A 2018 study concludes that acupuncture is an effective therapeutic method for the alleviation of tennis elbow (lateral epicondylitis). Researchers at Hubei Hanjiang Hospital compared two Traditional Chinese Medicine (TCM) protocols. Group 1 used acupuncture plus moxa (a heat treatment). Group 2 used electroacupuncture and rehabilitation training. Both protocols were effective, but Group 2 outperformed Group 1. Let’s take a look at this elbow pain acupuncture research in detail.
Lateral Epicondylitis
Tennis elbow is a chronic inflammatory condition affecting the muscles and tendons of the forearm. They become weakened or damaged from overuse or trauma. Tennis elbow presents as pain on the outside of the elbow. The pain is worse with gripping and when the forearm is extending (as when twisting a towel or sweeping the floor). Mild cases cause tenderness on the outer elbow. Severe cases can dramatically affect a patient’s daily activities and quality of life.
Acupuncture Results
Patients treated with electroacupuncture plus rehabilitation training (Group 2) had a total treatment effective rate of 90.0%. Using warm needle acupuncture (acupuncture plus moxibustion), the effective rate was 76.7%. Electroacupuncture outperformed warm acupuncture by 13.3%.
The electroacupuncture group had a mean Mayo Elbow Performance Score (MEPS) of 6.56 ±2.15 before treatment and 4.41 ±1.68 after treatment, indicating substantial improvement in elbow function. Alternatively, the warm needle acupuncture group had a mean MEPS of 6.64 ±1.98 before treatment and 5.39 ±1.85 afterwards, showing a less dramatic improvement in elbow function.
Study Participants
Sixty patients with tennis elbow participated in the elbow pain acupuncture research study. They were randomly divided into two groups of 30, the electroacupuncture group and the warm needle acupuncture control group. Both groups received treatment on same acupuncture points.
Both groups had similar demographics. The control group had 17 males and 13 females, with a mean age of 38 years and mean injury duration of 7 months. For the treatment group, there were 16 males, 14 females, the mean age was 39 years and the mean injury duration was also 7 months. The following primary acupuncture points were used in the treatments:
Acupuncture Treatment
The following primary acupuncture points were used in the treatments:
- LI10 (Shousanli)
- LI11 (Quchi)
- LI13 (Shouwuli)
- Ashi points (points of tenderness around the elbow)
All needles were sterile and single use. Upon insertion, a “deqi” sensation was obtained (slight achy feeling around the needle). Patients received acupuncture once a day for 6 days, for a total of 4 weeks.
[Editor’s Note: This treatment frequency is common in China, but not in the US. At Raleigh Acupuncture we treat tennis elbow patients once a week and get excellent results after 4 to 7 treatments. ]
For Group 1, the warm acupuncture group, a 2 cm moxa roll was attached to the end of each needle and ignited. The skin surrounding the acupuncture points was covered with custom-made cards to prevent falling moxa ashes from irritating the skin. Treatments lasted 30 minutes.
For Group 2, an electroacupuncture machine was connected to LI10 and Ashi points. A dense-disperse wave was used with an intensity level set to patient tolerance levels. Electroacupuncture was applied once a day for 30 minutes. The following protocol was used for rehabilitation training:
Rehabilitation Training for Elbow Pain
The following protocol was used for rehabilitation training:
- Relaxing exercise: Patients were asked to contract the forearm muscle to the point of discomfort and then relax it again. This exercise was repeated several times.
- Passive stretching exercise: Exercise began with patients in a seated position. The therapist held the patient’s elbow and palm on the affected side. With elbow fixed, the wrist was gently flexed to stretch the forearm muscle. This exercise was repeated several times.
- Active resistance exercise: Patients contracted the muscles on the affected forearm both statically or dynamically with the therapist resisting the movement. This exercise was repeated several times.
Research Conclusions
Based on the data, the researchers in this elbow pain acupuncture research study concluded that electroacupuncture plus rehabilitation training were most effective for the treatment of tennis elbow.
Additional Research
The following is more elbow pain acupuncture research. Researchers at Shanghai Sixth People’s Hospital (Wu et al.) conducted a sweeping literature review of independent tennis elbow clinical trials. They determined that acupuncture, electroacupuncture, and moxibustion were all effective in resolving tennis elbow. The following are some of the studies included in the literature review.
Distal Acupuncture
Zeng et al. determined that a distal acupuncture point was particularly effective for the resolution of tennis elbow. A clinical trial of 42 patients with tennis elbow found that acupuncture point Sanjian (LI3) effectively resolved tennis elbow 97% of the time. This point is located on the hand near the pointer finger.
Electroacupuncture
Liu et al. found electroacupuncture effective for resolving tennis elbow. Researchers from the First Affiliated Hospital of Heilongjiang Traditional Chinese Medicine University randomly divided 60 tennis elbow patients into an electroacupuncture treatment group and a conventional acupuncture control group. Both groups received acupuncture treatments on identical acupuncture points:
- Quchi (LI11)
- Shousanli (LI10)
- Waiguan (TE5)
- Hegu (LI4)
- Ashi points
The electroacupuncture group achieved a total effective rate of 93.3% compared to the manual acupuncture only group having an 83.3% effective rate. The addition of electric stimulation to conventional acupuncture increased the effective rate by 10.0%.
Acupuncture Works!
This elbow pain acupuncture research shows without a doubt that acupuncture effectively resolves tennis elbow. Of all the various techniques, electroacupuncture is most beneficial.
Elbow Pain Acupuncture Research
The primary research study described in this article conducted treatment very similar to the way we treat tennis elbow at Raleigh Acupuncture. The primary difference is that we get results faster, with less treatments.
Treatments are safe, natural and relaxing. Results are long lasting. If you have tennis elbow, try acupuncture.
Next Steps
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References
Zhu QY, Wu FH, Huang W. Clinical Observation of Electroacupuncture Combined with Ｒehabilitation Training on Tennis Elbow [J]. Journal of Hubei University of Chinese Medicine, 2015(6):89-91.
Wu Y, Wang CM, Dong XW, Gan CP. Progress in the treatment of external humeral epicondylitis with acupuncture [J]. World Clinical Drugs, 2015, 36(7):495-499.
Zeng QQ, Sun MF, Zhang HH. Research on effectiveness of needling Sanjian LI3 for the treatment of humeral epicondylitis [J]. Chinese Acupuncture and Moxibustion, 2006, 26(7): 510-510.
Liu Dan. Study on effectiveness of combined acupuncture needling therapy for the treatment of humeral epicondylitis [J]. Chinese Medicine Modern Distance Education of China, 2013, 11(4): 62-62.
It is encouraging that so much elbow pain acupuncture research has been performed in China. More needs to be done in the US as well.
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