Efficacy of Dry Needling in the Treatment of Lateral Epicondylitis
Condition: Tennis Elbow; Dry Needling
MeSH terms: Tennis Elbow
Study type: Interventional

Summary: 
      Lateral epicondylitis is painful tendinosis of the main extensor tendon that occurs at the
      fibro-osseous junction of the outer elbow region. Histopathological samples in patients with
      chronic lateral epicondylitis show that there is angiofibroblastic degeneration and failure
      in the normal tendon repair process rather than acute inflammation in this region. It has
      begun to be accepted that the main factor in lateral epicondylitis is not the inflammatory
      events but the degenerative process. There are many treatment methods that trigger structural
      healing in tendinopathies.

      In this study, the investigators aimed to evaluate the effect of the dry needling method of
      the lateral epicondyle region.
    

Detailed description: 
      Lateral epicondylitis occurs as a result of micro-tears and progressive degeneration caused
      by repetitive tension, especially at the attachment of the main extensor tendon to the
      lateral epicondyle. The treatment modality to be used, which causes an increase in functional
      cells, can prevent the apoptotic process; Thus, it is suggested that there are methods that
      can reconstruct tendon structure and function. Inflammation can have a positive effect on the
      healing process in the treatment of lateral epicondylitis. Methods such as prolotherapy and
      platelet-rich plasma therapy are among the methods that trigger the inflammation process in
      the lateral epicondyle region and subsequently contribute to the regeneration process. In all
      these treatments, there is evidence that the local healing process is triggered by the
      'needle effect'.

      Dry needle therapy is a method that has been widely used in musculoskeletal diseases for many
      years, and it is one of the safe and cost-effective applications.

      In this study, the investigators planned to evaluate the clinical efficiency of dry needling
      of lateral epicondyle area those are the origin of the extensor muscle groups of the wrist in
      addition to the home exercise program and to compare the groups in terms of pain severity,
      functionality, and improvement in handgrip strength with the participants applied for the
      only home exercise program.
    

Intervention name(s): Dry needling; Home exercise program
Intervention type(s): Other; Other
Intervention description(s): Three sessions dry needling of lateral epicondyle region, once per week with disposable acupuncture needles (0.25x25mm).; All participants will start the home exercise program during the study period consisting of range of motion exercises for wrist flexion, extension, ulnar and radial deviation, elbow flexion and extensor; forearm supinator, and pronator muscles; stretching exercises. Eccentric strengthening of the wrist flexor extensors, ulnar and radial deviation, forearm pronation, supination, and strengthening exercise training will be given to the elbow extensors and flexors. Progressive strengthening exercises will be added to the program. The exercise program will be terminated with stretching exercises. The exercises will be performed for 10 repetitions 2 times a day, stay in each position for 10 seconds, and rest for 30 seconds between periods. Both groups will be advised to continue the exercise program for 12 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Lateral epicondylitis; Dry needling; Pain