
- JOSPT (2017): Trigger point dry needling for musculoskeletal conditions, systematic review