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Understanding and Treating Tennis Elbow: The Role of Acupuncture

Tennis elbow, one of the most common arm injuries, gets its name from its prevalence among tennis players, with about 50% experiencing this condition. It is a type of tendonitis caused by sudden overstretching or overuse of the extensor muscles' tendons attached to the upper condyle of the humerus. The condition most frequently affects the lateral epicondyle (lateral epicondylitis), three times more common than medial epicondylitis, which affects the flexor muscles' tendons at the medial epicondyle. Medial epicondylitis, is more associated with sports like golf or bowling, leading to terms like "golfer's elbow" or "bowler's elbow." The efficacy of acupuncture in treating this condition has been confirmed in several rigorous controlled and double-blind studies.

Contemporary medical treatment of tennis elbow primarily focuses on alleviating local pain, microbleeding, and inflammation to promote healing and restore arm function, preventing recurrence. The most effective measures include cold compresses during the acute phase, followed by non-steroidal anti-inflammatory drugs (NSAIDs) and various heat therapies, including ultrasound, combined with rest of the affected limb, avoiding any painful activities.

Local injections of hydrocortisone are also commonly used and effective, but more than two injections are considered to be of no benefit and possibly harmful. Conservative treatments for tennis elbow show varied results; about 10% of patients still experience pain at discharge, and 26% have recurrences. While ultrasound therapy (53% effective) is less effective than corticosteroid injections (89% effective), it has fewer relapses. Acupuncture is considered an excellent alternative to corticosteroid injections. However, rapid cure of tennis elbow with acupuncture is not easy; mastering the stimulation site, method, including depth and duration of acupuncture, is key to enhancing effectiveness.

The best acupuncture points for treating lateral epicondylitis may include local or acupoints on the affected side, as well as symmetric points on the upper limb of the healthy side or corresponding points on the same side's lower limb, following the "corresponding acupoint method."

The depth of acupuncture depends on the depth of the acupoints. For instance, tender points on the lateral epicondyle are superficial and require only oblique or transverse insertion, whereas deeper insertion is possible for nearby tendon or muscle acupoints like QuChi or ShouSanLi.

In terms of stimulation methods, in addition to manual acupuncture, combinations with infrared lamp irradiation or skin needle tapping to induce bleeding are options. Self-massage of the local pain points is also a recommended therapy, gently massaging the painful spots 2-4 times daily for 3-5 minutes each, until pressing on them no longer feels painful.


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