Efficacy of Dry Needling Combined with Eccentric Exercise Versus Oral and Topical NSAID Treatment in Patients with Tennis Elbow: A Randomized Controlled Trial

Abstract

The study aimed to compare the effects of a combined intervention of dry needling and eccentric exercises versus oral and topical NSAID treatment, each combined with eccentric exercises, on pain intensity and hand function in patients with lateral epicondylalgia. A total of 111 participants with LE were randomly assigned to three groups: Dry needling plus eccentric exercise, oral treatment plus eccentric exercise, and Topical treatment plus eccentric exercise. Pain intensity was assessed using the Visual Analog Scale and pressure pain threshold at the lateral epicondyle, medial epicondyle, radial styloid, and ulnar styloid. Functional impairment was measured using the HAND10 questionnaire. Statistical analysis included repeated measures ANOVA and post-hoc tests. All groups showed significant improvements in pain intensity and function over the 30-day intervention period The DN group achieved the most substantial reduction in pain and the greatest improvement in pressure pain threshold and functional scores, followed by the TopA group. The OralI group demonstrated the least improvement across all measures. Significant differences were found between the three groups,with the dry needling group outperforming both Oral and Topical treatment groups in pain relief and functional outcomes. The combination of dry needling and eccentric exercises was more effective in reducing pain and improving hand function compared to NSAID-based interventions. These findings support the use of dry needling as an adjunct therapy to eccentric exercises for the management of lateral epicondylalgia.