Effectiveness of dry needling combined with eccentric strength training in lateral epicondylalgia with trigger points

Introduction. Lateral epicondylalgia (LE) is commonly presented with myofascial trigger points (MTrPs) among adults. Dry needling (DN) is used less frequently as a first-line treatment in LE with trigger points, and the short and long-term effectiveness of DN in these populations were not studied. Hence, this study compared the effectiveness of DN with conventional physiotherapy in the population of LE with myofascial trigger points. Methods. For four weeks, the experimental group (n = 19) received DN with weekly one session, and the control group (n = 19) received therapeutic ultrasound combined with deep friction massage for 2 sessions per week at the active sites of active MTrPs. Both groups performed two eccentric exercises sessions from the 5^th to the 6^th week. Handgrip, pain and disability scores of patient rated tennis elbow evaluation (PRTEE) at baseline, 4^th week, 6^th week, and follow-up of 12^th week were analysed. Results. Handgrip strength, pain, and disability scores were significantly improved for the experimental group at 4^th week (SMD of 1.21 kg in handgrip, 12.26 in PRTEE scores) and 6th week (SMD of 1.58 kg in handgrip, 10.15 in PRTEE scores) compared to the control group. However, no significant group differences (p > 0.05) after 12^th week either grip strength (SMD = 0.84) or PRTEE scores (SMD = 3.74) were obtained. Conclusions. Dry needling with exercise produced greater short-term improvements in grip strength and disability compared to the control group. However, no significant difference in outcomes was found between groups over a 12-week follow-up period.