Tennis elbow (medically known as lateral epicondylitis) can make simple tasks like lifting a coffee mug, turning a doorknob, or typing on a keyboard excruciating. For many residents in East Setauket, Stony Brook, and across Suffolk County, this nagging pain limits work, hobbies, and daily life.
Many patients try the standard route first: ice, rest, ibuprofen, and maybe a brace. While these methods might dull the pain temporarily, they often fail to fix the underlying problem. The moment you go back to typing or gripping, the pain returns.
This is where dry needling comes in. Unlike passive treatments that just mask symptoms, dry needling targets the root cause: the tight, dysfunctional muscle tissue pulling on your elbow. At Messina Acupuncture, treating orthopedic conditions like tennis elbow is a cornerstone of our practice. In this comprehensive guide, we explain the anatomy of the injury, how dry needling stimulates actual tissue repair, and why it is often more effective than cortisone shots.
Understanding the Anatomy: It’s Not Just for Tennis Players
Despite the name, you don’t need to play tennis to suffer from tennis elbow. In fact, fewer than 5% of diagnoses are related to the sport. Most of our patients in East Setauket are office workers, carpenters, landscapers, or nurses.
The Real Culprit: The ECRB Muscle
Tennis elbow is technically an overuse injury of the extensor tendons in your forearm, specifically the Extensor Carpi Radialis Brevis (ECRB). This muscle is responsible for stabilizing your wrist when your elbow is straight—like when you are holding a steering wheel, using a mouse, or carrying a grocery bag.
When this muscle is overworked, two things happen:
- Trigger Points Form: The muscle fibers contract and get stuck, forming localized “knots” or trigger points. These knots shorten the muscle, creating constant mechanical tension on the tendon.
- Tendinosis (Degeneration): The constant pulling causes micro-tears in the tendon where it attaches to the elbow bone (the lateral epicondyle). Because tendons have poor blood supply, they don’t heal easily. Instead of repairing, the collagen structure begins to break down.
This is why rest often doesn’t work. You can rest the arm for weeks, but if the muscle belly is still tight and shortened (due to trigger points), the tension remains on the tendon 24/7.
How Dry Needling Fixes the Problem
Dry needling is a targeted medical intervention designed to reset the muscle and restart the healing process. It works through three distinct physiological mechanisms:
1. The Mechanical Reset (The “Twitch”)
When we insert a fine filament needle directly into the trigger point of the ECRB muscle, it typically elicits a Local Twitch Response (LTR). This is a quick, involuntary spinal reflex where the muscle fibers contract and then immediately release.
Think of this like hitting “Ctrl-Alt-Delete” on a frozen computer. The twitch forces the muscle to let go of its chronic contraction. Once the muscle lengthens, the tension on the painful elbow tendon is instantly reduced.
2. Chemical Flush
Muscles with trigger points are essentially starving. They are acidic and full of inflammatory chemicals (like Substance P and CGRP). Research shows that immediately after a twitch response, the chemical environment of the muscle changes. The pH normalizes, and blood flow returns, flushing out the pain-causing chemicals.
3. Collagen Repair (Angiogenesis)
This is crucial for chronic cases. By creating a precise “micro-injury” with the needle, we trigger the body’s immune system to respond. This stimulates fibroblasts to lay down new collagen and encourages angiogenesis (the formation of new blood vessels). essentially, we are turning a chronic, stagnant injury back into an acute healing event so your body can finally fix it.
Dry Needling vs. Cortisone Shots: Which is Better?
Many patients come to us after being offered a cortisone injection. While cortisone is a powerful anti-inflammatory that can eliminate pain quickly, it comes with risks.
Recent studies suggest that while steroids provide short-term relief (4–6 weeks), they may actually inhibit collagen repair in the long term, leading to higher recurrence rates and weaker tendons. Dry needling takes longer to work (usually a few sessions), but it focuses on regeneration of the tissue rather than suppression of symptoms. It has no negative impact on tendon strength, making it a safer long-term solution.
What to Expect During a Session at Messina Acupuncture
If you have never had dry needling, it’s normal to be nervous. Here is a step-by-step walkthrough of what a treatment looks like in our East Setauket clinic.
Step 1: The Palpation Exam
We start by feeling the muscles in your forearm, triceps, and shoulder. We are looking for “taut bands”—areas that feel ropey or hard. We will press on these spots to reproduce your pain (confirming we found the source).
Step 2: The Treatment
We use a sterile, single-use monofilament needle. You typically won’t feel the needle penetrate the skin. When we reach the trigger point, you may feel a deep ache or a “cramping” sensation, followed by the twitch. This sensation lasts only a second.
Step 3: Comprehensive Care
We rarely treat the elbow in isolation. Tennis elbow often involves the shoulder and neck (the “kinetic chain”). We may needle points in the triceps or upper back to ensure the entire arm is functioning correctly. We might also incorporate acupuncture points to lower systemic pain levels.
What Does the Research Say?
Dry needling is not pseudoscience; it is backed by robust clinical data. A study published in the Journal of Orthopaedic & Sports Physical Therapy examined patients with chronic lateral epicondylitis.
The results were clear: Patients who received dry needling showed significantly greater reductions in pain and disability scores compared to the control group. Furthermore, grip strength—a key indicator of recovery—improved faster in the dry needling group.
Complementary Therapies for Faster Results
At Messina Acupuncture, we believe in a multi-modal approach. To speed up your recovery, we often combine dry needling with:
- Electro-Acupuncture: Running a gentle electric current through the needles can reduce pain signals to the brain and further relax the muscle.
- Medical Massage: Soft tissue mobilization helps break up fascial adhesions on the surface that the needles might miss.
- Cupping Therapy: This draws fresh blood to the area to support the healing response triggered by the needles.
Home Rehab: The “Messina Method” for Prevention
We don’t just want to fix you; we want you to stay fixed. Once the acute pain has subsided (usually after 3-5 sessions), we will guide you through a home care plan.
1. Eccentric Loading (The Tyler Twist)
Research shows that eccentric exercise (lengthening the muscle under load) is the best way to remodel tendon tissue. We may teach you how to use a FlexBar or a light dumbbell to strengthen the tendon without irritating it.
2. Ergonomic Adjustments
If you work at a desk in Port Jefferson or Stony Brook, small changes make a big difference:
- Vertical Mouse: Switching to a vertical mouse puts your forearm in a neutral “handshake” position, taking the pressure off the ECRB muscle.
- Keyboard Tray: Ensure your elbows are at 90 degrees or slightly open, not scrunched up.
Signs Dry Needling is Right for You
How do you know if you are a candidate? If you answer “yes” to these questions, dry needling is likely the solution:
- Does your pain get worse when gripping (e.g., shaking hands, lifting a gallon of milk)?
- Can you press on a specific tender spot in your forearm muscle that refers pain to the elbow?
- Have you tried resting for weeks, only for the pain to return immediately upon activity?
- Are you looking to avoid surgery or steroid injections?
Recover in East Setauket with Expert Care
Tennis elbow doesn’t have to be a permanent sentence. You rely on your hands for everything—don’t let pain limit your life. At Messina Acupuncture, Daniel Messina is dedicated to providing cutting-edge orthopedic care that gets results.
We work with you to build a personalized plan that addresses both pain relief and long-term function, helping you get back to the activities you love.
Ready to start your recovery?
Visit us at 100 N Country Road, Setauket, NY 11733.
Call 631-403-0504 today or book your appointment online.
Disclaimer: The information provided here is for educational purposes only and is not a substitute for professional medical advice. Always consult your doctor regarding your specific condition.
